Complying With Evolving Cannabis Law In Hospitals And Healthcare Education Programs
Some states have legalized marijuana for recreational or medical use, but there are still legal issues in healthcare and other industries because marijuana is illegal under federal law. This conflict between state and federal laws is especially important when it comes to patients using marijuana in hospitals. This memo is meant to help lawyers who advise hospitals understand these issues.
The Center for Medicare and Medicaid Services accredits healthcare facilities. Because marijuana is illegal under federal law, healthcare facilities could violate federal law, lose federal funding, and face penalties if they allow marijuana use improperly. Also, healthcare providers cannot prescribe or provide marijuana in hospitals because no marijuana product is approved by the U.S. Food and Drug Administration (FDA).
Another challenge is the lack of extensive research on marijuana products, their therapeutic benefits, and the risk of dependence or addiction. This makes it hard to create solid policies for using marijuana in healthcare settings. There isn't much scientific evidence proving marijuana's effectiveness for certain medical conditions. The American Medical Association (AMA) made a statement in 2019 advising health systems not to recommend non-FDA-approved marijuana products until federal laws allow their use. However, the AMA also said that good patient care requires open communication about all treatment options.
Despite these challenges, more and more hospitals are being asked to allow patients to use marijuana while they are in the hospital. The increasing use of marijuana for medical conditions makes this issue more urgent because suddenly stopping marijuana use can cause medical problems for patients. Over the past few years, more hospitals and state legislatures have started creating rules for the use of marijuana by inpatients.
When a hospital is considering a policy on marijuana use, there are several important questions to address:
- Legality: How is the marijuana product identified as legal under state law, and in what form should it be allowed?
- Verification: Does the hospital need to check the integrity of the marijuana product, and if so, how?
- Storage and Administration: How will the product be stored and given to patients, and how will the hospital prevent it from being misused?
- Drug Interactions and Side Effects: What are the potential issues related to interactions with other drugs and side effects?
Some organizations have created sample policies based on their state laws to address these issues. For example, the Washington Health Care Association has a template policy for hospitals in Washington state. This policy requires a healthcare professional to document that the patient has a terminal or debilitating condition that might benefit from medical marijuana. A designated provider is responsible for bringing and removing the marijuana. Hospital staff can only confirm the documentation and ensure compliance with the policy; they cannot help administer the marijuana.
The University of Pennsylvania health system has a policy that follows Pennsylvania law. It prohibits the possession or use of marijuana in any form except for one exception. Certified patients with a registered caregiver can use medical marijuana during their hospital stay if it is clinically appropriate and complies with hospital policies. Self-administration by the patient is not allowed; only the caregiver can administer the marijuana.
Several states have passed laws to address the use of medical marijuana in hospitals. For example, California, Connecticut, and Maine have laws that allow hospitalized patients to use medical marijuana under certain conditions. Each state has different rules about which patients qualify and how marijuana can be administered.
New York has changed its regulations to allow hospitals to allow patients to self-administer medications, including medical marijuana if they choose to. Hospitals must develop policies and procedures for self-administration, have a medical order for it, assess the patient's or caregiver's ability to self-administer, provide instructions for safe use, ensure the medication is secure, and document the self-administration in the patient's medical record. For medications brought by patients, the hospital must identify and check the medication's integrity. Suppose a hospital decides to create a policy for marijuana use. In that case, it is important to carefully consider the medical and legal issues and regularly review and update the policy to ensure it complies with federal and state laws.
