Medical guidelines changing in Washington

Admittedly I’m not all that in the loop on the medical marijuana side of things here in Washington. I mostly write about legalization, I502 and Clark County businesses.

But this may affect a bunch of local folks so I thought I’d at least mention it and see if anybody wants to add any comments.

(Medical Marijuana rules may soon change in Washington. - photo by Zachary Kaufman/The Columbian)
(Medical Marijuana rules may soon change in Washington. – photo by Zachary Kaufman/The Columbian)

The state Department of Health is changing the authorization guidelines for medical cannabis patients and doctors.

Information on all the changes are listed on the agency’s website.

People can submit written comments to the agency about the changes through Sept. 18 by clicking the email link on this website: http://www.doh.wa.gov/YouandYourFamily/Marijuana/MedicalMarijuanaCannabis

The draft guidelines are below:

Medical Marijuana Authorization Practice Guidelines (08/25/2014)

Purpose: To improve patient safety and maintain the dignity of the health professions in the state of Washington, the Board of Naturopathy, the Medical Quality Assurance Commission, the Nursing Care Quality Assurance Commission, and the Board of Osteopathic Medicine and
Surgery have worked together to adopt shared professional practice standards expected of all health care professionals who authorize medical marijuana under Washington State law.

A health care professional should provide documentation to authorize medical marijuana under Chapter 69.51A RCW under the following conditions:

Section 1: Patient Examination
1. A health care professional should obtain, evaluate, and document the patient’s health history and physical examination in the health record prior to treating for a terminal or debilitating condition.
a. The patient’s health history should include:
i. Current and past treatments for the terminal or debilitating condition;
ii. Comorbidities; and
iii. Any substance abuse.
b. The health care provider should:
i. Complete an initial physical examination as appropriate based on the
patient’s condition and medical history; and
ii. Review the patient’s medications including indication(s), date, type,
dosage, and quantity prescribed.Version 2 DRAFT 2

Section 2: Treatment Plan
2. A health care professional should document a written treatment plan that includes:
a. Review of other measures attempted to treat the terminal or debilitating
medical condition that do not involve the medical use of marijuana;
b. Advice about other options for treating the terminal or debilitating medical
c. Determination that the patient may benefit from treatment of the terminal or
debilitating medical condition with medical use of marijuana;
d. Advice about the potential risks of the medical use of marijuana to include:
i. The variability of quality and concentration of medical marijuana;
ii. Adverse events, including falls or factures;
iii. Use of marijuana during pregnancy or breast feeding; and
iv. The need to safeguard all marijuana and marijuana infused products from
children and pets or domestic animals.
e. Additional diagnostic evaluations or other planned treatments;
f. A specific duration for the medical marijuana authorization for a period no
longer than twelve months; and
g. A specific ongoing treatment plan as medically appropriate.

Section 3: Ongoing treatment
3. A health care professional should conduct ongoing treatment as medically appropriate to review the course of patient’s treatment, to include:
a. Any change in the medical condition;
b. Any change in physical and psychosocial function; and
c. Any new information about the patient’s terminal or debilitating medical

Section 4: Maintenance of Health RecordsVersion 2 DRAFT 3
4. A health care professional should maintain the patient’s health record in an accessible
manner, readily available for review, and include:
a. The diagnosis, treatment plan, and objectives;
b. Documentation of the presence of one or more recognized terminal or
debilitating medical conditions identified in RCW 69.51A.010(6) or approved
pursuant to RCW 69.51A.070;
c. Results of ongoing treatment; and
d. The health care professional’s instructions to the patient.

Section 5: Treating Minor Patients or Patients Without Decision Making Capacity
5. If the patient is under the age of eighteen or the patient is without decision making
capacity, the health care professional should:
a. Ensure the minor’s parent or patient surrogate participates in the treatment and
agrees to the medical use of marijuana;
b. Consult with other health care providers involved in the patient’s treatment, as
medically indicated and as agreed to by the minor’s parent or patient surrogate,
before authorization or reauthorization of the medical use of marijuana; and
c. Include a follow-up discussion with the minor’s parent or patient surrogate to
ensure the parent or patient surrogate continues to participate in the treatment.

Section 6: Continuing Education
6. A health care professional issuing authorizations or valid documentation for the medical
use of marijuana on or after the effective date of these guidelines should complete a
minimum of 3 hours of continuing education related to medical marijuana. Such
program should explain the proper use of marijuana, including the pharmacology and
effects of marijuana (e.g. distinction between cannabinoids (CBD) and
tetrahydrocannabinol (THC), methods of administration, and potential side effects or