SIOUX FALLS, S.D. (KELO) — A bill to add eight conditions to the list of those which qualify a patient for the use of medical marijuana passed through the Senate Health and Human Services Committee Wednesday morning on a 6-1 vote.
The conditions SB 1 would add are:
- Acquired Immune Deficiency Syndrome or HIV
- Amyotrophic lateral sclerosis
- Multiple sclerosis
- Cancer or its treatments
- Crohn’s Disease
In addition to adding these conditions, the bill would also remove the ability to add conditions from the state Department of Health (DOH), instead reserving that responsibility for the Legislature.
Sen. Erin Tobin (R-Winner) is the sponsor of the bill, and was also chair of the Medical Marijuana Oversight Committee (MMOC) in 2022, which requested the bill be introduced.
Testimony on the bill began with Tobin breaking down its two parts as she sees them. “It turns the ability to add [qualifying medical] conditions back to the legislature,” she said. “The way we had it before is that people could petition [to the DOH] to have a condition added.”
Tobin says there were a lot of conditions that needed to be met before a condition submitted by a patient could be added by the DOH. “The thing that happened is that there wasn’t any condition that actually went through the whole process,” she said.
According to Tobin, six conditions were submitted for review by patients, but none of them met all of the requirements that the DOH needed to include them. She argued that the system in which the DOH is responsible for adding conditions is not meeting the public’s needs.
Tobin added that the DOH is represented on the MMOC which proposed the bill, along with physicians, pharmacists and other relevant parties. “If I remember right, it passed unanimously,” she said.
The MMOC held townhall meetings to come up with the eight medical conditions that would be added by the bill, and also looked at medical research and the policies of other states to see what the most common conditions allowed were, Tobin explained.
Also speaking in support of the bill was Jeremiah M. Murphy, a lobbyist for the Cannabis Industry Association of South Dakota. He asked legislators to support the measure and thanked the MMOC for its work on the bill.
Murphy in particular wanted to make a point about the eight conditions which would be added. “Seven of those eight conditions could be met today under today’s definition,” he said.
Explaining himself, Murphy pointed out that under the current law, a patient with all eight of the new conditions, with the exception of PTSD, is already eligible for medical cards.
“You qualify today if you have chronic or debilitating disease or medical condition or its treatment that produces one or more of the following: cachexia — or wasting syndrome; severe, debilitating pain; severe nausea; seizures; or severe and persistent muscle spasms including those characteristic of multiple sclerosis,” read Murphy.
The issue, says Murphy, is that these symptoms are not clear enough to allow providers to confidently recommend marijuana. He contends that adding the conditions in SB 1 will help.
After Murphy concluded, opponent testimony began with Bonnie Omdahl, a retired physician who specialized in radiology who represented the anti-marijuana group Protecting South Dakota Kids.
Omdahl began her testimony by lecturing the committee on their responsibility. “This is a heavy burden for the South Dakota Legislature — this is a serious burden because for this particular drug you are what stands between South Dakotans and safety,” she said, arguing that the legislature is taking the role of the FDA if they expand access to medical marijuana.
While she was speaking in opposition to the bill, Omdahl said she does like one aspect of it; “that is change the process back to the legislature,” she said, adding that she believes the legislature will be more rigorous than the Department of Health, and that the review of the issue will be shorter than if the DOH was responsible.
Omdahl took issues with glaucoma and PTSD being included in the bill, due to effective alternatives to treating glaucoma, and the VA’s recommendation against treating PSTD with cannabis.
Possible side-effects were also a focus of Omdahl, who claimed that when she was still practicing she saw a significant number of patients with a condition called Cannabinoid Hyperemesis (CH) causing “violent, very painful vomiting — they call it scromiting,” she said. “I saw a lot of it.”
According to multiple sources such as the Cleveland Clinic, National Institute of Heath (NIH) and Cedars-Sinai, CH is a rare condition. Cleveland Clinic also notes that the cause of the condition is unknown, and that some researchers believe that genetics may play a role.
The NIH also notes that before selecting CH as a diagnosis, it is important to also rule out a number of conditions that have similar symptoms, including:
- Gastrointestinal reflux disease (GERD)
- Peptic ulcer disease (PUD)
- Sigmoid volvulus
- Biliary colic
- Urinary tract infection
- Ectopic pregnance
- Ovarian torsion
“I saw a lot of it,” claimed Omdahl.
About 11 minutes into Omdahl’s testimony, she was reminded by the committee that only about ten minutes remained for opposition testimony, and that others were still waiting to speak.
Omdahl continued, listing off general risks of heart attack and stroke for cannabis users, and claimed that she personally saw episodes of acute psychosis in young people when she was practicing.
Following an anecdotal account of treating a child for psychosis she claims was caused by cannabis, the committee chair again interjected, asking Omdahl to remain on topic.
Omdahl closed out her testimony, leaving approximately seven minutes for others to speak in opposition to the bill.
Next to speak was Justin Schweitzer, a Sioux Falls Optometrist specializing in the study of glaucoma. Schweitzer objected to the use of cannabis to treat glaucoma, on the grounds that it is not an ideal method.
“In order to reduce interocular pressure with something like medical marijuana, it would take roughly 18 to 20 milligrams of cannabis six to eight times a day to control the pressure,” Schweitzer said, noting effective alternative treatments such as eyedrops, laser treatments and surgical procedures which work well and are longer lasting.
Overall, Schweitzer, who spoke for only about two minutes, only seemed concerned with glaucoma’s addition to the bill, and asked that it specifically be removed.
The final opponent to testify was April Anderson with South Dakota Citizens for Liberty, a conservative group which shares conspiracies on its Facebook page.
Anderson objected to the bill on the grounds that Murphy had previously claimed that seven of the conditions to be added were already covered under law. “Why would we add more, why add things to the bill that it’s already taken care of,” said Anderson.
PTSD was the focus for Anderson, who described herself as a ‘mental health person.’ She said that there are already four drugs derived from marijuana that are approved by the FDA, and asked if medical marijuana laws are a good way to provide medicine for serious medical conditions.
Following opponent testimony, Tobin gave a rebuttal. “The people decided that they wanted access to medical marijuana,” she said. “We have eight conditions that other states have also used.”
Tobin also reiterated that the MMOC includes a pharmacist, a doctor and public safety individuals, all of whom recommended the bill. As to the issue of PTSD, she noted a large population of veterans who have asked for access to marijuana.
“In the end, the decision is up to the doctor or provider,” Tobin said. “They are the one that is closest to the patient.”
Following rebuttal, members of the committee asked questions.
Sen. Michael Rohl (R-Aberdeen) asked Schweitzer, the optometrist, if there is anything in the bill that would require her to recommend marijuana to a patient with glaucoma.
“No, I still have the choice as the doctor,” said Schweitzer .
In committee discussion, Sen. Julie Frye-Mueller (R-Rapid City) spoke first, thanking those who testified and announcing she would vote against the bill, saying she felt the testimony from the opponents was more in-depth than that from the proponents.
Tobin spoke next, invoking the image of the patients in need of medical marijuana. “We can’t create law that blocks everyone just to block the bad actors. We have to create law that provides access to those that need it.”
Rohl next moved do-pass on the bill, which was seconded by Sen. Tim Reed (R-Brookings).
Rohl, commenting on the motion expressed his support of the bill, noting that it gives doctors the opportunity to recommend medical marijuana, but does not require them to do so.
Reed followed this up, praising the process of the bill through the MMOC.
The last person to speak on the bill before voting began was Sen. Michael Diedrich (R-Rapid City), who held up the unsettled science of medical marijuana.
“I think the physicians who will be looking at recommending medical cannabis are going to understand the science that they research related to the conditions they specialize in, and they’re going to know their patient better than anyone. I think that’s really where the decision should be made,” Diedrich said.
The bill passed on a vote of 6-1. Frye-Mueller was the only senator in opposition, and the bill moved to the Senate floor.