Utah Medical Cannabis Act Update · Until 2021, an individual with a recommendation letter from a Utah-licensed physician, PA, or APRN may purchase medical cannabis from one medical

Presented by

Richard Oborn, MPA

Director, Center for Medical Cannabis

Utah Department of Health

October 2, 2020

HEALTHIEST PEOPLE | OPTIMIZE MEDICAID | A GREAT ORGANIZATION

Utah Medical Cannabis Act Update


UTAH MEDICAL CANNABIS ACT

Working with trained medical professionals, qualified patients will receive a recommendation for quality-controlled cannabis products from a licensed professional in a medicinal dosage form.

Utah Medical Cannabis Act Purpose

LEGALITY OF MJ ACROSS THE US

33 - States with medical marijuana laws (THC) 14 - States with adult-use marijuana laws

UTAH MEDICAL CANNABIS ACT

Transition Period: December 3, 2018 – December 31, 2020* *Medical cannabis cards and qualified medical provider registration are not required for use and possession during this transition period.

Individuals are not guilty of use or possession of medical cannabis under Utah law if, at the time of the arrest:

• The individual has been diagnosed with a qualifying condition and had a pre-existing provider-patient relationship with a Utah-licensed APRN, physician, or physician assistant who believed that the individual’s illness could benefit from the use in question; and

• The medical cannabis was in a medicinal dosage form in a quantity not to

exceed specified limits.

Until 2021, an individual with a recommendation letter from a Utah-licensed physician, PA, or APRN may purchase medical cannabis from one medical cannabis pharmacy without a medical cannabis card.


PROGRAM OVERVIEW

QUALIFYING CONDITIONS


• Chronic Pain - lasting longer than two weeks and that is not adequately

managed despite treatment attempts using conventional medications or physical interventions

• HIV or AIDS

• Alzheimer’s Disease

• Amyotrophic Lateral Sclerosis (ALS)

• Cancer

• Cachexia

• Persistent nausea under certain conditions

• Crohn’s Disease / Ulcerative Colitis

• Epilepsy / Debilitating seizures

• Multiple Sclerosis (MS) or persistent muscle spasms

QUALIFYING CONDITIONS


• Post Traumatic Stress Disorder (PTSD) which is treated by a licensed mental health therapist and has been diagnosed by either the VA or through an evaluation by a psychiatrist, or a Master’s level psychologist, LCSW, or a Psych-APRN

• Autism

• Terminal illness with less than 6 months to live

• A condition resulting in the patient receiving hospice care

• A rare condition or disease that affects less than 200,000 individuals in the US and is not adequately managed by a non-opioid or physical intervention.

Individuals who do not have a “qualifying condition” may submit a petition to the Compassionate Use Board (CUB) for review with help from their QMP. All patients under age 21, regardless of their medical condition, must have their application approved by the CUB.

QUALIFIED MEDICAL PROVIDERS

• Must be a Utah licensed physician, physician assistant or APRN with a controlled substance license.

• Must pay a $100 fee and complete at least 4 hours of education in medical cannabis during every two year renewal cycle. $50 renewal fee. Apply online at medical cananbis.utah.gov.

• May recommend cannabis treatment to no more than 275 active cardholders at the same time.

• QMP with board certification in anesthesiology, gastroenterology, neurology, oncology, pain, hospice and palliative medicine, physical medicine and rehabilitation, rheumatology, endocrinology, or psychiatry may recommend to no more than 600 active cardholders.

• QMP cannot advertise that they recommend medical cannabis but may communicate on a website: a green cross; a list of qualifying conditions they treat; or a scientific study regarding medical cannabis use.

• With permission from a QMP, DOH posts their name and contact info on the DOH website.


• May only recommend medical cannabis

treatment to a patient in the course of a physician-patient relationship after they have completed and documented in the patient’s medical record a thorough assessment of the patient’s condition and medical history based on the appropriate standard of care for the

patient’s condition.

Utah Code 26-61a-106

QUALIFIED MEDICAL PROVIDERS


Utah Code 26-61a-502 (4)

• When a QMP recommends medical cannabis to a patient, they may choose to recommend it with or without dosing guidelines and directions of use.

• If a QMP recommends but does NOT specify

dosing guidelines and directions of use, they are required to submit to the electronic verification system (EVS):

o an evaluation of the qualifying condition

underlying the recommendation;

o a description of prior treatment attempts with cannabis and cannabis products; and

o the patient's current medication list.

QUALIFIED MEDICAL PROVIDERS If a QMP recommends cannabis to a patient without specifying dosing guidelines or directions of use, these will be determined by a pharmacy medical provider (pharmacist or physician registered by UDOH) at the patient’s chosen medical cannabis pharmacy. When making this determination, the pharmacy medical provider (PMP) must: • review pertinent medical records, including

documentation submitted in the EVS by the QMP; and

• after completing the review, determine the best course of treatment through consultation with the patient regarding: o the individual’s qualifying condition; o indications for available treatments; o Directions of use and dosing guidelines; and o potential adverse reactions.


Utah Code 26-61a-502 (4)

MEDICINAL DOSAGE FORMS


Legal Term Product Examples Routes of

Administration

Tablet Tablet Oral Capsule Capsule Oral Gelatinous cube Gummy, chews, gelatin cube,

lozenge Oral

Unprocessed flower

Flower, Bud Vaporization, cooking

Wax Wax Vaporization

Resin Resin Vaporization

Liquid suspension Liquid suspension Oral Concentrated oil or viscous oil

Vape cartridge Vaporization

Transdermal preparation

Skin patch Transdermal

Sublingual preparation

Extract, Tincture Sublingual

Topical preparation

Salve, balm, lotion, cream Topical



Gummies / Chews



Cannabis Lotion



Cannabis Extract



Unprocessed Flower



Unprocessed Flower



Concentrated Oil / Vape Cartridge



For complete information about legal dosage forms, see Utah Code 26-61a-102 (32).

• No edibles, such as brownies.

• Unprocessed flower in a tamper resistant container.

• No smoking of cannabis.

PROHIBITED FORMS


DISPENSING LIMITATIONS

A medical cannabis cardholder in any one 28-day period, may purchase no more than the lesser of:

• an amount sufficient to provide 30 days of treatment on the dosing guidelines that the relevant QMP recommends; or

• 113 grams by weight of unprocessed

cannabis; or

• cannabis in medicinal dosage form that contains, in total, greater than 20 grams of total composite THC.


For complete information about medical cannabis pharmacy

requirements, see Utah Code 26-61a-502.

PHARMACY LOCATIONS


Name Location Opening Date

Dragonfly Wellness 711 S State St, Salt Lake City March 2, 2020

Perfect Earth Modern Apothecary 2150 N Main St, North Logan March 16, 2020

Perfect Earth Modern Apothecary 3775 Wall Ave, South Ogden April 28, 2020

WholesomeCo Cannabis 580 W 100 N, West Bountiful August 12, 2020

Curaleaf 3633 N Thanksgiving Way, Lehi

August 26, 2020

Deseret Wellness 222 N Draper Lane, Provo August 31, 2020

Beehive’s Own 1991 S 3600 W, Salt Lake City Fall 2020

Deseret Wellness 1351 Kearns Blvd, STE 110-B, Park City Fall 2020

Justice Grown TBA, Salt Lake County Before 2021

Justice Grown 1624 S Convention Center Dr, St. George Before 2021

Pure UT TBA, Payson Before 2021

Columbia Care 484 S 1750 W, Springville Before 2021

Bloom Medicinals 301 S Main St, Cedar City Before 2021

Beehive’s Own TBA, Brigham City Before 2021

MEDICAL CANNABIS PHARMACIES

• May have signage that includes a green cross, name of pharmacy with logo, and hours of operation

• May not advertise in any medium but may have

a website that includes information about:

• the location and hours of operation of the medical cannabis pharmacy;

• a product or service available at the medical cannabis pharmacy;

• personnel affiliated with the medical cannabis pharmacy;

• best practices that the medical cannabis pharmacy upholds; and

• educational material related to the medical use of cannabis.


For complete information about medical cannabis pharmacy requirements, see Utah

Code 26-61a-301.

PHARMACY STANDARDS

• Must have a pharmacy medical provider (PMP) registered with registered with UDOH onsite during business hours at all times to consult with patients.

• PMP must be a Utah licensed pharmacist, DO,

or MD with at least 4 hours of approved education related to medical cannabis treatment.

• All employees must either by a PMP or a

pharmacy agent registered by the UDOH.

• May only sell cannabis product in a medicinal dosage form, medical cannabis devices, or educational material related to medical use of cannabis.

• To enter medical cannabis pharmacy, an individual must be a cardholder (patient, guardian, or caregiver) and at least 18.



Code 26-61a-301.

MEDICAL CANNABIS PHARMACIES

Products sold by pharmacies must have a label on them placed by the processor that: • Clearly displays the amount of total composite

THC and CBD

• Unique ID number that is connected to the inventory control system and that identifies the manufacturing process the processing facility used to manufacture the cannabis product

• Identifies the cannabinoid extraction process that the cannabis processing facility used to create the product;

• Does not display an image, word, or phrase that the facility knows or should know appeals to children; and

• Discloses each active or potentially active ingredient and possible allergen.



Code 26-61a-301.

CANNABINOID PRODUCT BOARD


• Board members appointed by the Executive

Director of the Utah Department of Health for 4 year terms.

• Comprised of 7 members – 3 medical

researchers and 4 physicians. • CPB meets monthly or quarterly on an as

needed basis since 2017. • Published Utah’s Guidelines on the Suggested

Use of Medical Cannabis which includes: • a list of contraindications, side effects, and

adverse reactions associated with use of cannabis; and

• a list of potential drug to drug interactions between medications that the FDA has approved.

Medical Cannabis Program Statistics

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

Act

ive

Car

d N

um

be

r

Date

Active Patient Cardholder Growth

• 11,400 active cardholders as of October 1, 2020 • 6,041 unique recommendation letter customers as of

7/31/2020


Patient Age Number (N = 8,261) Percentage

Less than 10 years 2 Less than 1%

11-21 93 1%

22-30 1,582 19%

31-45 3,172 38%

46-55 1,315 16%

56-65 1,177 14%

66+ 920 11%

Patient Sex

Male 4,605 56%

Female 3,642 44%

Other 14 Less than 1%

Patient Cardholders by Age and Sex

County Number (N = 8,261) Percentage

Utah 3,670 44%

Salt Lake 2,406 29%

Weber 751 9%

Davis 396 5%

Cache 345 4%

Box Elder 130 2%

Washington 118 1%

Tooele 91 1%

Summit, Wasatch,

Carbon, Uintah,

Beaver, Sanpete,

Iron, Juab,

Duchesne, Sevier,

Morgan, Millard,

Emery, San Juan,

Kane, Daggett,

Garfield, Grand,

Rich, Piute, Wayne

There are between

1 and 52

cardholders in each

of these counties.

All 29 counties in

Utah have at least

one cardholder.

5%

Patient Cardholders by County


Qualified Medical Providers By County

County Number QMP Office

locations (N = 545)

Percentage

Salt Lake 218 40%

Utah 198 36%

Davis 51 9%

Weber 35 6%

Washington 14 2%

Cache 6 1%

Summit 4 Less than 1%

Beaver, Box Elder, Grand,

Iron, Juab, Millard,

Morgan, San Juan, Sevier,

Tooele, Uintah, Wasatch

These counties each have

between 1 and 3 QMP

locations.

3%

Daggett, Duchesne, Emery,

Garfield, Kane, Piute, Rich,

Sanpete, Wayne

These counties have no QMP

locations.

0%


QMPs by Number of Active Patient Certifications

Active Certifications

Total number of QMPs submitting

active patient certifications in this

range as of August 16, 2020 (N=419)

Percentage

276+ 1 Under 1%

200-275 10 2%

100-199 12 3%

26-100 69 16%

1-25 192 46%

0 135 32%

• Of the 419 registered QMPs as of August 2020: • 10 are responsible for 28% of the total patient certifications. • 5 are responsible for 16% of the total patient certifications. • 50% (209 of 419) are responsible for 98% of the total patient certifications.

• 5% (23 of 419) are responsible for 50% of total patient certifications.

QUESTIONS?


Contact Information Utah Department of Health Medical Cannabis Program

(801) 538-6504 [email protected] medicalcannabis.utah.gov

mailto:[email protected]

Utah Medical Cannabis Act Update · Until 2021, an individual with a recommendation letter from a Utah-licensed physician, PA, or APRN may purchase medical cannabis from one medical

Documents