Moved by stories of children suffering, a growing number of states are carving out exceptions to their laws against medical marijuana for an extract of the plant that advocates say helps relieve severe seizures.
So far, legislation has mostly appeared in the South, where no state is among the 20 in the U.S. that have already legalized marijuana for medicinal purposes. But Utah’s legislature was the first to pass such a bill, which Gov. Gary Herbert is expected to sign. Kentucky, which unanimously approved a bill in its Senate earlier this month, could be the next to join. Lawmakers in Florida, Georgia, Mississippi, Alabama and North Carolina have either submitted bills or pledged to push for legislation once their state assembly sessions begin.
The legislation from each state is different in terms of exact regulations and the emphasis on further research, but the underlying focus is the same: relaxing marijuana prohibitions to allow children suffering from epilepsy to take a marijuana extract that contains extremely low amounts of tetrahydrocannabinol, or THC, the molecule that makes users high. The oil is derived from a strain of marijuana that’s high in cannabidiol, or CBD, a component of the plant that the U.S. Food and Drug Administration approved for study last year hoping to find whether there’s a concrete link between the extract and relief from Dravet syndrome, a rare and debilitating form of epilepsy.
Evidence that cannabidiol reduces seizures is mostly anecdotal, but laws against medical marijuana have led the parents of some children with severe epilepsy to move to states where the extract is legal. About one million people in the U.S. suffer from severe epilepsy, characterized by seizures that are so frequent and intense they can threaten the life and development of patients, especially children. Cannabidiol is taken in liquid or capsule form. Transporting it across state lines remains a federal crime—and a drawback of many of the recent bills for advocates, who would still expose themselves to the risks of trafficking if there’s no access to the substance through research or legal sale.
So far, bills have advanced with unanimous or nearly total support as lawmakers have sought narrow limits but expressed concern for constituents suffering from sometimes hundreds of seizures a day. "These kids can’t wait," said Sen. Lyle Hillyard of Utah. The Utah bill would allow people to obtain registration cards from the Department of Health with a neurologist’s recommendation. The Department would keep records of recommendations and patient observations to evaluate the bill in two years.
The Epilepsy Foundation supports state laws that ease the options for people with severe epilepsy and lead them to seek specialty care, but it acknowledges the challenges created by the lack of uniformity in existing marijuana laws and encourages states to create a supply of cannabidiol.
“This is a very complicated policy landscape for someone seeking this option, and that’s why we’ve advocated for states including expanded access,” said Angela Ostrom, vice president of public policy and advocacy for the organization. “A state might pass something to make CBD oil not illegal but that still leaves the question of where would they get it, how would it be controlled and what would the safety recommendations be for consumers.”
The bill passed by the Kentucky Senate would allow a reserach university to administer the substance and give permission for patients to enroll in the FDA study. In Georgia, though, the bill moving through the Senate would allow people to take CBD without the supervision of a doctor or medical center as long as they could obtain it from outside the state. That bill walks back an earlier version in the House that would have allowed for wider research on the medicinal value of marijuana, underscoring the political peril surrounding the drug in parts of the south.
Some lawmakers in Kentucky were disappointed the bill doesn’t go further, while Senate President Robert Stivers sought the middle ground on whether the legislation marks a step toward greater acceptance of medical marijuana.
“I don’t think it opens the door for anything; I don’t think it closes the door,” he said. “I think people want to see something that has some research-based conclusion that proves — be it this drug or any drug — has some type of therapeutic or medicinal value.”
The recent trend has met with a lukewarm reception from some marijuana advocates, who say lawmakers are viewing the benefits of medical marijuana too narrowly.
“So long as the supporters in those legislatures realize that access to plant marijuana can be regulated just as well as component-specific or strain-specific extracts, these bills could very well be a good starting point for a conversation about the wider benefits of medical marijuana,” said Morgan Fox, a spokesman for the Marijuana Policy Project. “If lawmakers simply pass these bills and think they've gone far enough, they could delay much-needed reforms.”