The CTR newsletter is distributed to physicians with an active CTR and provides important updates for the Ohio Medical Marijuana Control Program. 

The State Medical Board of Ohio approved 15 new certificate to recommend medical marijuana (CTR) applications in September bringing the total number of active certified physicians to 575.

Petitions for Qualifying Conditions 

The State Medical Board of Ohio established Nov. 1, 2019 – Dec. 31, 2019 as the second submission period for petitions to add a qualifying medical condition to the Medical Marijuana Control Program. No petition will be accepted before Nov.1. Once the submission period has opened, petitions can be filed electronically through the State’s website, medicalmarijuana.ohio.gov. A petition needs to include (per Ohio Administrative Code 4731-32-05):

• The name and contact information
• Specific disease or condition requested to be added
• Information from experts who specialize in the study of the disease or condition
• Relevant medical or scientific evidence
• Consideration of whether conventional medical therapies are insufficient to treat or alleviate the disease or condition
• Evidence supporting the use of medical marijuana to treat or alleviate the disease or condition and other types of medical or scientific documentation
• Letters of support provided by physicians

Renewing Recommendations 
Patient & Caregivers

Registrations in the Patient & Caregiver Registry are valid until the expiration date found on the Registry card. Patients and caregivers will renew their registrations in the same fashion they activated their original registrations: by submitting payment information in the Registry. Once a physician issues a recommendation to a patient within 90 days of the patient’s registration expiring, the patient will see a button labeled “Renew Registration” on their Registry profile. By clicking that button, they can renew their registration by submitting payment information once again. Please refer to this guidance document for any questions on registrant renewals.

Physicians

For physicians, the process of renewing a recommendation adds an extra step beyond the typical issuance of a recommendation. When renewing a patient’s recommendation, physicians will be asked to complete a recommendation renewal survey with information provided by the patient. Please refer to this guidance document on recommendation renewal for more information.

As a reminder, the Board of Pharmacy can answer questions regarding the process of issuing or renewing recommendations, but for questions related to standard of care requirements, please contact the Medical Board.

Reminder About Medical Marijuana Product Ingredients

Tinctures are an approved form of administration within the MMCP. While tinctures may include alcohol, they are not intended to be consumed as a beverage. If, in your medical opinion, your patient should not consume medical marijuana products containing alcohol, please specify as such in the instructions for use section of the recommendation.

Available Products Update

To help inform physicians choosing to include instructions for use, the types of products currently available through the Medical Marijuana Control Program are listed below. This list of products is expected to grow as the program continues to mature.

Vaping

State and local public health officials in Ohio have confirmed 21 cases of vaping-related severe pulmonary illness and are investigating an additional 19 reports of illness among patients experiencing serious respiratory symptoms following e-cigarette or vaping product use. The Ohio Department of Health (ODH) is now requiring health care providers to report suspected cases of severe pulmonary disease of unclear etiology with a history of vaping in the past 90 days. The cases are to be reported to the patient’s local health department by the end of the next business day.

Under current law vaporizing is a permitted method of using medical marijuana. However, the Centers for Disease Control and Prevention (CDC) has recommended that individuals “consider refraining from using e-cigarette, or vaping products, particularly those containing THC.”

The Medical Marijuana Control Program will continue to work with the Ohio Department of Health and monitor CDC efforts to understand the causes of vaping illnesses. In the coming weeks, changes may be made to MMCP requirements including the prohibition of ingredients or products found to be toxic and unsafe for human consumption. The Ohio Department of Commerce is also encouraging its licensed processors to produce alternative medical marijuana products that would not be consumed through vaping.

Senate bill 57 legalized hemp in the state of Ohio. Now physicians, PAs and massage therapists may apply CBD oil as a topical treatment within their scope of practice as long it contains less than 0.3% THC. It is now legal to cultivate and process CBD products in Ohio and for products to be sold outside of a licensed dispensary.

The Ohio Department of Agriculture will be testing all CBD products for safety and accurate labeling to protect Ohio consumers. If you have questions about selling CBD in your practice, contact the Ohio Department of Agriculture.