Regulators approved Maryland's first medical marijuana dispensary on Wednesday, authorizing a Frederick company to open its doors immediately even though the drug will not be available for months.
Citing legal concerns, the University of Maryland's School of Pharmacy has canceled plans to offer training for those who work in the medical marijuana industry,
After consulting with the Maryland attorney general's office, the university asked pharmacy school officials to cancel the classes, a university spokesman said.
While marijuana has been legalized for medical purposes in Maryland, 28 other states and the District of Columbia, the administration of President Donald J. Trump has not indicated how it will handle enforcement of the federal marijuana law, which still classifies the drug alongside heroin and LSD.
"If there's any question of the law, they are often consulted," said Alex Likowski, a spokesman for the University of Maryland, Baltimore. "Regarding medical cannabis, even though Maryland and many other states have approved it, it's still illegal under U.S. law."
Katherine Bainbridge, chief counsel of the education affairs division in the attorney general's office, confirmed that she gave advice to the university about the medical marijuana law specific to the courses the pharmacy school planned to offer, but she declined to disclose what the advice was.
While the school said it has suspended the program indefinitely, prospective students seeking to enroll through a university-associated website still see a note that enrollments were "suspended temporarily while the business agreements are being finalized by the university."
The classes, initially scheduled to start in August, offered basic and advanced certifications in areas including cultivation, manufacturing, dispensing, laboratory standards and assessment.
It's unclear whether the courses might be offered in the future. Pharmacy school officials did not respond to requests for comment.
Leaders of the pharmacy program said in July they were not endorsing the use of marijuana, which is not approved by the U.S. Food and Drug Administration for any medical use. Rather, officials cited the school's long-established training mission and a desire to establish educational standards for those working with medical marijuana because it already was being used across the country and would soon be available in Maryland.
Doctors in Maryland are not required to gain any special certification to recommend medical marijuana, but state law requires workers employed by growers, processors, dispensaries and laboratories to have training in their areas.
Patrick Jameson, executive director of the Maryland Cannabis Commission, said workers must obtain training.
"The commission expects the most highly trained and knowledgeable people will participate in the program," he said.
It's unknown where those who want to work in the industry might turn for needed instruction. The state commission does not endorse any particular certification program..
Maryland's pharmacy school would have joined only a small number of established colleges and universities to lend credibility for training of workers.
The pharmacy school had adopted a curriculum developed by the advocacy group Americans for Safe Access, which has been offering training directly since 2002. University officials said suspension of the courses was a not a reflection on that content. The group did not respond to request for comment.
There are other online options for training available — directly through Americans for Safe Access and through the likes of such little-known organizations as Cannabis Training Institute, THC University and Green Cultured. Some state medical societies also offer training, but MedChi does not in Maryland.
Perhaps the only mainstream medical school offering training is the University of Vermont's Larner College of Medicine, which began offering courses in the spring of 2016. There is a course available to medical and other university students that focuses on clinical trial data, in addition to certification and continuing education courses available to the community.
Karen M. Lounsbury, a professor of pharmacology and co-director of Vermont's medical cannabis course, said officials there had no legal concerns, though they were careful to comply with university policies.
"The biggest concern was that when presenting the clinical trial data for medical cannabis, we could be construed as supporting the use of medical cannabis that is legal in many states, including Vermont, but still illegal at the federal level," she said. "We confirmed with the university lawyers that as long as we stated a clear disclaimer for each instructor, we would not be violating any university policy."
The disclaimer says: "The content of this lecture material represents the opinions of the instructor based on their research and experience and does not necessarily represent the opinions of the University of Vermont."
She said the program has an "evidence-based" approach and the classes are popular.
Medical marijuana advocates lamented that more well-respected universities were not offering medical courses for doctors or certifications courses for industry workers.
Paul Armentano, deputy director of the advocacy group NORML, said such institutions were needed to establish training standards and to directly educate workers and doctors, very few of whom have had any instruction on the subject.
He noted that few universities even support research into medical uses for marijuana, largely because accessing the plant is restricted by federal law and conducting studies is time-consuming and costly. Without more clinical data, many doctors would remain unwilling to recommend medical marijuana. Without training, those who have interest could end up relying on patients for information.
Not much will change as long as the legal cloud remains, he said.
Already in Maryland, two large medical systems — MedStar Health and LifeBridge Health — have asked their doctors not to recommend medical marijuana. The University of Maryland Medical System, which includes 13 hospitals, has not developed a formal policy. A system spokesman, Michael Schwartzberg, said it was a "complex issue both medically and legally."
Armentano said the industry has no choice but to try and establish its own standards for training.
"It is likely that medical schools will continue to shy away from cannabis education until the federal scheduling of cannabis is amended and/or the plant's therapeutic utility is formally recognized by the FDA," he said.