There are few subjects that can stir up stronger emotions among scientists, researchers, doctors, pharmacists, politicians, and the general public than medical marijuana. Should it be legal? Should it be decriminalized? Is it safe? Is it addictive? Has its effectiveness been proven? What conditions is it useful for? Is it really the “wonder drug” that people claim it is? Or is it simply just a ploy to legalize marijuana in general?

These are just a few of the questions which surround this subject.  Nonetheless, on August 6, 2019, Louisiana became the first Deep South state to dispense medical marijuana. Currently, there are nine medical marijuana pharmacies throughout the state which are permitted to distribute the drug, with the first product available in a flavored liquid tincture—a bottle containing a dropper to use.  Here’s everything you need to know about Louisiana’s new—and to some, controversial—option for medical treatment.

Louisiana first legalized medical cannabis for chemotherapy patients in 1978.  Over the next three decades state lawmakers added various qualifying conditions for its use. However, it wasn’t until May 2016 that Governor John Bel Edwards signed into law two billsSB 271 and SB 180which would allow for the medical distribution of medical marijuana.  SB 271 amended an already existing program that would allow doctors the ability to “recommend” the drug, as opposed to “prescribing” it (which, under federal law, can put physicians at risk of losing their ability to prescribe medications).  Meanwhile, SB 180 provided protections for patients and their caregivers for possession and consumption of therapeutic cannabis by amending criminal statutes regarding marijuana.

Mayor Adrian Perkins, Katherine Thomas and Fraser Snowden

In 2018, the governor signed HB 579 and HB 627 into law. These two bills further expanded the qualifying conditions for medical marijuana by adding a variety of new conditions, including autism, PTSD, and intractable pain. And while these laws solved a lot of problems for the thousands of Louisiana residents hoping to get medicinal marijuana, questions still remain.  

What exactly does this law do?

The law makes it legal—at least for now—the ability to produce and distribute marijuana oils for medicinal purposes in Louisiana. It does this by allowing two locations in Louisiana—the LSU Ag Center and the Southern AgCenter—to grow marijuana and produce medical cannabis oil for distribution and research. 

“It took longer than we thought and the whole time the other pharmacy owners and I had patients calling daily. These individuals are in real need and have tried every other type of treatment and nothing worked.”

Why did it take so long to pass this law?

The Louisiana General Assembly was at arms about how to produce marijuana in the state in a way that wouldn’t lead to getting the plant in the wrong hands. In the three years since medical marijuana was made legal to possess, Governor Edwards signed laws expanding what conditions could be treated with medicinal marijuana, but he and other legislators refused to pass bills to allow in-state production of the drug because they didn’t have enough security measures to prevent abuse.

Opponents of the current law—including sheriffs and religious groups—fear it isn’t narrow enough, saying the supply is too high for the number of patients and it could start a slippery slope leading to legalization of marijuana and a glassy-eyed population.  Another headache remains is that marijuana is a drug that is illegal under federal law; which means that any law allowing its in-state cultivation is—technically—illegal.

Wait, does that make Louisiana’s law illegal?

According to federal law—the Controlled Substances Act—marijuana is a Schedule 1 drug. This is the harshest classification and, according to the United States Drug Enforcement Agency, Schedule 1 drugs, substances, or chemicals are defined as “drugs with no currently accepted medical use and a high potential for abuse.”  For context and comparison, morphine, oxycodone, cocaine and methamphetamines are Schedule 2 substances, meaning they are seen as having some medicinal use.

There are efforts at the federal level to have marijuana reclassified as a Schedule 2 drug, but that progress has proven to be slow. So, until the DEA, federal, state, research and medical communities all catch up with one another, this will continue to seem contradictory.  

However, in 2013, states such as Washington and Colorado began legalizing recreational marijuana usage, which created a quagmire for the Department of Justice.  Ultimately they issued updated guidelines for how the DEA should manage conflicts with state laws regarding marijuana—basically saying it’s not a priority for DEA agents.  

So since its legal (sort-of) … what exactly is it, how does it work, and are there any risks?

Medical marijuana uses the marijuana plant or chemicals in it—called cannabinoids—to treat diseases or conditions. It’s basically the same product as recreational marijuana, but it’s taken for medical purposes.  The U.S. Food and Drug Administration does not recognize or approved the marijuana plant as medicine. However, scientific study of the cannabinoids has led to two FDA-approved medications that contain cannabinoid chemicals.  Obviously, continued research may lead to more medications.

In answering the “how does it work” question, your body already makes marijuana-like chemicals that affect pain, inflammation, and many other processes. According to the Mayo Clinic, medical marijuana can sometimes help those natural chemicals work better “to ease pain, nausea and other side effects of medical treatments, as well as to treat some diseases.”

That, however, doesn’t mean the drug is harmless. Medical marijuana is not monitored like FDA-approved medicines. When using it, patients don’t know its potential to cause cancer, its purity, potency, or side effects.  Research has indicated that chronic, heavy users may have impaired memory, learning, and processing speed, especially if they started regularly using marijuana before age 16 or 17.  So for some of the following medical benefits, there’s good evidence of its use; for others, there are plenty of reasons to continue conducting research.

What types of conditions are eligible for medical marijuana treatment?

In order to legally receive medical marijuana, patients must have “debilitating medical conditions” such as chronic pain, post-traumatic stress disorder, severe muscle spasms, cancer, HIV/AIDS, wasting syndrome, seizures, epilepsy, spasticity, multiple sclerosis, muscular dystrophy, Crohn’s disease, severe autism, Parkinson’s disease and glaucoma. Estimates are that over 100,000 residents in Louisiana are eligible for medical marijuana.

Who’s growing medical marijuana in Louisiana?

There are only two locations in Louisiana permitted to grow marijuana for medical distribution. The first is LSU Ag Center, which will also study the medicinal properties of the plant. LSU has enlisted the help of GB Sciences, a private Las Vegas-based bio-pharmacy company to help with its growth and extraction. The second location is Southern AgCenter, which also hired an outside company, Advanced Biomedics. Both locations were approved to start planting seeds in late summer 2018.

Are you allowed to grow your own marijuana?

Not unless you are a part of the two permitted locations sanctioned by the state.  Marijuana is still very much illegal in Louisiana. Growing pot is a felony that can carry hefty punishments of more than 30 years in jail and hundreds of thousands of dollars in fines.  

In what form will medical marijuana be sold in Louisiana?

Louisiana law prohibits marijuana from being sold in any form that can be smoked.  The medicine will initially be available in droppers, with three different dosing options.  One mix contains a higher concentration of CBD, a non-psychoactive chemical with purported healing properties. Another will have a higher concentration of THC, the psychoactive chemical in marijuana that gets its users high. The third mix will be a balance between the two compounds.  The doses are based on what little peer-reviewed research is available, since marijuana has been taboo for so long.  After some time, state pharmacies will introduce the medicine in Listerine-style strips that melt on the tongue; with pills, topical creams, oils inhalers, and lozenges eventually becoming available.

Can your doctor prescribe medical marijuana to you? 

As per SB 271, it cannot be “prescribed” by a doctor. It can, however, be “recommended” to you as a patient, but only by a physician who is licensed in Louisiana and part of the Louisiana Board of Medical Examiners Medical Marijuana Program. A legitimate doctor-patient relationship must be established.

So far, only 100 doctors have received permission from the Louisiana Board of Medical Examiners to “recommend” marijuana to eligible patients—as many doctors throughout the state have balked at the idea of recommending the drug because of its social stigma or fear of prosecution (remember, marijuana remains illegal under federal law).  No state registry or medical marijuana card necessary for purchase is required. And, in response to anticipated demand, a handful of specialized medical marijuana health clinics are opening across the state.

Will medical marijuana be covered by your insurance company?

As of now, medical marijuana itself is not covered by health insurances. This is due to the fact that cannabis is still classified at the federal level as a Schedule 1 controlled substance. Anything that is Schedule 1 cannot be legally prescribed. As such, in spite of several states approving the use of cannabis in medical treatments, patients have to pay for it out-of-pocket.

Where will medical marijuana be sold?

Dian Snowden, Doug Boudreaux

Not just any pharmacy; there are only a few that are authorized to dispense the drug.  One pharmacy will operate in each of the nine regions of the state established by the Louisiana Department of Health. The following cities will have a pharmacy: Baton Rouge, New Orleans, Madisonville, Lafayette, Houma, Lake Charles, Alexandria, Monroe, and Shreveport.

Locally, Hope Pharmacy—located in the heart of Shreveport’s Healthcare Corridor—will serve as the pharmacy for Northwest Louisiana.  Owned by Jennifer Boudreaux, Doug Boudreaux and Chris Whittington, the pharmacy finally began dispensing medical marijuana on August 6, 2019.

According to Doug Boudreaux, the area had waited a long time to get this product to patients that have been patiently waiting.  Doug is also president of the Louisiana Association for Therapeutic Alternatives—an organization founded by patients, pharmacists, doctors, and business professionals who worked to help create Louisiana’s medical cannabis system.

“It took longer than we thought and the whole time the other pharmacy owners and I had patients calling daily. These individuals are in real need and have tried every other type of treatment and nothing worked,” he continued. “It broke all of our hearts to see this many people in pain or suffering from seizures begging for help. We are all ecstatic to tell our patients that we are open and ready to get this product on shelves and available.”

In addition to dispensing medical marijuana, the Hope Pharmacy will conduct research into the effectiveness of the drugs.

Who was Shreveport’s first customer?

Dian Snowden, a 77-year-old woman from Natchitoches, made the one-and-a-half hour trip for the grand opening of Hope Pharmacy—and she has no regrets.  Snowden has had cancer three times—breast cancer twice and most recently lung cancer. And, as a result of radiation treatments and numerous surgeries, has residual chronic pain; however she is looking forward to managing the pain with medical marijuana so she “can feel more comfortable in her own body.”  

Her only intention is to control her pain and just wants to feel normal. “As a psychotherapist, now retired, I was cognizant of the fact that chronic pain can cause depression and suicidal ideation, and medical marijuana will be a benefit to these people as well.  Some patients struggle with side effects from antidepressants.”  

What kind of revenue could Louisiana expect?

Experts estimate the North American legal cannabis market will attract $16 billion in 2019. Louisiana’s industry will only represent a small fraction of that.  Prescription drugs in Louisiana are exempted from state sales tax. And since medical marijuana is a drug that is “recommended” and not “prescribed,” medical marijuana products will be subject to Louisiana’s 5 percent state sales tax on goods, with local sales taxes also applying to sales of the drug (in most places). Revenue will depend on whether these numbers are adjusted and how much is sold.

Early estimates of how many patients would use the drug in Louisiana range from less than 2,000 patients to north of 20,000. John Davis, president of GB Sciences Louisiana, said he expects between 5,000 and 10,000 will seek the drug in the first months of the program, but the market will mature to between 100,000 and 150,000.  Likewise, a 2016 report from the Colorado-based Marijuana Policy Group estimated the Louisiana market for the drug alone could generate between $3.7 million and $4.7 million (assuming a 4 percent sales tax rate). But those numbers assume the medical marijuana program is fully embraced by the medical community—which in Louisiana is an open question.