The rules: What every medical marijuana patient and doctor has to know

Monday, January 01, 0001
To buy medical marijuana from a dispensary when they open in the coming months, patients will have to follow a multi-step process. Here is a rundown of that process:

∎ Written certification from a physician. This is the key piece of documentation patients need. It tells the Department of Public Health that a patient has a debilitating medical condition. State law gives several specific examples of debilitating conditions, including cancer, glaucoma, positive status for HIV/AIDS, hepatitis C, ALS (Lou Gehrig’s disease), Crohn’s disease, Parkinson’s disease, multiple sclerosis. There’s also a category called “other debilitating conditions” as determined by a doctor.

Debilitating is defined as “causing weakness, cachexia, wasting syndrome, intractable pain, nausea, impairing strength or ability and progressing to such an extent that one or more of a patient’s major life activities is substantially limited.”

∎ Certification must not be for less than 15 days or longer than one year.

∎ Physicians may certify for up to a 60-day supply, which is defined as 10 ounces of marijuana.

∎ After receiving certification from a physician, a patient must apply to the Department of Public Health for a registration card. The application requires patients to prove their age and that they live in Massachusetts, among other requirements. Children under 18 need permission from a parent or guardian to register.

∎ Once a registration card is issued, patients or designated personal caregivers, who must also register with the state, are allowed to buy marijuana from a dispensary by showing the card and valid proof of identification. Dispensaries must provide education to patients that describes proper dosage and different ways to take marijuana.

∎ Once registered, a patient must carry the registration card at all times while in possession of marijuana.

Rules for physicians

Though no doctor is required to certify patients for medical marijuana, those who do must first register with the state. That requires doctors to have a full, active Massachusetts license and at least one established place of practice in the state. The physician retains the registration indefinitely, unless they break one of several rules, including fraudulently issuing a written certification to patients or failing to meet continuing education requirements outlined by the state.

Other rules call for physicians to:

∎ complete at least two hours of continuing medical education credits relating to medical marijuana, starting July 1.

∎ have a bona fide physician-patient relationship with the patient. This means that before issuing a certification, a doctor acting in the usual course of his or her professional practice must conduct a clinical visit, complete an assessment of the patient’s medical history and current medical condition, and continue to provide care and treatment for the patient.

∎ use the state Prescription Monitoring Program before issuing a written certification to review a patient’s prescription history.

∎ not issue a certification to immediate family members or themselves.

∎ not have a financial interest in a dispensary, offer a discount to a patients for using a particular dispensary or receive anything of value from a dispensary.