Governor Dayton Representative Melin May 11, 2014 Page 3 The House measure requires the Commissioner to first determine what forms and chemical composition of medical cannabis can be available before any access is granted. This is a curious requirement in light of the Commissioner’s publicly stated objection to any access. Further, he and the HHS Commissioners have stated that the potential harms and unknowns should in large part rule out its use. I fear that this is another pretext to s imply doing nothing. The Commissioner has the authority to extend this work for an additional 18 months beyond the first deadline next year.

Conditions and symptoms covered

The Senate bill provides a very narrowly construed listing of those qualifying conditions and symptoms. Chief among those left out in the House bill are those with intractable pain. Despite the misrepresentations that this expands the availability of medical ca nnabis to too many people, intractable pain has a specific statutory definition. In short, it is pain that will not respond to any other form of treatment. I would again propose as I did in writing prior to the House vote that it be included, and go a step further, requiring a second diagnosis from a Board certified pain specialist medical doctor. Use of cannabis for this purpose has shown to allow for reduced use of expensive and harmful pain medications including highly addictive opioids. Under the House bill, doctors need only certify a particular ailment, not whether the corresponding symptoms might respond to cannabis, again leaving many out unnecessarily. Paradoxically, unlike the Senate bill, this creates a situation in which many would qualify who should not because of this reliance on a mere disease diagnosis instead of a qualitative analysis. A patient with non-malignant skin cancer requiring no chemotherapy and involving no pain would qualify, while a veteran who suffers from residual limb pain whose doctor believes cannabis would be a safe and effective treatment option would not. Finally, to leave out those with severe nausea and severe wasting / cachexia from chronic conditions eliminates a wide swath of those commonly recognized to have potential benefits not otherwise available to them. Again, as I proposed prior to the House vote, including these individuals is important.

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