MONTGOMERY — The Alabama Senate on Thursday evening passed an 86-page bill that would legalize medical cannabis, i.e. medical marijuana, in the state. However, passage in the upper chamber was not a simple process, just as the legislation itself is complex and laden with little-known details.

The Senate ultimately passed SB 165 as substituted on the floor and then subsequently amended on the floor 10 times. The vote on passage was 22-11. The respective votes on the various amendments, including additional ones that failed, can be found here.

The legislation will now go to the House to consider after the legislature gets back from its spring break on March 31.

The version of the bill that will first go to a House committee for consideration, and more possible changes, stipulates that medical marijuana can be used by “registered qualified patients” only in certain forms.

The allowed forms of use are:

1. Oral tablet, capsule, or tincture.
2. Gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or rectangular cuboid shape.
3. Gel, oil, cream, or other topical preparation.
4. Suppository.
5. Transdermal patch.
6. Nebulizer.
7. Liquid or oil for administration using an inhaler.

The legislation explicitly does not allow the use of medical marijuana via, “Raw plant material … Any product administered by smoking, combustion, or vaping … [or] A food product that has medical cannabis baked, mixed, or otherwise infused into the product, such as cookies or candies.”

It is also important to note the definition of a “registered qualified patient” under the legislation:

Either of the following:
a. An adult who meets the requirements described in subsection (a) of Section 20-2A-30 and is authorized to acquire, possess, and use medical cannabis pursuant to this chapter.
b. A minor who meets the requirements described in subsection (b) of Section 20-2A-30 and is authorized to use medical cannabis pursuant to this chapter with the assistance of a registered caregiver.

The section quoted above further explains that a “registered qualified patient” allowed to “purchase, possess, or use medical cannabis” must be:

(1) A resident of this state who is 19 years of age or older is a registered qualified patient if he or she meets all of the following conditions:
a. Has been certified by a registered certifying physician as having a qualifying medical condition.
b. Is registered with the commission.
c. Has been issued a valid medical cannabis card by the commission.

Or, for patients able to “use medical cannabis but… not purchase or possess medical cannabis,” the requirements are as follows:

(1) A resident of this state who is under the age of 19 is a registered qualified patient if he or she meets all of the following conditions:
a. Has been certified by a registered certifying physician as having a qualifying medical condition.
b. Is registered with the commission.
c. Has a qualified designated caregiver who is the patient’s parent or legal guardian.

Both of those definitions beg the question: “What exactly is ‘a qualifying medical condition?’”

Well, those are spelled out one by one in the legislation. However, some of the terms certainly leave wiggle-room for doctors to decide what qualifies and what does not.

The legislation states, “Any of the following conditions or symptoms of conditions, but only after documentation indicates that conventional medical treatment or therapy has failed unless current medical treatment indicates that use of medical cannabis is the standard of care,” constitutes a “qualifying medical condition.”

List of “qualifying medical conditions” as follows:

a. Anxiety or panic disorder.
b. Autism Spectrum Disorder (ASD).
c. Cancer-related cachexia, nausea or vomiting, weight loss, or chronic pain.
d. Crohn’s Disease.
e. Epilepsy or a condition causing seizures.
f. Fibromyalgia.
g. HIV/AIDS-related nausea or weight loss.
h. Persistent nausea that is not significantly responsive to traditional treatment, except for nausea related to pregnancy, cannabis-induced cyclical vomiting syndrome, or cannabinoid hyperemesis syndrome.
i. Post Traumatic Stress Disorder (PTSD).
j. Sleep disorders.
k. Spasticity associated with a motor neuron disease, including Amyotrophic Lateral Sclerosis.
l. Spasticity associated with Multiple Sclerosis or a spinal cord injury.
m. A terminal illness.
n. Tourette’s Syndrome.
o. A condition causing chronic or intractable pain in which conventional therapeutic intervention and opiate
therapy is contraindicated or has proved ineffective.
p. Menopause or premenstrual syndrome.

The last line, “Menopause or premenstrual syndrome,” was tacked on through a floor amendment by State Sen. Vivian Davis-Figures (D-Mobile). The vote on that amendment was 18-10.

Sean Ross is the editor of Yellowhammer News. You can follow him on Twitter @sean_yhn