Cincinnati hospitals reluctantly realize that medical marijuana is coming to town

Anne Saker | Cincinnati Enquirer

Show Caption Hide Caption Medical marijuana in Ohio: The basics When will medical marijuana in Ohio be available? Will I need a prescription? Can I use it for recreation?

Mason nurse-practitioner Teaera Roland has long wanted to bring medical marijuana into her work with patients. But she couldn’t do that and work a big local medical system.

“I understand their reluctance,” she said. “Once you’re a corporate provider, you have to follow their rules.”

For Greater Cincinnati’s hospital organizations, the coming of medical marijuana means that certain questions can’t be avoided much longer.

Can employee doctors recommend what still is a federally outlawed drug? Will patients with state permits, including children, be allowed to use medical marijuana when hospitalized?

The Enquirer asked officials of the region’s hospitals how they plan to work with a new drug-delivery system set to open in September and expected to draw at least 200,000 Ohioans under 21 qualifying conditions.

Some systems took weeks to respond. All needed legal sign off before answering. There's a reason for the hesitation: Hospitals receive millions of dollars in federal taxpayer money for research or patient care through Medicare or Medicaid. Handling a federally banned drug in a hospital, even when Ohio law says OK, would complicate access to those federal dollars.

Health insurance companies are also examining how to proceed. Anthem Blue Cross Blue Shield and UnitedHealthcare said they will not cover medical marijuana that is not FDA-approved or doctor visits specifically to get a card. Medicaid and Medicare do not pay for medical marijuana in any way.

Mercy Health

Mercy Health, for one, votes no. The Catholic health system, the largest in Ohio and based Bond Hill, "requires that its physicians follow state and federal laws and operate within the scope of their practice," said spokeswoman Nanette Bentley. "Mercy Health is not recommending its physicians to undergo the two-hour certification program at this time."

For Roland, the attitude of traditional medicine overall toward medical marijuana was the push she needed to open her own practice, Lotus Health of Mason in October 2017. She recruited Dr. Naila Goldenberg, who will sign recommendations.

Cincinnati Children's Hospital

At Cincinnati Children’s Hospital Medical Center, the answer also is: no thanks. “Cannabis is still currently classified as a Schedule I drug under the Controlled Substances Act,” said spokesman Jim Feuer. “Any use, even possession, of any amount of a Schedule I substance is illegal and can result in criminal prosecution under that federal law.”

Other hospital systems say they are trying to navigate a new world of legal medical marijuana.

UC Health

“We’re still finalizing our policies and procedures around medical marijuana,” said Amanda Nageleisen, spokeswoman for UC Health, the nonprofit that runs University of Cincinnati Medical Center. “Given the complexity of the issue, and the fact that we are an academic health system whose physicians participate in federally funded research and who treat patients with many of the 21 approved disease states, there are many factors we have to take into consideration.”

Christ Hospital

At the Christ Hospital Health Network, “No final decisions have been made,” said Mike Jennings, vice president and chief medical officer. Yet Christ Hospital may be leaning in favor.

TriHealth

TriHealth spokesman Joe Kelley said a task force has studied what to do for nearly two years but isn’t ready to release conclusions. “Once all regulations have been announced and the medical marijuana program is operational in Ohio, TriHealth will share its approach to the use of medical marijuana including as appropriate any new policy as well as prescribing clinicians.”

Cincinnati VA

Post-traumatic stress disorder, an affliction for many U.S. veterans, is a qualifying condition in Ohio for medical marijuana. Yet officials at Cincinnati VA Medical Center kicked questions to Washington. The only response from the Department of Veterans Affairs in Washington was a May 2017 quotation from the VA secretary at the time. “Until the time that federal law changes, we are not able to prescribe medical marijuana for conditions that may be helpful.” Dr. David Shulkin left the job in March.

Medical marijuana comes to Ohio

Since 1970, the federal government has listed marijuana as a Schedule I drug with no therapeutic value although Chinese records from 5,000 years ago record humans using marijuana as medicine.

For two decades, individual states have loosened restrictions on medical marijuana. Ohio did not consider the prospect until 2015, when a full-legalization ballot initiative lost 2-1 in large measure due to the heavy public opposition from Ohio’s hospitals. Yet polls showed Ohioans wanted medical marijuana. By June 2016, the Republican-controlled General Assembly created a program, and Republican Gov. John Kasich signed the bill into law. Ohio was the 25th state to approve medical marijuana.

Last month, the Ohio Hospital Association devoted a session of its annual meeting to the impact of medical marijuana. Lawyers are pumping out analyses counseling that hospitals must heel to the law and state regulation on medical marijuana.

So far, only 185 of the 46,000 doctors in Ohio have taken the two-hour training course and completed paperwork for the Ohio Medical Board to certify them to recommend medical marijuana. A Medical Board survey revealed that slightly more than 40 percent of Ohio's doctors were not likely to recommend medical marijuana. But more than 30 percent of doctors said they would consider it.

Twenty-one certified doctors are in Greater Cincinnati, many of them solo practitioners or in independent groups where they can adopt methods and treatments more quickly than through a hospital bureaucracy.

Roland, the Mason nurse practitioner, said she expects the conversation in Greater Cincinnati about medical marijuana will only grow louder. “We’re in a very conservative part of the country. I’m just happy that the discussion is happening. I’m happy that my patients have access to it now.”

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