As the state begins to implement new laws allowing adult recreational marijuana use, the Michigan State Medical Society wants a voice in the process.
The Medical Society, a professional association representing 15,000 physicians, actively opposed the 2018 ballot proposal that legalized recreational marijuana use in Michigan, as well as the proposal a decade ago that ushered in medical marijuana.
After the passage of recreational marijuana use, the Medical Society now seeks rules and regulations that minimize “potentially severe adverse effects” of marijuana use. Its approach is similar to how the Medical Society for years has advocated against smoking tobacco.
“It’s just another public health fight in terms of vying for the public’s attention and making sure people are aware of the potential adverse effects,” said Christin T. Nohner, director of state and federal government relations.
The Medical Society recently issued a series of regulatory and policy recommendations it wants the state to consider before finalizing rules for recreational marijuana. They include:
• Warning labels that “make clear the content, potency, as well as the known safety and health risks” of marijuana “based on the best available scientific evidence.”
• Clear labeling of medical and retail marijuana products that “identifies the content of Tetrahydrocannabinol (THC) and Cannabidiol (CBD), percent of potency of THC, warnings regarding use by adolescents, pregnant women, and other vulnerable populations, and other known risk factors.”
• Funding for more research “to determine the consequences of long-term marijuana use, especially among youth, adolescents, pregnant women, and women who are breastfeeding.”
• Sanctions on sellers who misrepresent the health benefits of marijuana.
• Dedicating a “substantial portion of tax revenue from marijuana sales toward public health purposes.”
• Funding for ongoing surveillance “to determine the impact of marijuana legalization and commercialization on public health and safety.”
With both medical and recreational marijuana legal in Michigan, the Medical Society plans to focus as well on public messaging “to make sure that people have access to information (and) to make sure that our members have access to information to share with their patients if their patients ask them about it,” said Stacey Hettiger, director of medical and regulatory policy.
On the regulatory side, the Medical Society wants labeling so “folks know what they’re ingesting and have as much information as possible,” particularly when it comes to marijuana edibles and their single-serving sizes, Hettiger said.
“When edibles are ingested, you don’t really feel the effects for several hours after you ingest it. They have found in other states people will take way more than one serving and then they’re going to an emergency-room because they’ve ingested too much,” Hettiger said.
Legalized marijuana also has implications for medical care and has special implications for hospitals because of the “added issue that we’re responsible for people’s lives,” said Nancy McKeague, chief operating officer at the Michigan Health & Hospital Association.
The state law legalizing recreational marijuana allows employers to uphold their drug policies. Care providers can remove an employee while investigating whether they are impaired or under the influence, McKeague said.
In patient care, providers say there is still much learning to do when it comes to marijuana.
“We’re normalizing the use of this substance and we haven’t researched it and there is so much we don’t know about it and how it can impact people,” Hettiger said.
Kaiser Health News reported this month how care providers in Colorado are working to learn the effects of marijuana on users when they undergo surgery. The Kaiser Health News story cited the results of small study issued in May that found “marijuana users required more than triple the amount of one common sedation medicine, propofol, (versus) nonusers.”
There’s also research needed on the potential for adverse reactions between marijuana and medications, Hettiger said. Doctors need to know if a patient coming to an ER or preparing for surgery uses marijuana, she said.
“That is absolutely critical to the health-care decision by providers who treat them,” McKeague said. “It would make a tremendous difference in what anesthetic we consider or what pain medication they’re put on when discharged.”
Asking a patient if they use marijuana, illicit substances or alcohol is a common protocol in an ER or preparing for surgery, said Dr. Josh Kooistra, an emergency department doctor at Spectrum Health and senior vice president and chief medical officer for the delivery system.
Kooistra has seen an increase in patients using medical marijuana. Patients today are “much more forthright” now that marijuana is legal in Michigan.