From Stephen Robinson, MD, of the SCC to Howard Krauss, MD, of the Medical Board of California, June 14:

Greetings, Dr. Krauss:

I am writing as a Board member of the Society of Cannabis Clinicians.

As you’re aware, guidelines developed by the Medical Board of California (MBC) governing both the recommending of medical cannabis, and its use, by physicians, has direct bearing on our members.  We were pleased you expressed a willingness to seek out research scientists who could provide the MBC with an objective foundation for their deliberations.

At the last meeting of the Marijuana Task Force, I believe you and I discussed potential candidates whose backgrounds could establish their credibility with the MBC.  One of them, Dr. Igor Grant, as the director of the Center for Medicinal Cannabis Research (CMCR), has been designated by the legislature to provide such input.

I found several documents and publications from the CMCR and Dr. Grant which examined the question of functional impairment induced by cannabis use.  Last month, I emailed copies of these to Ms. Kirchmeyer, and she assured me she would forward them to you and Ms. Lawson.  Fortuitously, I met Dr. Grant at the annual “Patients Out of Time” Conference in Berkeley, where we were both presenting.  I took the opportunity to apprise him of some of the issues under discussion by the MBC, and he suggested that he would be glad to review his findings with the MBC and/or the Task Force.

I had forgotten that we’d exchanged cards and, instead, called Ms.

Kirchmeyer for an update regarding the Marijuana Task Force. She said the guidelines were being developed, and subsequently would be reviewed by the Task Force.  The schedule for the anticipated “interested parties meeting” had to be pushed back until August or September.  She also said that the MBC had gotten input on the guidelines from the CMCR, but I wasn’t clear whether this was with regards to physicians recommending medicinal cannabis, using medicinal cannabis, or both.

Considering that she said the full board wants to finalize these guidelines at their October meeting, I have several questions:

        Is the development of policy related to physician use of medicinal cannabis still proceeding?

        Do you still plan to have the researcher(s) present their findings to the Task Force, or the full MBC?

        Will the meeting(s) be open to the public?

        Will there be sufficient time for public commentary before these guidelines are formally approved?

Thank you for your attention to these issues.  I look forward to the next meeting of the Task Force.

Sincerely,

Stephen S. Robinson, MD, MPH

To Stephen Robinson, MD, from Kimberly Kirchmeyer, director of the Medical Board of California, June 15:

Dr. Robinson:

Thank you for your email regarding the Marijuana Task Force.  In response to your questions in the email below, the Board is proceeding with the development of guidelines for physicians for recommending marijuana for a medical purpose.  To that end, Board staff met with CMCR to discuss the Board’s guidelines that are being drafted to obtain their input.

Board staff is working now to incorporate the suggestions from CMCR and then the guidelines will be submitted to the Marijuana Task Force for their input.  Once they have been reviewed by Dr. Krauss and Ms. Lawson, Board staff will schedule the next Marijuana Task Force interested parties meeting.  The purpose of this meeting will be to receive input from all stakeholders on the draft guidelines.  As stated, that meeting is being planned to be held in August or September.  This meeting will provide sufficient time to hear from individuals on this draft.

After that meeting, the guidelines will be finalized.  Depending upon the input received, the guidelines may be amended and then final approval will be received from the Marijuana Task Force.  Once approved by the Task Force, they will be ready to be presented to the full Board, which is scheduled to take place at the October Board meeting.  At the October Board meeting, public comment will again be allowed during the full Board discussion.  The Board will then determine whether the guidelines are complete and ready to be released or whether changes still need to be made and what those amendments should be.

At this time, the Board is not developing a policy related to physician use of cannabis.  Business and Professions Code sections 820, et. seq. and 2239 allow the Board to take action if a physician is impaired and cannot practice medicine safely.  The Board will continue to use these sections of law when investigating a physician who is using cannabis, the same as they would when investigating a case for any other substance abuse/impairment.

As requested by Dr. Krauss at a previous Board meeting, the Board will be having a presentation at a future meeting on the impact of cannabis use on physicians.  This presentation will be held at a full Board meeting, which is open to the public.  Which future meeting, will be determined by discussions with the Board President and Vice President based upon timing and other necessary presentations and issues for the Board.  Any presentation will be posted on the Board’s agenda.

Again, I want to thank you for your input on and recommendation of Dr. Grant for such a presentation.  I was able to meet him at the meeting we had with CMCR and I believe he definitely has a lot of information that could be provided to the Board.  CMCR has done some significant research and they will definitely be a resource for the Board on these issues.

I am hopeful that this email answered all of your questions, however, should you have any follow-up questions, please feel free to email me.