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Spokane, Washington  Est. May 19, 1883
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Sue Lani Madsen: ‘Essential’ marijuana still subject to sin tax

Sue Lani Madsen, an architect and rancher, writes a weekly column. (Jesse Tinsley / The Spokesman-Review)
Sue Lani Madsen, an architect and rancher, writes a weekly column. (Jesse Tinsley / The Spokesman-Review)

Now you know how you rate – essential or non-essential. Doctors and nurses, cops and firefighters, grocery store stock clerks and electrical linemen, farmers and truck drivers are all essential. And to the surprise and mockery of many, cannabis retailers.

It’s a turning point from rebellious recreational past time to essential service. Dr. Selena Eon supports the essential designation. She is a naturopathic physician with Origin Holistic Natural Medicine in Bellevue, also serving patients in Eastern Washington. “Cannabis patients have severe health conditions by definition,” said Dr. Eon. For them, access to medically prescribed marijuana is essential to managing chronic pain, seizure disorders, PTSD, traumatic brain injury or the side effects of cancer treatment.

Cynics have suggested the state just wants the tax revenue, but Gov. Inslee’s declaration follows the trend to mainstreaming marijuana. Washington is one of 16 states declaring cannabis sales essential. That number may change by the time this column is published, but the trend is clear. Change will be in the more rather than less direction among states where marijuana has attained legal status.

Washington has had medical marijuana for more than 20 years, and legal recreational marijuana after the passage of I-502 in 2012. Tracy Sirrine had been helping patients jump through medical marijuana hurdles through her Spokane Valley based company, Patients for Patients Medical. She recently closed the company in December due to health problems of her own. Patients for Patients connected those who qualified for medical cannabis to doctors who understand its use and how to match dosage to an individual’s body chemistry.

Sirrine had been sending patients with referrals from their primary care provider or oncologist to Dr. Eon in Bellevue. Because it’s still a Schedule 1 restricted drug under federal regulations, no providers in Eastern Washington have been willing or able to prescribe marijuana, according to Sirrine and Eon. Healthcare providers working for large clinics or systems receiving any federal dollars are blocked from getting directly involved.

When the state adopted legislation enacting I-502’s mandate to legalize recreational marijuana, it eliminated the network of medical dispensaries. It also clamped down on the ability of patients to grow and process their own. Sirrine and Dr. Eon agreed affordability is a huge problem for low-income patients, who used to take care of themselves.

Theoretically, the state mandated testing system for medically compliant marijuana will improve the quality of products available to patients. Legislative intentions were good, but the reality has been higher prices and reduced availability.

For producers and processors, it’s a matter of cost according to Sirrine. The cost of keeping above board, the cost of testing for a product to be labeled medical is more expensive than recreational product. The higher the production cost, the higher the price to the consumer and the lower the demand.

The result is medical patients buy recreational products when medically compliant products aren’t available. In a November 2018 interview, Sirrine said the state’s traceability system showed 99.8% of all cannabis tested was for recreational use. Recreational products have less stringent limits on residues of concern to the health conscious. “Patients frequently tell me they can’t find any acceptable products,” said Sirrine.

Dr. Eon coaches her patients to be savvy consumers and label readers, but sees the impact of the limit on home production on her low income patients. Where the maximum used to be fifteen plants, they are now limited at four plants unless they agree to register with the Department of Health. Many patients are reluctant to self-incriminate to a federal felony on a state list, no matter how many promised protections to prevent its abuse by federal drug enforcement.

And then there’s the 37% state excise tax.

“My patients are essentially paying a sin tax for their medicine,” said Dr. Eon. “Opiates are covered 100%, some health supplements can be covered, but all cannabis is out of pocket.” Eon works with Regence, Premera and First Choice Network. She has seen patients choose to stay on what some might consider a more dangerous product because it’s covered by insurance.

Sirrine may have closed her company, but she is committed to continuing to press the Legislature to fixing the original legislation. “The promise was we have to pass it now, we’ll fix it later,” said Sirrine. Being declared essential in an emergency may be a first step to removing the sin tax for medical users.

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