{"id":30553,"date":"2018-07-26T15:48:20","date_gmt":"2018-07-26T20:48:20","guid":{"rendered":"http:\/\/stateimpact.npr.org\/oklahoma\/?p=30553"},"modified":"2018-07-26T15:54:42","modified_gmt":"2018-07-26T20:54:42","slug":"oklahoma-could-become-the-only-state-to-require-pregnancy-tests-for-medical-marijuana","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/oklahoma\/2018\/07\/26\/oklahoma-could-become-the-only-state-to-require-pregnancy-tests-for-medical-marijuana\/","title":{"rendered":"Oklahoma could become the only state to require pregnancy tests for medical marijuana"},"content":{"rendered":"<div id=\"attachment_30555\"  class=\"wp-caption module image aligncenter\" style=\"max-width: 1920px;\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-30555 size-large\" src=\"https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-1920x1440.jpg\" alt=\"\" width=\"1920\" height=\"1440\" srcset=\"https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-1920x1440.jpg 1920w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-500x375.jpg 500w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-768x576.jpg 768w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-150x113.jpg 150w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-300x225.jpg 300w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-620x465.jpg 620w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-1440x1080.jpg 1440w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-1832x1374.jpg 1832w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-1376x1032.jpg 1376w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-1044x783.jpg 1044w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-632x474.jpg 632w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/07\/IMG_0251-536x402.jpg 536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<p class=\"wp-media-credit\">Jackie Fortier \/ StateImpact Oklahoma<\/p>\n<p class=\"wp-caption-text\">Christina Juris Bennett, a public health law assistant professor at the University of Oklahoma.<\/p>\n<\/div><p>Avery Huckabee is looking over the menu at the Earth Cafe in Norman with her friends. With the passage of State Question 788 in June, which <a href=\"https:\/\/oklahomawatch.org\/2018\/06\/27\/mapping-the-medical-marijuana-vote-by-county\/\">legalized medical marijuana\u00a0<\/a>in Oklahoma, the high school senior is looking forward to talking to her doctor about getting a license.<\/p><p><iframe loading=\"lazy\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/477103776&color=%23ff5500&auto_play=false&hide_related=true&show_comments=false&show_user=true&show_reposts=false&show_teaser=false&visual=false\" width=\"100%\" height=\"150\" frameborder=\"no\" scrolling=\"no\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p><p>\u201cI have really bad anxiety,\u201d Huckabee said. \u201cI\u2019ve been taking CBD oil and it\u2019s been known to help. There is no reason not to if it\u2019s available.\u201d<!--more--><\/p><p>Huckabee has followed the news and uproar over contentious, <a href=\"https:\/\/stateimpact.npr.org\/oklahoma\/2018\/07\/11\/fallin-signs-oklahomas-first-medical-marijuana-rules-including-controversial-amendments-pushed-by-health-leaders\/\">last-minute requirements <\/a>added by the state Board of Health to the medical marijuana regulations, but she was unaware the state\u2019s new rules require most women get a pregnancy test before a doctor can recommend medical marijuana.<\/p><p>\u201cThat\u2019s so dumb, that\u2019s all I can say,\u201d she said, laughing. \u201cIt\u2019s just the most Oklahoma thing.\u201d<\/p>\n<h4>Doctor discussions<\/h4><p>Here\u2019s how Oklahoma\u2019s medical marijuana licensing process works: Doctor and patient discuss if medical marijuana is right for the patient. If a doctor thinks it is, a male patient gets a <a href=\"http:\/\/ddeer.publishpath.com\/Websites\/ddeer\/images\/Application%20Information\/OMMA%20-%20Adult%20Patient_Physician%20Recommendation%20Form.pdf\">medical marijuana recommendation<\/a> and moves to the next step of applying for a license with the <a href=\"http:\/\/omma.ok.gov\/\">Oklahoma State Department of Health<\/a>.<\/p><p>The process is different for female patients. Doctors are barred from recommending medical marijuana to women of \u201c<a href=\"http:\/\/omma.ok.gov\/Websites\/ddeer\/images\/MMR%20Draft%2007102018.pdf\">childbearing years<\/a>\u201d without first conducting a pregnancy test. Since licenses last two years, women will have to take \u2014 and likely pay for \u2014 pregnancy tests multiple times.<\/p><p>\u201cIt\u2019s to inform the conversation between the patient and the physician,\u201d said Buffy Heater, director of government and regulatory affairs at the Oklahoma State Department of Health.<\/p><p>Heater is managing the rollout of the state\u2019s medical marijuana program and helped write the regulations. She says the outcome of the pregnancy test doesn\u2019t matter \u2014 even if a patient is pregnant, they can still get a medical marijuana recommendation.<\/p><p>\u201cThere\u2019s not a prohibition in the rules that would prevent a pregnant woman from receiving that medication,\u201d she said. \u201cThat pregnancy test is simply meant to make sure that the physician and the patient are informed of potential pregnancy and have a conversation about potential effects, and then determine that best course forward.\u201d<\/p><p>But <a href=\"http:\/\/publichealth.ouhsc.edu\/FacultyandStaff\/FacultyandStaffContacts\/HealthAdministrationandPolicy\/Bennett.aspx#2860743-contact\">Christina Juris Bennett<\/a>, an assistant public health law professor at the University of Oklahoma, says the state&#8217;s pregnancy test requirement is superfluous.<\/p><p>\u201cIf that\u2019s what you want, then write the rules so that you\u2019re requiring a conversation, or an explanation of risks instead of requiring a pregnancy test,\u201d she said.<\/p><p>The rules don\u2019t define what childbearing age is, which she said could lead to strange consequences. A woman may have to somehow prove to a doctor that she\u2019s stopped menstruating due to menopause, for example, to avoid taking a pregnancy test she knows will be negative.<\/p><p>And, Juris Bennett, asked: What about women who simply can\u2019t be pregnant?<\/p><p>\u201cWhat about the people who are just not having sex? What about the women who are having sex with women? \u00a0What about transgendered people \u2014 what do you do for them?\u201d<\/p><p>Under the current medical marijuana rules, all such women are required to take a pregnancy test. Juris Bennett says the rules also apply different legal standards to medications.<\/p><p>\u201cWhat makes medical marijuana different from opioids, which we do prescribe without a pregnancy test and that we do know there are effects on fetal development,\u201d she says. \u201cThat\u2019s a very reasonable question that maybe the courts would have to decide on.\u201d<\/p>\n<h4>Patients pay the cost<\/h4><p>Urinary pregnancy tests cost between $<a href=\"https:\/\/www.healthcarebluebook.com\/page_ProcedureDetails.aspx?cftId=L1668\">12 and $60 f<\/a>or women without insurance in Oklahoma. Blood tests can cost much more. The state\u2019s rules don\u2019t specify the type of test, leaving it up to the doctor. That cost will likely get passed on to patients, and in some cases, taxpayers.<\/p><p>Women on Soonercare, Oklahoma\u2019s Medicaid program, would have their pregnancy tests covered. Physicians and laboratories would receive the much lower Medicaid reimbursement rate, depending on the test \u00a0\u2014 and Heater says that any increased cost to the Oklahoma Healthcare Authority, which administers Soonercare, was not taken into consideration when the marijuana rules were written.<\/p>\n<h4>Pregnancy and pot<\/h4><p>Adding barriers like pregnancy tests could push some women to turn to the black market for marijuana, said\u00a0<a href=\"https:\/\/www.drugabuse.gov\/about-nida\/organization\/divisions\/division-extramural-research-der\/der-office-director-od\/biography-susan-weiss-phd\">Susan Weiss<\/a>, part of the senior leadership team at the <a href=\"https:\/\/www.drugabuse.gov\/\">National Institute on Drug Abuse<\/a>.<\/p><p>\u201cWe know that if something is very easy to do, people are more likely to do it,\u201d she said. \u201cIf you start adding a cost, if they have to get a blood test, anything that makes it more difficult is also going to keep people from going and getting it through the medical system,\u201d she said.<\/p><p>Weiss supports requiring a conversation between doctors and patients who may become pregnant about marijuana\u2019s <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK425751\/\">effects on fetuses<\/a>. A growing number of <a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2594398\">women in the U.S<\/a>. treat pregnancy nausea and morning sickness with marijuana, and Weiss says there is a misperception that it\u2019s safe.<\/p><p>But the conversation requirement puts doctors in a tough position. They are supposed to counsel patients on the risks, but the science is unclear on exactly what those risks are.<\/p><p>\u201cWe don\u2019t have all the answers, we don\u2019t know exactly what cannabis does during pregnancy, but we know enough to be concerned,\u201d Weiss said. \u201cAnd when you\u2019re talking about someone who is pregnant, you always want to be cautious.\u201d<\/p>\n<h4>Murky future for marijuana rules<\/h4><p>State health officials <a href=\"https:\/\/oag.publishpath.com\/Websites\/oag\/images\/Bates.07.18.2018.pdf\">are reconsidering<\/a>\u00a0controversial amendments to the state\u2019s medical marijuana rules, and state lawmakers are <a href=\"http:\/\/publicradiotulsa.org\/post\/medical-marijuana-working-group-will-meet-until-it-has-something-works\">holding capitol hearings\u00a0<\/a>about future marijuana legislation.<\/p><p>But Christina Juris Bennett, the OU law professor, is concerned that the pregnancy test requirement will stay in place when permanent rulemaking begins.<\/p><p>\u201cAs it\u2019s written right now, it has a lot of issues. I think we\u2019re in danger of building a very vague statement into the final set of rules that we really haven\u2019t analyzed or considered how we\u2019re going to enforce it,\u201d she said.<\/p><p>If it does, Oklahoma could become the only state in the nation that requires most women take a pregnancy test before they can get a medical marijuana recommendation from their doctor, according to multiple marijuana policy experts interviewed by StateImpact. Heater said other states\u2019 medical marijuana regulations were reviewed when OSDH personnel drafted Oklahoma\u2019s regulations, but to her knowledge no other state has a pregnancy test requirement.<\/p><p>Two lawsuits have also been filed challenging the rules \u2014 and the American Civil Liberties Union of Oklahoma has <a href=\"https:\/\/www.acluok.org\/sites\/default\/files\/field_documents\/request_for_recision_of_medical_cannabis_rules_enacted_july_10_2018_.pdf\">promised to fight<\/a> the pregnancy test requirement.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Avery Huckabee is looking over the menu at the Earth Cafe in Norman with her friends. With the passage of State Question 788 in June, which legalized medical marijuana\u00a0in Oklahoma, the high school senior is looking forward to talking to her doctor about getting a license.\ufeff\u201cI have really bad anxiety,\u201d Huckabee said. \u201cI\u2019ve been taking [&hellip;]<\/p>\n","protected":false},"author":199,"featured_media":30554,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[23],"tags":[245,833,920,834,200],"acf":[],"_links":{"self":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts\/30553"}],"collection":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/users\/199"}],"replies":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/comments?post=30553"}],"version-history":[{"count":6,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts\/30553\/revisions"}],"predecessor-version":[{"id":30565,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts\/30553\/revisions\/30565"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/media\/30554"}],"wp:attachment":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/media?parent=30553"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/categories?post=30553"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/tags?post=30553"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}