Maine’s Medical Marijuana Program was recently scored as the best program in the country in terms of patient access, regulation, and oversight by the national group Americans for Safe Access (http://bangordailynews.com/2014/07/08/news/state/new-report-calls-maines-medical-marijuana-program-the-nations-best/).
We certainly have come a long way in Maine to provide access to this safe and crucial medicine for Maine’s most vulnerable citizens. We have a robust regulatory program for Maine’s eight dispensaries, and over 1,500 individual caregivers are now registered with the Department of Health and Human Services. DHHS and the active participants in the program should be applauded for bringing the program to this point. Still, there is room for improvement.
We can do better to ensure that Maine’s patients are receiving medicine in a form and dose that is as safe as it can be and as helpful as it can be. This can be accomplished by regulating Maine laboratories to allow for consistent testing of cannabis for the presence of pesticides and other contaminants, and secondarily for potency.
Recently, a Washington state researcher gathered samples of cannabis from providers around that state, and tested them for the presence of a number of contaminants, including molds and bacteria. (It is interesting to note that in Washington State, retail providers – growers – of adult-use cannabis are required to test their products, whereas their medical dispensaries are unregulated and have no such requirements.
This researcher was able to isolate a number of contaminants in several of the samples she took, most alarmingly, the human fecal bacteria Enterobacter asburiae. Other, similar studies have revealed the presence of other contaminants, such as heavy metals, human or animal hair, and the bacteria E. coli, in cannabis meant for therapeutic use.
While the health risks of smoking bacteria are unknown, they can cause infections when transferred dermally to open cuts or sores. Inhaled molds and mildews are risk factors for patients with suppressed immune systems. And dog or human hair? Well, just think about how you felt the last time you found a hair in your food. No one wants it in their medicine either.
So there’s the “sick” factor, and the “just plain ick” factor. And the frustration factor: anyone who purports to be growing this herb for therapeutic use should follow common-sense bathroom hand-washing etiquette, and gloves and hairnets are inexpensively available at a local CVS Pharmacy. These are simple precautions that anyone who purports to be providing therapeutic-grade cannabis should be taking as a matter of course.
Findings like these out of Washington underscore the need for states to implement testing protocols to promote public health and safety. While the FDA oversees food and drug product contaminants, and the American Herbal Products Association issues guidance on contaminants in herbal products, no agency is yet tasked with ensuring the safety of therapeutic cannabis.
That means that in places like Maine, it’s up to us to protect the patients who rely on us for their medicine. Additionally, research is beginning to only scratch the surface in understanding the therapeutic benefits of the component parts of the cannabis plant. Patients deserve for this research to continue and to fully understand what is in their medicine through laboratory testing and clear and consistent labeling of its active compounds.
Currently, Maine law only allows the possession of cannabis by patients, caregivers, and dispensaries. Laboratories can operate under these constraints, but only to a limited degree. Because the ability of laboratories to handle the amounts of cannabis required for testing is not explicitly spelled out in our state regulations, and because the product is still federally prohibited, most are not willing to work with cannabis.
To take a huge step forward in patient safety, Maine must better regulate access to testing laboratories for all participants in the Maine Medical Use of Marijuana program. Laboratories need the freedom to handle the amounts of cannabis required for this crucial testing.
And finally, laboratory regulations need to be implemented to ensure Maine citizens that these facilities operate at the highest standards in order to best protect the safety of our patients.