Posted by Lori Ann Reese on 10/06/2021 in Cannabis Laws
On September 28th, 2021, California Governor Gavin Newsom approved new legislation that will help terminally ill patients in hospitals. Senate Bill 311 is also known as “Ryan’s Law,” and senator Ben Hueso sponsored it. It will allow patients to receive hospital cannabis, under certain conditions and diagnoses.
In the newly passed Bill 311, hospitals in California will now be able to allow cannabis use for terminally ill patients. California has permitted legalized medical cannabis for more than twenty-five years. But it remained a non-option for patients with medical cards.
One of the reasons why California Senate Bill 311 gained traction, was understanding the experience for a terminally ill patient. And, for the friends and family of someone with a terminal illness. The only option has been to provide prescription pain medications like opioids with increasing potency.
That left people with a constant fog or sleeping and drowsy through their last days. Numbing the pain reduces the social competency and alertness that most patients want as they spend time with family. And that the use of opioids can rob families and patients of precious time and quality of life.
But if patients with terminal illness could be provided with a Sativa and Indica hybrid that provided pain relief, euphoria or happiness, and relaxation without the sedative effects? That would make a big difference. And that is what the new Bill 311 (Ryan’s Law) will make possible. Hospitals can now dispense medical cannabis only for patients receiving compassionate care for a terminal diagnosis.
When you are admitted to the hospital for a procedure, or for an emergency incident, your prescription drug information travels with you. States have electronic health information exchange (HIE), which means that important information for patients who opted in is available through a secure health portal.
If you are admitted to the hospital and you cannot provide the information yourself, the HIE (health information exchange) can be accessed by authorized health providers. Arguably, the ability is already there for patients who have electronic health records. Hospitals should be able to see your whole health history.
This is important because it is possible for hospitals to administer cannabis if a patient has a medical card. Providing the patients health records are available to check for conflicts with other prescriptions drugs, or health concerns.
Right now, there are many patients in the United States who have made a choice to not use prescription opioid or NSAID medications. Instead, they got their medical card. Tired of the side effects and risks, many have been successfully using doctor-supervised cannabis instead of highly addictive prescription painkillers.
But if you have your medical card and are admitted to the hospital, cannabis isn’t even a choice. If cannabis remains a federally prohibited substance. Hospitals literally will ‘not touch’ the argument about providing patients with medical cannabis, even in cases where cannabis may be safer than other medications.
Hospitals receive funds from both state and federal agencies. To go against what the federal government and specifically HHS mandates means big risks for hospitals. Healthcare institutions are accredited by the Center for Medicare & Medicaid Services. Breaking federal law has harsh consequences for hospitals and cost them millions in much-needed funding.
There is a recent example of how much power the federal government has over hospitals. In 2020, the Health and Human Services Department announced that it would withhold federal funding to any hospital that did not report COVID-19 cases as required.
The loss of federal funding could be financially catastrophic to most hospitals. Even in states that have legalized medical cannabis, hospitals are reluctant to provide it to patients. If you are a patient with a medical card, you still will not be able to get cannabis during your stay at the hospital.
Not only will hospitals not administer it, but they will not allow patients to have medical cannabis brought to them. Smoking cannabis in a hospital is not an option, but healthcare institutions will not allow other forms like edibles, capsules, or tinctures.
The U.S. Department of Health and Human Services (HHS) was consulted before signing the bill. Rather, Senator Hueso sent a letter to the HHS to get a critical confirmation. The Senator wanted HHS to promise not to penalize hospitals with funding cuts if the healthcare institutions provide medical marijuana.
There are some obstacles when you think about the possibility of getting medical cannabis during a hospital stay. For example, if you are a patient who has not gone through obtaining a medical card, a hospital would be unlikely to prescribe it even if cannabis was federally legalized.
When a patient applies for a medical card, they must go through an extensive administrative process. First, they must complete a health history review and check-up with a licensed physician. In some states, a medical cannabis referral can only come from a doctor that knows the patient. Or has seen the patient previously for other healthcare matters.
A certification letter is provided if the physician feels that medical cannabis could help with symptom management and be reasonably safe for the patient. Then the second part of the medical card application process is through the state. The physician’s certification is reviewed, along with other information the patient provides. The state determines whether to issue a medical card to the patient or not.
Even if federally legalized, a hospital would be unlikely to prescribe and administer cannabis to a patient, regardless of the circumstance. It would make the hospital accountable for providing an off-label prescription. If the patient was harmed because of drug interaction, the hospital would be liable. And open to legal action for injury or wrongful death.
The concerns about contraindications (medication conflicts) and side effects are less of a consideration for patients who have been diagnosed with a terminal disease. Cannabis is well-tolerated and conflicts with very few prescription drugs. But cannabis can also cause some medications to be reduced in efficacy. That may not be a problem for some patients or a critical issue for patients with heart conditions (for example). A side effect of mild nausea may not be a concern for a patient in end-of-life care.
If the patient has not used cannabis before to help with symptom management, medical marijuana may be very effective. It could help with mood disorders like depression and anxiety. Cannabis can also help with pain management and appetite stimulation for patients suffering from Cachexia or wasting.
A patient using medical cannabis (cardholder) may have found it to be the most effective method of pain relief—for continuity of care, providing that for the patient while hospitalized can be safer, rather than trying new or potentially less effective drugs.
Providing that continuity of care with medical cannabis matters for patients with a terminal illness. It can mean less stress and more comfort (emotional and physical) for patients. But families already facing the pain of losing a loved one make the path to getting medical cannabis in a hospital easier.
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