More than half of the states in the country have legalized marijuana for medical use, and some people have wondered whether West Virginia will join in that wave.

Many lawmakers interviewed expressed support, at least when it comes to medical marijuana, including Gov. Jim Justice.

"Gov. Justice wants to hear from West Virginia's medical experts before our state makes any moves on medical marijuana," said Grant Herring, Justice's deputy press secretary. "He believes in compassion for those who are ill and is open to the idea."

However, many also expressed concerns and have questions.

Delegate Mike Pushkin, D-Kanawha, plans to introduce a medical marijuana bill in the upcoming session. He said he knows he will run into roadblocks.

“But I'm still going to introduce it,” he said. “I'm going to push for it.”

During the last special budget session, Pushkin introduced a bill to decriminalize marijuana to get the conversation started. He noted that in the budget session, legislators are limited in what they can introduce. Bills have to be germane to the state's finances.

He doesn't plan to introduce this type of bill this time around. Instead, he said he wants to focus on medical marijuana.

He said the issue is important because of the potential benefits to people diagnosed with various conditions.

“People are going through chemo, ALS – people are suffering and would like to try this other than the laundry list of people being prescribed pharmaceutical drugs,” he said. “There are people who are sick and suffering, and we are treating them like criminals.

“There are people suffering, from little old ladies to Medal of Honor winners,” Pushkin said. “There is a benefit from medical use. Whether it has a chance of passage or not, I will introduce it because it's the right thing to do.”

With the session starting in the next week, the chance of a medical marijuana bill passing in the two chambers is still unknown. There also are differences in opinions of House and Senate leadership.

Senate President Mitch Carmichael said he could foresee a medical marijuana bill doing well. House Speaker Tim Armstead, however, said he doesn't foresee it going anywhere.

Carmichael, R-Jackson, said he supports medical-only marijuana to relieve pain and suffering under supervision.

“Who are we to deny legitimate alleviation of suffering and pain if it's been medically proven that it's effective?” he said. “Who wouldn't want to relieve suffering and pain? There's enough evidence under doctors' supervision, I believe, that supports the use of medical marijuana, but I am a harsh critic of recreational use or decriminalization.”

Carmichael said although he is for medical marijuana usage, that doesn't mean the full Senate would be or that he would push a bill not supported by the caucus or majority of senators.

“Honestly, the likelihood in the Senate is more, but it's a personal decision for people guided by medical evidence as well as the compassionate response to those in need, rather than political implications."

Federal law in limbo

Armstead, R-Kanawha, wondered whether the new attorney general would enforce the federal law against marijuana. He said West Virginia should see what happens first.

“In the past, marijuana use is illegal from a federal standpoint,” he said. “The only directive from the Justice Department is that it has not been prosecuted. We should step back and see what the new administration will do with whether those current statutes on the federal level will be enforced, because if they are, then it's irrelevant. We can't legalize if the federal government is going to prosecute and enforce federal law.”

Armstead said he doesn't believe there is support in the legislature for recreational or medical use.

“I truly believe myself that a federal agency, the FDA, tests and analyzes any substance used for health care and to determine whether those should be subject to use through prescriptions or otherwise,” he said. “Let the FDA do its job first to see whether this is a substance they believe that the advantages outweigh the disadvantages. They have yet to do this.”

Pushkin also noted marijuana is illegal by federal law and is still a Schedule 1 drug.

“For the past 20 years, no matter who the attorney general was or the president, this was not enforced,” he said. “With the new attorney general, he has the authority to enforce it so all these states that now have medical marijuana could see it reversed.”

“Half of the country has medical marijuana,” Pushkin later said. “If he decides to enforce it, there will be a lot of people losing money and losing medicine. There will be a lot of unhappy people.”

Some Raleigh and Greenbrier delegates expressed support of medical marijuana or said they would like to see research presented to the Legislature on the topic at the very least.

Delegate John O'Neal, R-Raleigh, did not wish to comment on the issue. Delegate Lynne Arvon, R-Raleigh, did not return phone calls.

Sens. Sue Cline, R-Wyoming, and Jeff Mullins, R-Raleigh, also did not respond to phone calls seeking comment.

Changes in thinking

Newly elected Delegate Stephen Baldwin, D-Greenbrier, supports the issue. However, “I wouldn't have been probably 10 years ago,” he said.

Baldwin, a pastor at Ronceverte Presbyterian Church, talked about his upbringing. He grew up in a religious environment where substances were frowned upon heavily.

“I've never smoked a cigarette,” he said. “I've never had an illicit substance. I tried alcohol once and hated it.”

He remembered the chain of events that changed his mind on medical marijuana, tracing it back to working as a hospital chaplain in Nashville.

“I worked in a burn unit, particularly acute pain,” he said. “For the first time in my life, I had seen people deal with acute pain on a daily basis. It caused me to ask questions about health care and options they have. I did research and from what I've been able to find, folks can find relief from medical marijuana as long as that's done in a supervised relationship between patient and doctor.”

Baldwin said he has heard of benefits from people who live in other states. “It seems to work for some and not for others, and it happens within the confines of the doctor-patient relationship. I've seen, even with those confines, that go wrong with opioids and don't want to repeat that.”

Like Baldwin, Delegate Mick Bates, D-Raleigh, said his attitude has changed.

“If you asked me the same question three years ago, I would say no way. It's a bad idea. Forget about it. As I've become more educated, I see the pros and cons and think it's something we need to and should consider.”

Bates said in his clinical practice, he sometimes sees people whose conditions could be effectively managed with medical marijuana.

“If West Virginia is slow to act, then it could potentially experience all the negatives without seeing all the positives that could come from legalization medically or recreationally for this product. It's never been my thing, but a lot of people including my clinical practice told me it would be beneficial to them. It's less harmful than a lot of the things we prescribe.

“The issue is not going away,” he said. “Within a short period of time, in a majority of states, this product will be available. If we don't get ahead of the curve, we will look at West Virginians crossing the border with no way to regulate or control this.”

Potential abuse of the system

Delegate Rick Moye, D-Raleigh, said he supports medical marijuana but “the devil is in the details.”

“My opinion about it is the devil is in the details on it because personally, I think that for someone who has a true medical need, especially those with cancer, taking chemo and other true medical needs for it, then me personally, I think that's when you have something available that would truly help out that it should be available to you,” he said.

“Now as far as us doing it, man, there are just so many intricate little parts that would have to come into play before I could support something like that. As with opioids, it's legal but it's gone to an extreme and has been abused. I fear very much the same thing could be done with marijuana. Do we really want to put physicians in the position as they possibly have been in with opioids, having everyone come into the office claiming to have a need?”

Bates, Moye and Baldwin expressed concerns about abuse of the system.

“To me, this is an issue of pain relief as an option for patients to use when they can't get relief otherwise,” Baldwin said. “It's another tool in the toolbox. There are also concerns of people using it for other things. We have those concerns about alcohol and opioids. I'm not sure what the answers are. There is a big debate about it based on facts.”

Moye also mentioned a concern with people driving under the influence of medical marijuana. However, he said he wants to see more research because he doesn't think many people who have a real medical need would be out driving anyway.

“There are a lot of things that have to come together,” he said. “For those people who have true medical needs, it's something worth looking at and exploring to see how we could possibly do that without opening the floodgate to abuse.”

Moye said he'd like to talk to physicians about abuse of the system.

“I would like to see what role they want to play in this, and we've got to be careful,” he said. “If we were to do something and move forward with medical marijuana, we've got to be sure that sufficient guidelines are in place so it's not abuse. It's a lot easier to take care of the problems to start with than on the back end when you figure out that you've messed up. Caution — that's the biggest word I have to say about moving forward. Extreme caution.”

Learning from others

Bates said West Virginia is fortunate to see other states' experiences.

“I have concerns about edibles, concerns about impaired employees in the workplace,” he said. “We have those now. There has to be a better way. Prohibition or just say no has not been shown to be an effective method of public policy. There is an argument that can be made for regulation and taxation.

“Any physician will tell you the biggest killers and two biggest health problems come from alcohol and cigarettes,” he added. “These are two things that result in an immense amount of harm in our society but we regulate and tax.”

Bates said one issue that would have to be addressed is insurance coverage, mentioning PEIA and Medicaid in particular.

“The issue is if we say, OK, it's now viable and a legal product for use, does that mean you pay with it for medical insurance or cash? These are questions that we should get answers to. Why should Oxy be covered for your management of chronic pain when research supports there may be an alternative that is more effective and less harmful? We have had an advantage to see what other states' experiences are.”

Pushkin said insurance coverage should be worked out in a committee.

“They say the statehouse is a laboratory for democracy,” he said. “We have half of the statehouses in the country to look at. Half of the states have some form of legal marijuana for medical purposes. It's something we could work out during committee.”

Pushkin said he'd also want to look at how edibles would be marketed.

“A lot of times, you hear concern in some states from a marketing perspective like marketing gummy bears or cookies where a child could possibly get into it,” Pushkin said.

Bates said with the current composition of the House of Delegates, he's not sure if the votes are there for medical or recreational. He would like to see the issue come forward and educate and advocate for the best approach for West Virginia to address the issue, noting it's not going away.

“We have to start talking about these things,” he said. “Right now. We can't just ignore it. It's here now. We're waiting too long to get serious with how we're going to deal with this, and it is a mistake. My focus is going to be on the budget and all the things that go along with it. This could be part of what gets us there. However, it shouldn't be the first reason it gets us there.”

Budget versus health

Many lawmakers interviewed said although West Virginia could see a budgetary effect, this shouldn't be the only reason for looking at the topic.

Pushkin noted marijuana could help the state's finances but said this is secondary to public health.

“The generous estimate just on tax revenue alone is about $190 million,” he said. “That's high. This is taking into account West Virginians but also people who live in close-by cities like Columbus. You take that in the situation like the jobs — transport jobs, research jobs, security jobs. I think it would benefit the state financially but more importantly, it would benefit people who could use this as medicine.”

Bates also said there could be economic benefits but said compassion is the reason to take up the issue.

“We have to be open to the economic benefits but not just consider doing this just for economic reasons,” he said. “Creating jobs in West Virginia is a good thing but at the same time, I don't think it's the foremost reason to look at doing this. There is an extensive body of research that it is beneficial for a whole range of maladies. To exclude that from a patient or a family member or someone in need – you have to look at the compassion aspects of it first and also the potential economic benefits.”

Moye too said he didn't want to consider it only for the budget.

“We are talking about the medical use of marijuana and therein, I think looking at taxation is the wrong point of view,” he said. “It's not what can the state do to help itself? It's what can we do to help citizens that have a need. I don't see medical marijuana solving all the state's budget woes.”

Carmichael agreed, saying this isn't a money issue for him. Instead, he said he wants to help alleviate the suffering of cancer patients. “Perhaps, it's the only way they could have food and nourishment as well as seizure elimination or alleviation. There's enough medical evidence that public policy makers should not get in the way of medically validated facts.”

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