Citing a federal prohibition against marijuana, Saint Francis Healthcare System says it will not allow its affiliated physicians to become certified to prescribe medical cannabis.

Meanwhile, SoutheastHEALTH is exploring the issue as health care providers across the state grapple with conflicting state and federal laws.

The Southeast Missourian reached out to both Cape Girardeau hospital systems to inquire about their medical marijuana positions.

Dr. Thomas Diemer, chief medical officer at Saint Francis, issued a statement saying while the state will allow physicians to recommend marijuana for medical purposes to patients with qualified illnesses and medical conditions and Missouri Department of Health and Senior Services provides a physician certification form for this purpose, “marijuana is still illegal” under federal law.

“Many questions remain about the use of marijuana as a medication,” he said. “Saint Francis Healthcare System is therefore developing a policy in which Saint Francis Medical Partner Physicians will decline to participate in the medical marijuana physician certification process.”

The Missouri Hospitals Association has warned that hospitals and their affiliated physicians could face federal sanctions and risk their status as Medicare and Medicaid participating providers if they prescribe or administer cannabis products once they become legal in Missouri in 2020.

The lack of prescribing physicians could play a major role in the availability of medical marijuana in the Cape Girardeau region, as many primary care physicians and specialists are affiliated with either Southeast or Saint Francis.

But while proposed Saint Francis policy would prohibit its providers from certifying patients or prescribing medical marijuana, SoutheastHEALTH said it is still “exploring” the subject.

According to a statement from SoutheastHEALTH, its affiliated physicians “understand the medical and scientific research on the benefits and risks of cannabis products as part of medical treatment similar to the same discretion on all pharmacology treatments.”

The statement added, however, “it is too early to make a final position” on whether to participate in the prescription process.

“We are in the initial stages of engagement with the medical staff and exploration of the regulatory and prescriber requirements and its legal impact of those decisions,” said Dr. Gabe Soto, interim chief medical officer at Southeast.

Missourians voted in November to legalize the cultivation, production, distribution and use of medical marijuana. Since that time, the Missouri Department of Health and Senior Services (DHSS) has been drafting rules and regulations for qualifying patients to use medical marijuana and for certifying physicians to prescribe it.

Missouri is the 33rd state to approve the use of medical marijuana for use by people with certain “qualifying conditions,” including, but not limited to, cancer, epilepsy, glaucoma, migraines that are unresponsive to other treatments, any terminal illness and numerous other conditions and symptoms that, in the opinion of a certified physician, qualifies a patient for a medical marijuana prescription.

But while the majority of states now allow the use of medical and/or recreational marijuana, it is still illegal and considered a “Schedule 1 controlled substance drug” under federal law and viewed by the federal government as having a high potential for abuse with no legitimate medical use.

In addition to risking federal funding by certifying patients and prescribing medical marijuana for their use, industry experts say physicians and health care providers could be subject to federal sanctions by the U.S. Drug Enforcement Administration or found to be in violation of the federal Controlled Substances Act.

Statewide input

Although the Missouri Hospital Association has neither endorsed nor discouraged the certifying, prescribing and administering of medical marijuana by its member institutions, MHA has posted a medical marijuana “tool kit” on its website with policy templates and suggested guidelines on how to deal with the subject. Those guidelines and policies not only deal with provider certifications and patient prescriptions, but also whether hospital patients with valid prescriptions can use the medical marijuana while they are under hospital care.

“Regardless of an institution’s legal or medicinal stance on marijuana, numerous existing policies will be affected by the prohibition or approval of marijuana consumption within the facility, and new policies may be needed to implement the hospital’s decision,” according to a statement on the MHA’s website.

Meanwhile, the Missouri State Medical Association has called for the federal government to decriminalize medical marijuana.

“MSMA believes there is evidence that suggests marijuana and its related derivatives may have therapeutic benefits for patients with certain medical conditions,” according to a statement on the association’s website. “As such, MSMA calls on the Food & Drug Administration and the Drug Enforcement Administration to promptly revise marijuana’s current classification as a Schedule 1 controlled substance in order to facilitate evidence-based, scientifically valid clinical research to evaluate its efficacy and safety.”

Local ordinances

The Jackson Board of Aldermen will hold a public hearing at 6 p.m. Monday on a proposed zoning ordinance dealing with any future businesses that will cultivate, process, test and/or distribute medical marijuana within Jackson city limits.

The Cape Girardeau City Council is expected to give final approval to a medical marijuana zoning ordinance at its meeting Monday night.

For additional information, visit the Missouri State Medical Association’s web pages on medical marijuana at www.msma.org/medical-marijuana.html and the Missouri Hospital Association’s medical marijuana links at https://web.mhanet.com/medical-marijuana.aspx.