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Medical marijuana giving Georgia medical board a headache

Georgia's tortured foray into medical marijuana is generating more drama at the state Capitol this week, with some proposals on life support, suffering children appearing before legislators, and tough words from the governor and an advocacy group.

Now the issue has reached the calm confines of the Georgia medical board, where professionals must write workaday rules to implement the baby-steps law that passed last year.

Even there, roadblocks have popped up, as doctors voiced fears that in trying to enforce the law, the state might dump too much on them -- perhaps looking for them to police patients' residency, or report on patients whom they no longer serve.

It all underlines the tension surrounding who will be responsible for making sure the law doesn't unwittingly open a door to misusing the drug.

Last year, after a long battle, the state Legislature legalized a form of cannabis that doesn't cause a high, but that seizure patients and others say uniquely alleviates their symptoms. Advocates argued that patients' families were being split up or forced to leave the state just to obtain medicine without breaking Georgia law.

On the other side, some law enforcement backers were still concerned that the action would make drug enforcement harder.

The limited law that passed in April doesn't legalize sale of the drug. It just makes it legal under state law -- not federal law -- for patients with one of 8 conditions to possess small amounts.  That means Georgia doctors still can't prescribe it, because it's still illegal for a Georgia pharmacy to sell it.

Instead, they are the gatekeepers for which patients can register for legal possession.  They're already registering patients, more than 400 so far, and soon -- maybe -- they will have rules that spell out those procedures in more detail.

The state medical board wrote up a proposed rule on the subject, and discussed it at a meeting Jan. 7. But after hearing concerns of doctors, the rule went back to the drawing board.

The doctors’ concerns are so strong they’ve been heard at the Capitol.  The Macon Republican who has taken leadership of the medical marijuana issue, Rep. Allen Peake, said Friday that the he hopes to add language to the follow-up bill currently under consideration (House Bill 722) that will move many of the burdens currently on doctors to the Department of Public Health.

What the doctors don't want is to become the legal gatekeeper for all the other restrictions set up in the law.  Georgia legislators were so afraid the law would be abused that they set restrictions that even opiate patients don't face.  For example, only Georgia residents of a year or more can register to possess medical marijuana, so that outsiders don't parachute in to take advantage. But for people who take opiates, the medical board has no restrictions on residency for a medically qualified patient who wants to have their pain pills while visiting here.

The doctors say they can't be a residency police.  But they found even a purely medical requirement, that the patients have "severe" or "end stage" conditions, to be problematic, too.  A physicians' representative raised the specter of government officials having a different idea of what "severe" means and blaming the doctor for letting unqualified people slip into the registry. The representative, William Bornstein of Emory Healthcare, suggested the rule say in black and white that the doctor's judgment on the meaning of those terms will suffice.

The medical marijuana issue has put the state in a twist for years now. A key problem with the new law is that patients who want to possess the drug must first obtain it, so traveling with it is a risk of violation in itself. So recently, Rep. Peake, apparently trying to make a point, said he had transported it for patients. Gov. Nathan Deal made a point of his own, implying the representative might belong in the justice system: "the real emphasis of civil disobedience is accepting the punishment to what you consider to be unjust. I’ll leave it at that,” Deal said. The group Georgia Care, which advocates to legalize marijuana, issued a press release calling Deal's comment "a veiled threat."

But medical officials intend to work it out, even those with qualms about the gray areas. Dr. Bornstein, Chief Medical Officer at Emory, has spent months trying to sort out the issue. He told the board, "I've started to feel like C.M.O. stands for 'Chief Marijuana Officer.'"

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About the Author

Ariel Hart is a reporter on health care issues. She works on the AJC’s politics team and has reported on subjects including the Voting Rights Act and transportation.