By Lucas Thomae
Lawmakers are once again deliberating whether to legalize marijuana for medical use, an issue that has plenty of supporters in the state Senate but has failed to become law the past two legislative cycles.
Sen. Bill Rabon (R-Southport), a primary sponsor of the bill and a colon cancer survivor, has been pushing for several years for North Carolina to join the 38 U.S. states, the District of Columbia and territories that allow the use of marijuana — also referred to as cannabis — for medical purposes. Reasons given for opposition to the proposal in years past have varied. This year, many of the bill’s detractors have argued that legalization would make North Carolina’s roadways more treacherous.
The bill passed the state Senate with bipartisan support, but House members had pointed questions for Rabon on May 30, when he took the floor at a House Health Committee meeting to make his case for the Compassionate Care Act.
Rabon, a veterinarian and state senator since 2011 who is head of the powerful rules committee, takes anybody willing to listen along his journey to becoming an advocate for medical marijuana.
It’s personal for him.
At age 48, Rabon was diagnosed with stage 3 colon cancer and began chemotherapy. To battle the nausea associated with the treatment, he was prescribed dronabinol pills, a man-made form of tetrahydrocannabinol (THC), the component of cannabis that produces the “high.” Rabon’s doctor, however, said the pills wouldn’t be enough, telling his patient he “might as well stick them in (his) ear.”
“He said, ‘You need to get some good marijuana,’” Rabon shared with the House Health Committee members.
So that’s what he did.
Rabon said he went to his local law enforcement officials and told them he was planning on buying marijuana illegally to manage the side effects of his cancer treatment. “I never bought the first drug,” Rabon said.
It just so happened that bags of marijuana began showing up in his mailbox on an “as-needed basis.”
Rabon tried to keep his schedule as routine as he could. He started his days at 7 a.m. at the veterinary hospital, worked until about 2 p.m., went home, smoked and didn’t go back out until the next day.
“I did that until I completed my chemo,” Rabon said. “And that’s the only reason I’m alive today.
Driving while high: A proven concern?
Several speakers made public comments at the hearing, in support of and against the bill, before the conclusion of the committee meeting.
Corinne Gasper, an Ohio resident and spokesperson for several anti-marijuana organizations, recounted the story of her daughter’s death in an automobile collision which she claims was caused by a driver impaired from his marijuana use. Gasper’s daughter, 22-year-old Jennifer Hrobuchak, died as a result of injuries sustained in the crash.
“She was impacted in an intersection by a man driving high on so-called medical marijuana,” Gasper said.
Gasper, who has spoken out in several states against the legalization of medical marijuana, alleged that the man involved in the crash had a medical marijuana card and admitted to smoking before the collision.
“(My daughter) lost her life because of (a) medical marijuana driver, and countless others will do the same,” Gasper said.
While marijuana remains a Schedule I controlled substance under the federal Controlled Substances Act, the Department of Justice announced in 2009 that it wouldn’t prosecute people in states with medical marijuana laws who were complying with those statutes. Since that change, a steady stream of U.S. states have passed legislation legalizing cannabis in smokeable and edible forms for medical use.
One 2020 study sought to examine the impact of medical marijuana laws and the decriminalization of the drug on fatal traffic crashes in U.S. cities. It found that “cities that are located in states that enacted [medical marijuana laws] experienced fewer fatal crashes.” The same study found that full marijuana decriminalization was associated with a slight increase in fatal crashes, particularly among young males aged 15 to 24, but the rate of those crashes decreased over time.
A more recent study from 2022 compared quarterly crash rates per mile of travel across five states that had legalized recreational marijuana (Colorado, California, Nevada, Oregon and Washington) and didn’t find a conclusive trend. The change in injury crash rates across the five states, measured from 2009 to 2019, ranged from a 7 percent decrease to an 18 percent increase. Legalization of recreational marijuana, however, was associated with a 6.5 percent increase across the board.
Charles M. Farmer is in charge of research at the Insurance Institute for Highway Safety and was the lead researcher for that 2022 study. He said differences in crash rates among states that have legalized marijuana may come down to specific policy.
“States do different things, and their enforcement levels are different,” Farmer said. “The campaigns that they put out there to tell people that it’s still wrong to drive after using marijuana, those are different among states. And all of that should affect driver behavior.”
Farmer also offered a possible reason for why there might be fewer fatal crashes in certain places after the passage of medical marijuana laws. People who previously may have turned to opioids or alcohol to manage their pain could substitute medical marijuana to ease their symptoms.
“(Researchers) actually saw a decrease in crash risk because of that transfer from a much more dangerous drug to a less dangerous drug,” Farmer said. “I don’t know if that’s true, and it may not be true for North Carolina.”
What the bill does — and doesn’t — say
If passed as written, the Compassionate Care Act would be a relatively stringent law that allows the distribution, possession and use of medical marijuana only in very specific situations. That’s intentional. Republican lawmakers say they are not in favor of legalizing marijuana for recreational use.
Still, some North Carolinians argue that legalizing marijuana for medical use won’t stop the drug from being misused. Darryl Rodgers, a Cary resident whose son died in a marijuana-involved automobile crash, said that the bill still doesn’t go far enough to protect North Carolinians from the potential dangers.
“There’s no cap to the potency (of medical marijuana) in this bill,” Rodgers said. “One of the other issues is that there’s no limit to daily purchases. Can you imagine if you went to your doctor’s and you got a prescription for a medicine, you could go to the pharmacy and get any dosage you want and refill it as many times as you want? That’s what this bill does.”
Under the Compassionate Care Act, prospective medical marijuana users would need a written certification from a physician stating they have been diagnosed with one of 13 “debilitating medical conditions.” That list includes cancer, epilepsy, HIV/AIDS, sickle cell anemia, amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease or ALS), Parkinson’s disease and post-traumatic stress disorder. Patients would be able to receive only a 30-day “adequate supply” of the substance.
The bill does not permit marijuana as a treatment for anxiety disorder, arthritis, depression or menopause, all of which are qualifying conditions under Virginia’s medical marijuana laws.
Heather Breeden does advocacy for the National Multiple Sclerosis Society. North Carolina’s bill does include multiple sclerosis as one of the qualifying conditions, and Breeden said that passage of the proposed legislation is a long time coming for those living with the disease.
“We want people with MS to have access to as many options for symptom management as possible,” Breeden said.
Qualified patients who receive a physician’s certification would be allowed to apply for a registry identification card and receive marijuana from an approved medical marijuana dispensary. The bill would regulate where the marijuana could be used and how it could be transported.
Registry identification cardholders would not be permitted to smoke or vape marijuana inside a vehicle, nor would they be permitted to have an open container of marijuana in the passenger compartment of a vehicle. The cardholder’s name and amount dispensed to them will be added to the new registry’s database.
As the bill is written, it “shall not be construed” to “permit the operation of any vehicle, aircraft, train, or boat while under the influence of cannabis.”
If the bill becomes law, Rabon told NC Health News that violators still would be subject to prosecution under North Carolina’s impaired driving law, which prohibits operating a vehicle on any roadway “while under the influence of an impairing substance.”
The senator responded curtly to critics who say the bill would make North Carolina’s roads less safe.
“People with ALS and stage three and four cancer don’t do a whole lot of driving,” Rabon told NC Health News. “I think that a certain percent of the population, a very small minority, are against this bill, and I think they may be scared of the boogeyman or something. The boogeyman’s not there.”
What’s next for the Compassionate Care Act?
The bill was designated “for discussion” during the May 30 meeting, so no votes on the proposed legislation were taken in the House committee. It’s unclear what path the proposed legislation will take next. It wasn’t on the agenda for the House Health Committee meeting June 6 and did not come up for discussion.
If the bill takes the traditional route, it still faces votes in the health, finance and rules committees before heading to the House floor. Lawmakers have said they hope to complete this legislative session in the next few weeks. That means the window is closing for pushing any medical marijuana legislation through the General Assembly this session.
If that doesn’t happen, the Compassionate Care Act remains eligible for consideration in 2024 since the state Senate already has approved the bill.
So for now, a question that has loomed large in previous legislative sessions remains: Will this be the year that North Carolina makes it legal to use marijuana for medical purposes?