Board of Health history concerning petitions to add a debilitating condition

 
Board of Health history concerning petitions to add a debilitating condition to the list of conditions for which a patient may receive medical marijuana
 
The Medical Marijuana Registry (“MMR”) was created in 2000, Section 14 of Article XVIII, Colorado Constitution, see also Section 25-1.5-106(3)(a)(VII), C.R.S. Patients are permitted to use marijuana to alleviate debilitating medical conditions if they have received a physician's recommendation and obtained a registry card from the MMR. The MMR program is administered by the Colorado Department of Public Health and Environment (“Department” or “CDPHE”).
 
The Colorado Constitution establishes the following debilitating medical conditions as qualifying for medical marijuana use:  Cancer, Persistent muscle spasms, Glaucoma, Seizures, HIV or AIDS, Severe nausea, Cachexia, and Severe pain.  The Department, through the State Board of Health, may add debilitating conditions to the list of debilitating conditions established in the Constitution.
 
The petition process is communicated on the Board of Health’s website. Any petition to add a debilitating condition is first reviewed by the Department pursuant the process delineated in 5 CCR 1006-2, Medical Use of Marijuana rules. The rules delineate when the department is required to deny a petition. The appropriateness of requiring randomized control trials, evidence of efficacy, peer reviewed studies and a lack of evidence of harm were discussed during the stakeholder process. The board adopted the current criteria on January 19, 2011. 
 
If the criteria communicated in the rule are satisfied, the Department advances the petition to the State Board of Health for the board’s consideration. There are two instances where a petition has advanced to the board: 
 
Tourette’s syndrome 
On September 15, 2010, after the department determined that there exists some scientific evidence of efficacy in humans as demonstrated in a randomized controlled trial, and no evidence of harm associated with the use of marijuana for Tourette’s syndrome, the Board held a public rulemaking hearing to consider whether Tourette’s syndrome should be added to the list of debilitating conditions. The Department’s Chief Medical Officer indicated that the petition met the criteria for conducting a rulemaking hearing but he was unable to say that the benefits outweighed the harm. The board received public testimony. Following the testimony and board deliberations, the board unanimously voted to deny the petition to add Tourette’s syndrome to the list of debilitating conditions. 
 
Post Traumatic Stress Disorder (PTSD)
On July 15, 2015, after the department determined there was evidence from one small, well designed, randomized controlled trial that marijuana is effective in treating PTSD nightmares and possibly other PTSD symptoms, and that the adverse effects were not dissimilar to FDA-approved drugs, the Board held a public rulemaking hearing to consider whether PTSD should be added to the list of debilitating conditions. The board received public testimony. During deliberations the board discussed the value of transparency of actual usage, the lack of scientific evidence to establish efficacy and safety, the need to study the efficacy of medical marijuana, the imperfections of the FDA drug approval processes, patient care, prescription drug abuse, and the compelling testimony of the many who spoke of medical marijuana providing relief and improving their quality of life. Following the testimony and board deliberations, the board voted 6-2 to deny the petition to add PTSD to the list of debilitating conditions.
 

● In 2014, the Colorado General Assembly created the medical marijuana research grant program. The purpose of the program is to “gather objective scientific research regarding the efficacy of administering marijuana and its component parts as part of medical treatment,” Section 25-1.5-106.5, C.R.S. The Board of Health approves the grants and receives an annual progress report. The most recent report was discussed on January 16, 2019. The January 16, 2019 Board of Health meeting minutes provide a summary of the board’s discussion.