Colorado's House chambers. (Andy Cross, Denver Post file)

Colorado PTSD marijuana bill advances with House amendments focused on children

Lawmakers add stipulations that would require additional physician clearance for patients under 18

Colorado doctors should be allowed to recommend medical marijuana in treating PTSD symptoms of adults, but there should be additional guardrails when it comes to children, state lawmakers decided Thursday.

An amended Senate Bill 17, which would add post-traumatic stress disorder to Colorado’s list of qualifying conditions for medical marijuana, passed a second reading Thursday in the state House.

“On this auspicious day, we’ve got a serious bill,” bill co-sponsor Sen. Jonathan Singer, D-Longmont, said, with a nod to the 4/20 marijuana holiday. “We know that there is no medical cure for post-traumatic stress disorder. Therapy, medication, exercise, diet — there’s no silver bullet. We also know in the state of Colorado, we have one of the highest suicide rates in the nation.”

Military veterans often have served as the primary faces of this bill and past efforts to add PTSD as a qualifying condition. On Thursday, the topic of children took center stage.

A consistent sticking point throughout SB 17’s brief lifespan has been language that allows medical marijuana to be recommended for minors under 18 who have been diagnosed with PTSD.

Prior to Thursday’s second reading, the bill’s sponsors had met with concerned parties, notably state organizations representing psychiatrists, pediatricians and physicians, to craft an amendment that would serve as a compromise: The provision adds stipulations that one of the two recommending physicians required for such patients needs to be a pediatrician, board-certified family physician or board-certified child and adolescent psychiatrist who is part of the family’s medical care team.

A counter amendment proposed Thursday would have scrapped bill language allowing recommendations for minors.

Rep. Timothy Leonard, R-Evergreen, who sponsored the latter amendment, expressed concerns about the effects of marijuana on a developing brain.

Earlier this year, the American Academy of Pediatrics warned against medical and recreational marijuana use for children. The National Academies of Sciences, Engineering and Medicine, in its comprehensive assessment of 10,000 marijuana studies on health benefits and risks, called for more research on the impact of cannabis on the developing brain and a host of other areas.

“Let’s not have that experiment on children,” Leonard said Thursday.

Leonard’s amendment ultimately failed and the bill now awaits a vote by the House. If approved, it would return to the Senate for final approval.

Leonard’s concerns about research were echoed earlier this week by Dr. Jennifer Hagman, a Children’s Hospital psychologist and member of the Colorado Psychiatric Association, who spoke with The Cannabist as the bill awaited its second reading.

“I think there are a lot of really good questions out there, but, unfortunately, really no good answers,” she said. “I think it comes down to just not having reliable studies.”

The conversation about medical cannabis is evolving in Colorado, Hagman said, adding that she’s optimistic for research to advance as well. She noted a provision of the recently introduced Senate Bill 275, which could allow for some marijuana grown and sold in Colorado to be utilized for medical research.

Since Colorado implemented its medical marijuana law in 2001, no new qualifying conditions have been added to the original list of eight: cancer, glaucoma, HIV/AIDS, cachexia, persistent muscle spasms, seizures, severe nausea and severe pain.

The Colorado Board of Health has denied multiple petition requests to place conditions such as PTSD on that list and previous bills to include PTSD have failed. A legal petition to add PTSD as a qualifying condition that was denied in 2015 currently is before the Colorado Court of Appeals.

To this point, SB 17 has experienced relatively smooth sailing.

It cleared the Senate’s State, Veterans and Military Affairs Committee with a unanimous vote. Days later, the GOP-controlled Senate advanced the bill 34-1. Last month, the House’s State, Veterans and Military Affairs committee voted 8-1 to get the bill to the House floor.

Among the amendments the bill has gained along the way:

  • The patient’s PTSD diagnosis needs to come from a licensed mental health professional.
  • The patient must have a “bona fide physician-patient relationship” that includes a full assessment of the patient’s medical history and appropriate physical examination.
  • Patients under 18 need to have received diagnoses of PTSD from two physicians, with at least one of those doctors explaining the potential risks and benefits to each of the patient’s parents, if they are living in Colorado.
  • Parents who reside in Colorado need to consent in writing to the state health department to permit the use of medical marijuana and one parent would additionally consent in writing to serve as the primary caregiver.