Medical Marijuana Laws Changing in Illinois

Illinois’ medical marijuana laws recently saw dramatic changes. Stay abreast of how the new law impacts your practice. Be sure that you’re also tuned into how you can (legally and ethically) integrate these therapies into patient care!

This past summer, Illinois Governor Bruce Rauner signed into law a new measure that will change the way Illinoisans use medical marijuana. While Illinois remains one of the most restrictive states for marijuana usage, this stands to change once Governor-elect J.B. Pritzker assumes office. On the campaign trail, Pritzker vowed to fully legalize marijuana.

New marijuana law: what’s changing?

In late August 2018, Senate Bill 336 was signed by Rauner and became the Alternatives to Opioids Act of 2018. This Act expands upon the program already in use to manage medical marijuana in Illinois, and which remains in place through July 2020. That program, the Illinois Compassionate Use of Medical Cannabis Pilot Program, describes some of the factual history of marijuana’s legitimate medical uses. According to the Illinois Department of Public Health, this program will not change patient safety or reduce the standards of the medical marijuana program.

The Act allows any patient with an opioid prescription to obtain medical marijuana. This aims to reduce opioid reliance, overdose, and death in Illinois.

Patients with a qualifying condition — one of about forty medical conditions which allow a provider to certify the patient’s need for marijuana — will eventually be able to bring their doctor’s certification directly to the dispensary, bypassing the middleman (ahem, the State). Patients will no longer be required to submit to background checks and fingerprinting, making the process of obtaining medical cannabis more like any other prescription medication.

Who can access medical marijuana in Illinois?

Under the new law, all patients who have been prescribed an opioid medication will have access to medical marijuana. Qualifying patients must follow a series of steps to ensure that they can legally purchase marijuana.

To be eligible, patients must:

  1. Obtain written certification from a doctor within 90 days of submitting an application to the Illinois Department of Public Health
  2. Complete the State’s medical cannabis application form.
  3. Pay an application fee. A one-year medical cannabis card currently costs $100, a two-year card costs $200, and a three-year card is $250. Veterans and those with disabilities are eligible to receive a 50% discount on these fees.
  4. Be able to prove Illinois residency, age, and identity. The patient needs two forms of proof of Illinois residency.

Although these steps appear fairly simple, barriers to accessing medical marijuana remain. The biggest barriers include cost and discrimination or provider bias.

Cost barriers

The cost of obtaining a medical cannabis card is one of the biggest remaining barriers. For example, a patient with an advanced disease who cannot work may find it difficult to pay $100-$300 to apply for a medical cannabis card. This widens the already significant inequality between low- and high-income patients. Additionally, uncertainty over the cost of medicinal marijuana may cause a patient to instead rely upon medications covered by their insurance – even if they aren’t the ideal treatment.

Discrimination and provider bias

On the other hand, discrimination or a provider’s gender and racial biases also dictates the types of treatment which are accessible to patients. Because the new law allows patients to use an opioid prescription to obtain medicinal marijuana, deeply rooted racial biases may prevent certain individuals from finding a provider who will prescribe them either opioids or marijuana.  Racial stereotypes concerning which groups are more likely to abuse opioids or use marijuana recreationally may cause providers to instead prescribe a less effective medication.

Persistent biases against women in pain also create a significant barrier. There has been much written about women’s marginalized complaints of pain, and female pain is often seen as exaggerated or melodramatic. Because providers are often less responsive to women’s pain, women have a harder time accessing appropriate pain care – something that one would expect to also create barriers to obtaining medicinal marijuana prescriptions.

Governor-elect promises efforts to destigmatize marijuana

This new law does not mean that marijuana is completely legal. When Governor-elect Pritzker assumes office, advocates expect to see change to the State’s marijuana laws. Pritzker has announced that he would review and commute the sentences of individuals who have been imprisoned for marijuana-related offenses. Such efforts can help to further destigmatize the use of marijuana generally, which will have the tangential effect of normalizing medicinal marijuana use by patients for whom it is offers an effective treatment.

Why medicinal marijuana laws impact your practice

Staying abreast of the State’s medicinal and recreational marijuana laws is important for many healthcare professionals.

  • Prescribing doctors consider their patient’s marijuana use and access when prescribing other medications;
  • Occupational and physical therapists consider the potential impact of their patient’s marijuana use when working through various rehabilitative tasks;
  • Pharmacists and dispensaries educate patients about the legal risks of using marijuana;
  • Psychiatrists evaluate the impact of their patient’s marijuana use on their mental health symptoms;
  • Veterinarians use marijuana products to treat veterinary health conditions educate patients about legality, evaluate side effects, and consider the relationship between marijuana and the animal’s other medications.

Your potential questions include:

  • As a pharmacist looking to integrate medical marijuana and medicinal products into my business, how does the interplay between federal and state laws impact me? What are the potential legal consequences? Can I offer mail-order marijuana prescriptions?
  • As a prescriber who relies heavily upon telehealth for patient visits, am I required to perform an in-person patient exam prior to prescribing marijuana?
  • What informed consent considerations apply when I’m dispensing or prescribing marijuana?
  • I signed off on my patient’s disabled parking placard application and certified them for medical marijuana. Am I exposing myself to legal risk if the patient drives under the influence?
  • I operate a care management business. Can I charge patients to guide them through the certification process?
  • If I’m expected to share information about my patient’s prescription with the State, what HIPAA considerations apply?
  • Can I own an interest in a marijuana dispensary if I’m a prescriber, or does that violate Stark Law?

Jackson LLP’s healthcare attorneys can help.

Reach out to us to learn more about how medical marijuana changes impact your practice and how you can integrate these therapies into patient care. Jackson LLP’s healthcare-focused attorneys understand the healthcare industry and are poised to help you take advantage of newly favorable laws and business opportunities.

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Written by Ezinna Adiele and Erin Jackson.