Gov. Martin O'Malley's administration withdrew its opposition to legislation allowing doctors and nurses to dispense medical marijuana to patients through academic medical centers, raising prospects for passage this year.
Dr. Joshua M. Sharfstein, the state secretary of health and mental hygiene, said Friday that the administration could support the bill but only if it gave the governor the "flexibility" to suspend the program if the federal government threatened legal action over what it still classifies as an illegal drug.
"If it's clear it's not something that's going to bring prosecution on state employees, we can go forward," Sharfstein told members of the House Government Operations and Judiciary committees, who held a joint hearing on the issue.
Under what Sharfstein called a "yellow-light approach" to medical marijuana, the bill would allow dispensing the drug to patients with cancer, intractable pain and other conditions.
O'Malley had threatened to veto medical marijuana legislation last year, saying that U.S. attorneys in Delaware and Washington had warned that those states' employees would not be immune from prosecution and that possession or distribution of marijuana remained illegal under federal law, regardless of what state laws say. Maryland Attorney General Douglas F. Gansler also expressed concerns.
But though federal prosecutors have gone after some dispensers of medical marijuana since then, Sharfstein said, they have not charged any state's employees. He added that he expected the Justice Department to give U.S. attorneys more guidance on the issue soon.
"I think we feel a little more comfortable moving forward," Sharfstein said in an interview before the hearing.
Del. Dan K. Morhaim, a Baltimore Democrat and physician, welcomed the administration's support for the medical marijuana bill, one of two he introduced this year. He expressed hope that after a decade of debate, Maryland would join 18 other states and the District of Columbia in allowing the medical use of marijuana.
If the bill passes, Morhaim said, it will be the "tightest and most controlled" medical marijuana program of any state's.
With the administration backing that bill, Morhaim said he was withdrawing a broader medical marijuana measure, which would have registered not just medical centers but physicians, marijuana growers and patients eligible to receive the drug.
Though some might favor that as a quicker, more direct approach, Morhaim said the administration's backing gave the more limited bill a better chance of passage.
But Del. Cheryl D. Glenn, a Baltimore City Democrat, urged lawmakers to adopt a more sweeping bill she's championing that would authorize state-regulated "compassion centers" to dispense marijuana to qualified patients or their designated caregivers.
Glenn has said she became an advocate for medical marijuana after seeing her mother and brother-in-law waste away, suffering from pain that prescribed medications did not ease.
Glenn said she was "extremely skeptical" that the research-based medical marijuana system envisioned by Morhaim would help many suffering patients, or as quickly, as her bill would. She said 11 other states have distribution networks similar to what she has proposed.
It might take a year or two for academic medical centers to set up medical marijuana programs and get them approved by the state, Morhaim said, but under the law the drug could be distributed by any provider with whom the medical center established an approved partnership.
Lawmakers heard from a parade of witnesses supporting medical marijuana in Maryland, including physicians, people who have self-medicated for cancer and other health problems and caregivers tearfully recalling the suffering of loved ones. Several appealed to the legislature to make marijuana available as quickly as possible.
"We are hurting, we are in pain," said Barry Considine, 59, of Halethorpe, who testified from a wheelchair.
Considine said he suffers from post-polio syndrome and other neurological conditions that leave him in constant discomfort. He said he's been traveling to Annapolis since 2007 to urge medical marijuana legislation, and he voiced frustration that legalization might have been delayed a year by the O'Malley administration's opposition.
State associations of police chiefs and sheriffs submitted written opposition to any medical marijuana legislation, saying it would be inconsistent with federal law and public education campaigns aimed at discouraging youths from trying the drug.
"For years, we have told our young people, with good reason, that marijuana is a harmful and dangerous drug," the law enforcement groups said. "Expecting our youth to understand the finer distinctions in this ongoing debate is unrealistic and conveys inconsistent and dangerous messages to them."
Mike Gimbel, former drug czar for Baltimore County, spoke out Friday against the bills from Baltimore, saying lawmakers should leave it up to the U.S. Food and Drug Administration to decide if or when marijuana should be used medically.
Sharfstein, a former official of the FDA, said he believed the research-based approach in Morhaim's bill represents a reasonable compromise between those who believe the benefits of making medical marijuana widely available outweigh any potential abuse and those who think the dangers outweigh the benefits.
He said the Institute of Medicine had taken a similarly cautious attitude, recommending treating it as an "investigational" drug.
The health secretary said he'd seen evidence of marijuana's harmful impact through his own clinical practice in the past.
"I've taken care of patients where they were really knocked off their life course by marijuana," he said, and called its medical use "a complicated issue."
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