Six months after medical marijuana became available in the District, officials have registered less than 15 percent of the people projected to participate, leading council members to propose broadening the list of conditions that qualify patients for the struggling program.
D.C. Council members on Wednesday questioned Joxel Garcia, who has been tapped to become director of the city's Department of Health, about his own plans to expand the program.
"I believe the expansion of the conditions for a prescription for medical marijuana is appropriate and needs to be done as quickly as possible," said council member David Grosso, at-large independent, before asking Dr. Garcia about the proposed timeline for expanding the list.
The District's tightly regulated program identifies only four illnesses as eligible for medical marijuana treatment — HIV/AIDS, cancer, glaucoma, and conditions characterized by severe and persistent muscle spasms, such as multiple sclerosis. Other states allowing for the use of medical marijuana use a wider set of qualifying conditions that often include epilepsy, post-traumatic stress disorder and Crohn's disease — illnesses that Mr. Grosso has asked that the District also recognize.
The city's first medical marijuana dispensary opened in July, but since then only 120 patients have been approved for use of the drug. Fiscal impact statements from the city's chief financial officer indicate officials had expected to process applications for 800 patients within the first year of the program, with enrollment increasing by 50 percent each year after that.
Dr. Garcia, who has served as the city's acting health director since August, said the department must still appoint members to the committee that is tasked with vetting medical marijuana regulations and making such recommendations.
He expects the Medical Marijuana Advisory Committee, authorized by the mayor in October, to hold its first meeting in late January or early February and to begin reviewing scientific evidence about medical marijuana use before making any recommendations.
"I don't want patients to assume this is a panacea. I also don't want to make the practice of medicine a mandate from the director of health," Dr. Garcia said. "The beauty of medicine of our country is that it is based on science and based on research. I think with medical marijuana we have to balance that act very much."
But pressing to speed up the bureaucratic process, Mr. Grosso said unless significant progress is made soon, he plans to introduce legislation in February that would expand the conditions that qualify a patient for medical marijuana from the four currently accepted illnesses.
Those conditions would include endometriosis, post-traumatic stress disorder, epilepsy, dystonia, and Crohn's disease.
"I hate bureaucracy more than anything when it comes to care and delivery of care," Mr. Grosso said. "I'm willing to give some time to figure this out, but I have a sense of urgency here."
Medical marijuana advocates, would-be patients, and dispensary and cultivation employees testified at a hearing in October about the program's slow start. Business owners lamented the difficulties that patients have had securing access to the drug, saying that their operations have yet to become fiscally sustainable.
Dr. Garcia cautioned that doctors need to see scientific evidence that medical marijuana will be an effective treatment for illnesses before recommending it and he hopes the committee will be able to provide that information.
"We can open the list to 100 [conditions], but if the physicians don't feel comfortable, don't believe it will help, then essentially it is not going to work out," he said.
"Do you think you can do this in the next 90 days?" Mr. Grosso asked.
"I can say I hope so, but I don't want to say 100 percent yes," Dr. Garcia said.
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