A primer on the Arkansas Medical Marijuana Amendment.

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Who can get a prescription?

Well, technically, no one.

Doctors can't prescribe marijuana as they prescribe other drugs, because the substance is still considered to have "no accepted medical use" by the U.S. Food and Drug Administration, despite ample scientific evidence to the contrary. Instead, a doctor will sign a document certifying that a patient "has a qualifying medical condition and the potential benefits of the medical use of marijuana would likely outweigh the health risks for the qualifying patient," as stated in the amendment. The Department of Health will then issue a "registry identification card" to the patient, permitting him or her to obtain cannabis from a dispensary. The card, which is valid for one year, will cost a fee that is yet to be determined.

The amendment specifically lists 12 qualifying medical conditions: cancer, glaucoma, HIV/AIDS, hepatitis C, amyotrophic lateral sclerosis (Lou Gehrig's disease), Tourette's syndrome, Crohn's disease, ulcerative colitis, post-traumatic stress disorder (PTSD), severe arthritis, fibromyalgia and Alzheimer's disease. However, it also includes any "chronic or debilitating disease or medical condition or its treatment" that results in one of the following symptoms: "cachexia or wasting syndrome; peripheral neuropathy; intractable pain, which is pain that has not responded to ordinary medications, treatment, or surgical measures for more than six months; severe nausea; seizures, including without limitation those characteristic of epilepsy; or severe and persistent muscle spasms, including without limitation those characteristic of multiple sclerosis." The state Department of Health can also add other conditions to the list, and the public may petition it to do so.

Where will medical marijuana be available?

The Medical Marijuana Commission will initially distribute 32 dispensary licenses in Arkansas. As of the date of this article's publication, the commission was still considering how best to geographically distribute those 32 initial licenses so as to minimize coverage gaps. It will likely subdivide the state into several areas (by congressional districts, perhaps) and give out a certain number of licenses within each subdivision. The amendment specifies that no county can contain more than four dispensaries and says the businesses cannot be located within 1,500 feet of a school, church or daycare, but other details about their placement are left up to the commission — and to local governments.

The citizens of a city or county may prohibit dispensaries and cultivation facilities from operating within their borders by means of a local election, just as they can do for alcohol. It's quite likely some of the state's more socially conservative communities will vote themselves "dry" — which will further limit access. The amendment also allows cities and counties to enact "reasonable zoning regulations" to apply to dispensaries, "provided that these zoning regulations are the same as those for a licensed retail pharmacy."

What if I don't live near a dispensary and I'm too sick to travel?

The amendment allows for a "designated caregiver" to obtain a registry identification card from the Department of Health, thus allowing the caregiver to purchase marijuana for a qualified patient and deliver it.

Who's going to be growing all this pot?

The Medical Marijuana Commission will initially award five cultivation facility licenses statewide, and these growers will presumably supply the bulk of the marijuana distributed in the state. Issue 6 also allows for dispensaries to cultivate up to "50 mature marijuana plants at any one time plus seedlings." However, the commission plans to charge much higher licensing fees to dispensaries that choose to cultivate marijuana, which seems likely to discourage small-scale cultivation and benefit the five big growers. The amendment does not allow patients or caregivers to grow their own marijuana.

How much will it cost and what sorts of products will be available?

This is to be determined — by supply, demand and regulation. Price is a concern for patient advocates, who say licensing fees on dispensaries and growers may drive up costs and make the drug prohibitively expensive for low-income patients. Neither private insurance nor Medicaid will pay for cannabis, and the amendment does not contain price controls or financial assistance for the poor. (It's possible dispensaries could choose to offer marijuana at discounted rates to low-income patients, as has happened in some other states.)

The Department of Health will require marijuana to be labeled with its strain, its producer and its concentration of THC and CBD, among other information. Aside from the plant itself, it is not yet clear exactly what other products — such as extracts or concentrates — state regulators will allow to be sold in Arkansas. In states like Colorado, edibles are a big part of the medical (and recreational) marijuana business, but critics worry those products appeal to kids. On the other hand, it's in the interest of patients to provide a drug delivery mechanism that doesn't require smoking the stuff.

Can a qualified patient live out of state?

Draft regulations being prepared by the Department of Health require a valid Arkansas driver's license to obtain a registration card. However, the amendment does allow for reciprocity with other jurisdictions that allow medical marijuana. An out-of-state patient with his or her state's equivalent of a registry identification card can patronize an Arkansas dispensary, provided his or her condition qualifies under the Arkansas law.

If I'm a qualified patient, can I lose my job or be evicted for marijuana consumption?

No. But there are always gray areas.

The amendment prohibits employers, landlords, schools, professional licensing boards and others from discriminating against individuals based on their status as a qualifying patient. However, some jobs — such as those involving heavy machinery — come with their own rules regarding the use of medications that could affect the operator's mental state. Chris Burks, a labor lawyer in Little Rock, said that it should be an "easy fix" for employers to amend their policies to accommodate medical marijuana in the workplace because prescription drugs are already covered. "Most places will want to revise their employee handbooks ... but most handbooks need a little work, not a lot," Burks said.

As for rental property, the amendment does allow a landlord to forbid a qualifying patient to smoke marijuana on the premises, as long as the patient is not prohibited from ingesting it by other means.

Will people still be arrested for possessing or selling weed?

Yes, sadly. Possession and distribution of cannabis outside the strictures of the amendment remain illegal, and the many Arkansans whose records have been blemished by a criminal marijuana offense will get no relief from this change in law. That being said, local law enforcement policies regarding small-scale marijuana possession vary from jurisdiction to jurisdiction, and it remains to be seen whether the new medical marijuana law will change how local police and sheriff departments handle arrests.

At the state level, Bill Sadler, a spokesman for the Arkansas State Police, said the agency is waiting for clarity from the legislature. "It would not be prudent to start making policies with respect to how this law would be enforced — with respect to any traffic stops, individuals who may exhibit signs of being impaired by marijuana, what documents would be necessary [for a patient to have in the vehicle] — until we have the facts from the General Assembly," Sadler said. "These are issues that have got to be cleared up, and we believe that before the end of the session, we'll have a pretty good idea."

How do I get into the dispensary or cultivation business?

Becoming a cultivator isn't easy. An applicant must prove he has $1 million in assets, $500,000 in cash and pay an application fee of $15,000. The annual licensing fee is $100,000. The five cultivation licenses will be awarded on a merit-based system according to a rubric that has yet to be finalized by the Medical Marijuana Commission. (See accompanying main story for more details.)

Dispensaries are somewhat more doable. For those dispensaries that plan to grow plants, the initial license fee is $25,000; for stores that merely sell the product, it's $2,500. The application fee for both types of dispensary is $7,500. Licenses will be awarded by a lottery system, though applicants must meet minimum requirements before being considered.

Both types of businesses come with in-state residency requirements and a long list of other minimum qualifications.

What happens to the taxes and fees associated with marijuana?

State sales tax generated by marijuana is allocated for specific purposes under the amendment. Ten percent will pay for the operations of the Department of Health and ABC (regulating a new industry takes additional staff, which costs money) and the Medical Marijuana Commission. Ten percent goes toward workforce training programs at the Department of Career Education, 50 percent will support vocational and technical colleges, and the final 30 percent goes into state general revenue. Licensing and other fees collected by the commission, the Department of Health and ABC will also fund the regulators' operations.


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