Facilitating access

Morhaim said while he is happy both panel plans "recognize that the status quo is flawed and that it's time to move forward," he hopes the plan he backs gains momentum in the legislature rather than the plan backed by Sharfstein.

He said restricting distribution of the drug to research institutions would limit the benefits of the drug, especially in areas of the state without such institutions, and would unnecessarily proscribe the participation of well-qualified doctors across the state who know their patients best but who don't work at one of the institutions.

"Why should physicians who are perfectly competent and who work in those areas not be able to help their patients?" he asked.

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More importantly, Morhaim said Sharfstein's plan simply isn't viable on a practical level, because research institutions like Johns Hopkins University or the University of Maryland that receive federal funding aren't likely to risk that funding — or their own legal standing — by participating in a program that, while created under state law, would still break with federal law.

Sharfstein disagreed, and said he has already heard interest in his plan's potential from state institutions, though he declined to name them.

He also said the amount of evidence on medical marijuana as a therapeutic drug is still insufficient for a system of use based on doctor recommendations. That makes it more appropriate to treat medical marijuana as an investigational drug, and academic institutions often offer the first line of study and testing of such drugs, he said.

"When you don't have convincing evidence that the benefits outweigh the risks, then it's appropriate to be gathering data and to be thoughtful about which patients should be trying the therapy and why," Sharfstein said. "Academic centers do exactly this."

Riffle said he shares Morhaim's concerns about Sharfstein's plan.

How to create state medical marijuana law that contradicts federal law is a concern in general, Riffle said, but it's not an insurmountable obstacle to new state legislation, as was shown with the state legislation passed during last year's session.

"We've already sort of passed that bridge," Riffle said. "We've already said the state of Maryland is going to diverge from federal law when it comes to patients who need medical marijuana."

Now, Riffle said, the discussion is all about "how best to facilitate access."

Del. Shirley Nathan-Pulliam, a Democrat who represents District 10 that includes Catonsville, and a registered nurse, said her stance on medical marijuana is in line with Morhaim's plan, largely because of her concerns with access.

There needs to be a law in Maryland that allows people with serious medical conditions to receive medical marijuana "without endangering their lives and going out on the street, and possibly facing arrest," she said.

She said she would like to see substantive progress on the matter this session, beyond what would be provided by categorizing medical marijuana an "investigational drug" that can only be handled by research institutions.

The medical community has already largely agreed on the medical benefits of the drug for certain patients, she said, including "people with cancer and other diseases that are nauseating" and patients who have trouble eating.

In fact, the drug has been shown to be beneficial for patients suffering from a broad array of illnesses, she said, including multiple sclerosis, as former talk-show host Montel Williams testified when he advocated for a medical marijuana law in the state last year.

"We know that it works," she said. "I don't need to spend a whole lot more time and money investigating it."

Whichever bill emerges as the most likely to succeed — one of the two reflecting the work group findings or Glenn's bill — Morhaim said he hopes the issue receives the same open-minded, bipartisan consideration as the legislation that passed last year.

Medicalizing the use of the drug will help everyone, he said, in part by diminishing its appeal as a street drug.

"It loses its glamour when it's grandma's medicine," he said.