Vermont Senator Dick Sears dropped S.186, a bill intended to address some issues with Vermont’s Medical Cannabis Registry, and would delay the implementation of the new medical cannabis statutes from March 1, 2022 to July 1, 2022.

Draft Bill Template (vermont.gov)

There are a number of decent proposals in the bill, including:

• Eliminating the requirement that a patient diagnosed with PTSD be engaged with psychotherapy or counseling to qualify for the Registry
• Increasing the number of cannabis plants a registered patient or the patient’s caregiver can cultivate from 2 to 6 in flower and from 7 to 12 in veg;
• Allowing a caregiver to serve two patients (currently allowed 1)
  • There is a problem in that a patient would only be allowed to be a caregiver for one other person.
• Eliminating the annual renewal fee for patients who have a qualifying condition other than chronic pain and for the caregivers who serve those patients
• Eliminate the requirement that caregivers be fingerprinted and have a criminal history record check (other checks do apply)

However, there are a number of changes we would like to see with the bill as well.

Eligibility

Currently, 7 conditions and one catchall clause are eligible for medical cannabis cards:

• Cancer
• Multiple sclerosis
• HIV+/AIDS
• Glaucoma
• Crohn’s disease
• Parkinson’s disease
• PTSD

The catchall clause allows for “a disease or medical condition or its treatment that is chronic, debilitating, and produces one or more of the following intractable symptoms: cachexia or wasting syndrome, chronic pain, severe nausea, or seizures.”

Who is better qualified to decide who specifically benefits from what medical treatment - a politician or a doctor?

As advocates, patients and medical professionals, we believe this list isn’t nearly comprehensive enough, and should include ANY condition that a medical provider deems appropriately treated by cannabis. That's one change we will continue to ask for.

The larger question, though, is why the legislature is making any decisions about individual patients' medical care at all. Who is better qualified to decide who specifically benefits from what medical treatment - a politician or a doctor?

The truncated nature of this list of conditions excludes so many people, including patients who have had spinal fusions and surgeries, plastic mesh or steel rods, amputees, or other challenging genetic disorders. It fails to account for too many patients to even name.

All these patients - whose medical conditions and pain will unfortunately never go away - will still have to re-apply annually. Year after year, patients will have to schedule another doctor appointment, pay another copay along with the state's annual registration fee, just to continue being allowed to purchase medicine that isn't covered by insurance for their lifelong illness or disability. Year after year, we will have to go to the legislature asking them to update this list. This is, to my mind, discrimination.

Plant Counts

When it comes to plant counts, the bill says that a registered patient or caregiver may cultivate no more than 6 mature and 12 immature plants.

There is no logic behind these numbers. For patients in need of high dose concentrates, six plants do not guarantee a successful, fruitful harvest to meet all their medical challenges. It does not guarantee that the patient will get the most helpful medicine to address their symptoms. It does not insulate the patient from any accidents in growing, harvesting, or processing. We are advocating for a minimum of 12 plants in flower and unlimited immature plants.

Caregivers

This bill allows a caregiver to attend to two patients. However, there's a catch. If the caregiver is also a patient, this will mean they can only support one other patient, not two patients the way a non-patient caregiver can.

I am a nurse and a medical patient. I have been caregiving for another nurse for years, and now my own child is on the registry due to chronic pain. This 1:2 designation means that I - or anyone like me - won’t be able to provide for myself, my nurse patient, and my son. It also does not allow a patient to have more than one caregiver, unless they are a pediatric patient (more on that in a moment).

Maine has no limits on the number of patients a caregiver can serve. Caregivers are permitted to treat as many patients who are registered to their care as possible, given the limits of their cultivation. What does the Maine legislature understand that the Vermont legislature does not?

Patients need more than one caregiver for many reasons including:

• If a caregiver gets sick or needs a break, they have no wiggle room at all.
• Administering consistently and caregiving daily is a 24/7 hard job.
• Growing cannabis is hard work.
• Caregivers deserve sick days, personal time, and vacations as much as anyone else.
• Caregivers also frequently need to work another full time job.

Particularly in a time of a pandemic, it makes no sense to deny patients and caregivers any form of security and comfort. Patients need more support.

Not to mention the fact that success growing cannabis, even for the most experienced grower, isn’t a given. If a caregiver's grow fails, for any reason, their patient has no recourse.

However, if they have another caregiver, they’ll have more options and won’t have to live in fear of their health being negatively impacted by the reality of potentially scarce resources.

Kids

Finally (for now), only allowing pediatric patients to have two caregivers is impractical, because, as we know, more than half of children's homes are split homes, often with two different households.

We need to allow for the providing parent to have a day off once in a while. Allowing a respite worker, another family member, a health care provider, even a school nurse to be eligible to help and support in the needed care isn’t a dangerous choice. It’s a compassionate one.

The CCB should have the power to make special accommodations for the allowed number of caregivers. Otherwise, we are absolutely setting people up to fail - and that means increasing pain and suffering, not alleviating it.

Photos by Add Weed on Unsplash