Controlled Substances
A few years ago, an Arizona law was passed that established a Controlled Substances Prescription Monitoring Program which requires pharmacies and medical practitioners who dispense Schedule II, III, and IV controlled substances to a patient, to report prescription information to the Board of Pharmacy on a weekly basis. The purpose of this legislation is to improve the State’s ability to identify controlled substance abusers and refer them for treatment, and to identify and stop diversion of prescription controlled substance drugs in an efficient and cost effective manner that will not impede the appropriate medical utilization of licit controlled substances. Despite the passage of the Arizona Medical Marijuana Act, marijuana remains classified as a Schedule I controlled substance- but because of the way the Act was written, physicians would have no way of checking the database for their patient’s marijuana use as a Qualified Patient.
House Bill 2585 would require the Board of Pharmacy’s controlled substances monitoring program database controlled substances monitoring program database to include people that have a medical marijuana card issued by ADHS. If the bill passes and is signed, we would share the data regarding who our Qualified Patients are (for marijuana use) so that doctors have access to that information before making a decisions about how to manage their patient’s medical condition- just like they can with other controlled substances.
Impairment
Another Bill being evaluated is House Bill 2541, which addresses some gaps in current statute around the employer employee relationship. Under Arizona Medical Marijuana Act, the existence of marijuana metabolites does not mean that employee is under the influence of marijuana. House Bill 2541 does a few things to help employers be able to navigate the change in law. Most significantly, the bill more clearly defines the term “impairment” with a set of symptoms similar to what we would all commonly understand. Things like slurred speech, the inability to walk, appearance, and strange behavior are outlined as impaired. This is pretty much what a police officer looks for when doing a field sobriety test for a suspected DUI. It also clarifies that an employer can take action against an employee who is impaired at work.
Another part of the bill defines a new term called a “safety-sensitive position” which is exactly what it sounds like, a job that could impact the safety of the public or other employees. Things like operating heavy manufacturing equipment would fall under this category. The importance of this definition is that the law also allows employers to exclude employees from performing safety-sensitive jobs if they believe the employee is engaged in current drug use.
Lastly, the bill also helps protect employers from legal action by defining “good faith” and outlines some ways that an employer can act in good faith when determining if an employee is impaired. This bill goes a long way towards helping employers keep the job site safe and gives them clear direction when they have an employee that is a medical marijuana card holder.
Would you please provide examples of what harm could come from patients who are on medicinal marijuana when mixed with other prescribed medications. Sounds like that is the “spirit” of HB 2585 and without merit the bill seems counter productive and directly contradicts the voters intent with the passage of Prop 203.
HB 2541 again seems to go against what was voted in by the Arizona citizens. I feel its a shame that you only speak on one side of the matter and that is on the side of discriminating against medical marijuana patients. You make no mention of what measures will be done to protect patients whose employers who abuse this bill if it passes?
Grant-
ADHS does not regulate employers.
House Bill 2541 seems to be easily abusable. All it takes is someone’s word that you are impaired for it to be a good faith action on the part of the employer. This could easily provide a mechanism for inter-personal relationships to affect one’s employment regardless of the veracity of the claim.
In the case of alcohol there are numerous ways to determine the current level of impairment. In most cases the same can be said for other drugs due to the short time frame they show up in a drug test; which would show recent use. With marijuana, the metabolites are detectable for a very long time, especially in someone who is using it to treat a chronic condition.
Until we get a verifiable way of determining current impairment levels in a medical marijuana patient; this really just presents an opportunity for co-workers or anyone wishing to cause damage, to affect the patient with little or no recourse against the accusation.
Do you anticipate that Dispensaries will be required to report sales of Medical Marijuana? And if so, will they also have access to the CSPMP to determine whether a patient is purchasing more frequently than allowed? How will this affect HIPAA?
Deborah,
Yes, the database will track sales (quantity) and ensure dispensaries have info to stop selling at the 2 1/2 ounce every two weeks level.
Looks like it took a marijuana law to protect us from the pill poppers.
Will,
What is your personal opinion of Marijuana? Do you think the DEA should change the classification to a schedule 3?
Jason,
I am not an expert on this so I’d have to defer to the FDA.
Will,
I didn’t ask for an expert opinion. Just your personal opinion. Do you have one? Just curious what it was. Do you personally think it’s safe to use for certain medical conditions?
The program will be a complete failure to the patients and they will be better off buying in the black market and popping OC like tic taks
I would agree. Without there being a real way to determine impairment it is the employer who holds all the cards.
Mr. Humble,
With such a short time left before the rules come out on March 28, could you please address how qualified patients will be submitting their information to ADHS? You indicated all the forms will be available online and patients won’t be able to “walk-in” but how do they return their forms? I assume by mailing them in with their completed application and payment. Are you going to accept photocopies of driver’s licenses, birth certificates etc?
Also regarding the designated caregiver which is a separate application form. One of the requirements to be a caregiver is to be fingerprinted and have a criminal records check. I already have a Level 1 Fingerprint card issued by the State of Arizona – Department of Public Safety that doesn’t expire until 12/01/2015. You need to indicate in your rules that if a designated caregiver already has a valid fingerprint card they do not have to go through the time and expense (it runs around $75.00 to obtain a fingerprint card) to be re-fingerprinted and issued a duplicate card.
Your application process requires several IDs to be submitted including a Driver’s License, Birth Certificate etc. You are not requiring people to go get a new Driver’s License if they already possess one, and many, many people already have fingerprint cards and should not be required to go get another one in completing the application process for a Designated Caregiver Card.
I have asked this question on previous occasions at your blog and you have never answered this question so please let everyone know that possession of a valid Finger Print Card (issued by the State of Arizona) is sufficient without re-fingerprinting.
Thank you
Michelle,
The final rules will not be out until March 28th, and the start of the program will be April 14th. We will have fact sheets available with these answers but yes, we will be accepting pdf files as attachments on the applications.
Thanks,
Will
Michelle-
A little more information…
ADHS’s statute, 36-2819, requires all applicants (except patients) to submit a full set of fingerprints. Applicants have to attest that they have not been convicted of an excluded felony offense and ADHS may run the fingerprints of applicant to verify this. An excluded felony offense means:
(a) A violent crime as defined in section 13-901.03, subsection B, that was classified as a felony in the jurisdiction where the person was convicted.
(b) A violation of a state or federal controlled substance law that was classified as a felony in the jurisdiction where the person was convicted but does not include:
(i) An offense for which the sentence, including any term of probation, incarceration or supervised release, was completed ten or more years earlier.
(ii) An offense involving conduct that would be immune from arrest, prosecution or penalty under section 36-2811 except that the conduct occurred before the effective date of this chapter or was prosecuted by an authority other than the state of Arizona.
It’s almost March 28th and I’ve checked everywhere for doctors who say they will recommend medical marijuana. So far my research has only come up with 9…..and none so far in rural areas. Will this present a problem for AZ Health Dept….a problem for patients??
I’m concerened doctors are being prohibited from recommending by their clinics and hospitals. If they aren’t restricted, they may also be worried about federal hasrassment. For people in rural areas that have no transportation and little money…ultimately there will be a shortage of doctors.
Shirley-
Please be sure to check Osteopathic, Naturopathic and Homeopathic Doctor’s as well as MD’s.
Thanks,
Will
Will—-
Does a doctor of chiropractic qualify?
Shirley-
The initial draft that the voters approved limited certifications to MD’s, DO’s, ND’s and Homeopaths. We do not have the authority to expand this to other professions.
More comments Will……My current chiropractor is a DO, He also provides accupuncture and he has a great deal of expertise.
Will—thanks for the suggestion. Also very few homeopaths and naturopaths in this area. Is a chiropractor (DO) doctor eligible to give recommendations. Thanks Shirley
Shirley,
No, Chiropractors will not be able to write reccomendations.
Will….
I want to complement you and your staff on a very hard task.
Whatever rules you implement keep the patient in mind first. Many patients are handicapped. Many patients are stuck in their homes with very limited incomes. Anyway you can make rules easy for those who honestly need it is appreciated. Any way you can keep marijuana costs down at the dispensary levl is greatly appreciated.
I live in NE AZ. I’ve contacted doctors, homeopaths and naturopaths in Springerville, Saint Johns, Concho, Snowflake and Holbrook. Not one of the people I’ve contacted is willing to recommend medical marijuana to any patients period. Either the hospital/clinic has rules against it or they are afraid of the government. It will be very diffucult for those with severe disabilities to travel long distances to Phoenix to get a recommendation
Mr. Humble – when the rules/policies are released next week, will they include requirements with which each AZ MMD must comply in regard to things such as the filing of attestations that annual criminal background screens have been performed on all MMD staff to retain their AZ MMD License or policies for AZ MMDs to follow in regard to a regular drug testing program to ensure that employees are not using the ‘product’ unless they themselves are a MM patient card holder?
If not the AZ-DHS, who will be publishing/providing the guidelines for AZ MMDs in this regard?
Many thanks!
Jill-
Yes, our rules will address this.
Excellent – THANK YOU. Our company has been overwhelmed with potential Dispensary Agents who wish to establish a relationship with us to provide these services and assist them in compliance!
Mr. Humble –
We found nothing in the 203 rules released yesterday addressing a reasonable drug testing program for MMDs or Cultivation sites… Are these found elsewhere?
Are we correct to presume that ANYONE owning/employed by a certified MMD or Cultivation site must hold an appropriate certification issued by the AZ-DHS, renewed annually?
We found no attestation requirements per se in accordance with my previous post regarding background screens and drug screens for dispensary/culivation site staff.
Jill-
1st-No, will are not going to test the medical cannibus in the dispensaries and at cultivation sites.
2nd-For employee/dispensary owner information please refer to the faq’s.
For other conditions please see R9-17-301 through R917-312
3rd-An attestation is a written statement from the dispensary owner that will have to be included in the dispensary application process..the applications are not available yet.
I can’t find any professionals that will be recommending Medical MJ. It seems like only a handfull are recommending and they are in Phoenix.
Oh, please also keep dispensary costs down so marijuana costs won’t be so high.
In regards to HB 2541. This bill is definitely designed to GUT the AZMMP, by allowing someone who I work with, that doesn’t like me, can turn me in to the Company and all of a sudden I’M Fired? No, no, no…. The attempt to GUT Prop. 203 by the Legislature who is against the program itself.
Mr. Humble…. A question in which I’ve NEVER seen asked or answered before. The AZMMP goes into effect April 14th 2011, and the State continues to strive for that. However, if the program starts on Apr. 14th, WHEN will the first patient approved be able to PURCHASE Medicine from a Dispensary? After the 70% rule was deleted…. Will they allow the Dispensaries upon “START UP” April 14th, to purchase Medical MJ from other “out-of-state” Dispensary’s to do the “Initial Stocking of product” for their Dispensary’s. If unable to do that, then please don’t refer to the “Start Date” as April 14th, 2011. Please tell the truth on the ACTUAL START DATE of the program….
Kevin-
We will accept applications for patients and caregivers by 4/14/11. Our rules, which will be released March 28th, will explain the licensing process for dispensaries.
Thanks
Mr. Humble,
I think your team did an outstanding job on the final rules this last week. I can sincerely appreciate the daunting task at hand. Bravo. I’ve heard through AZDHS, perhaps a rumor, but unverified that the rating system for initial applications will be an individual applicant, then a JV / Partnership and so on. AKA less is more and AZDHS is supporting the “mom & pop” with historical roots here in AZ. Can you comment on the “ideal applicant” and priority given to those of us who are local without 100 million in funding to put in 100 licenses. Also, is the source of capitol rated with an in state / out of state funding criteria? Thanks Will!
TY-
We will only be using the criteria in Article 3, and what you have describes isn’t there.
Will,
I really appreciate this blog. Thank you!
What about dispensary AGENT applications?? I see the Patient Applications start 4/14/11 and Dispensaries can submit applications beginning 6/1/11 – Are these “Department approved applications” going to be online? Are the Dispensary Agent applications a different deadline than 4/14/11 or are they the same? So confusing! Again thanks for your time!
Kate,
Yes, applications will be online and we will begin to accept them June 1-30th..
Agents must be associated with a dispensary.
Mr. Humble, can you explain the rules or crimes considerd to be a violent crime in section 13-901.03 subsection b. theat prevents some felons from the ability to operate or work in a Marijuana dispencery? Thanks.
Zeb,
13-901.03. Violent crimes; allegation; definition
A. The allegation that the defendant committed a violent crime shall be charged in the indictment or information and admitted or found by the court. The court shall allow the allegation that the defendant committed a violent crime at any time before the date the case is actually tried unless the allegation is filed fewer than twenty days before the case is actually tried and the court finds on the record that the defendant was in fact prejudiced by the untimely filing and states the reasons for these findings.
B. For the purpose of this section, “violent crime” includes any criminal act that results in death or physical injury or any criminal use of a deadly weapon or dangerous instrument.
What about pre-employment and random drug tests? How are those supposed to be reported to the employer? Are the doctors supposed to report that I am positive for marijuana metabolites, but with a medical marijuana card? Or is the lab supposed to report me as negative because I have a card?
This question is outside of the scope of our activities. You might want to contact an attorney.
As a chiropractor, we don’t prescribe medications in our practice but we do understand that there are times when it becomes necessary. If something works it is our responsibility to use it. There are certainly plenty of drugs that are dangerous, which is why it requres a physician to prescribe them, this just seems like a lot of smoke and mirrors to me.
So its ok for a pill popper to have a job? If i need to treat myself with marijuana at home I should be shunned from society,be fired from my job, not be able to get another job,even though my treatment in no way effects my work? so heroine is ok as long as you get it from a doctor but marijuana is real bad? wow no wonder kids are confused about drugs.