Framing Questions for the Migraines Policy

Summary

The proposed policy suggests adding chronic and complex migraines to the Texas Compassionate-Use Act for low-THC cannabis prescriptions as it was done regarding numerous other healthcare problems.

What is the policy lever—is it legislative, administrative, regulatory, or other?

The proposed policy is legislative as it requires enactment through a law-making process by

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a governing body. The process consists of evaluating, amending, and voting on a legislature (Legal Information Institute, n.d.). If the majority supports adding low-THC cannabis to the allowed treatments of migraines in Texas, the proposed policy becomes a legal regulation.

What level of government or institution will implement it?

The legislative and executive branches of the government will implement the proposed policy. The Department of Public Safety of the State would accept and approve the program and issue or renew the practice licenses for the qualified specialists (Texas State Law Library, n.d.). They would also control the procedures for the safe practice of the newly implemented policy.

How does the policy work/operate? (e.g., is it mandatory? Will enforcement be necessary? How is it funded? Who is responsible for administering the policy?)

Texas Department of Public Safety regulates and operates the Compassionate-Use Registry of Texas (CURT) for low-THC cannabis (Texas State Law Library, n.d.). Doctors have to be board certified by the American Board of Medical Specialties or the Bureau of Osteopathic Specialists (Ritter Spencer PLLC, 2020). The program is funded by the state government of Texas.

What are the objectives of the policy?

The policy’s main objective is an expansion of the list of qualifying conditions under the Texas Compassionate Use Act for low-THC cannabis to include chronic and complex migraines. Qualified medical specialists of Texas should be able to help the patients with the mentioned conditions if the proposed treatment is a reasonable option.

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What is the legal landscape surrounding the policy (e.g., court rulings, constitutionality)?

In June 2015, Texas Governor Abbot signed Senate Bill 339, the Texas Compassionate Use Act which legalized low-THC cannabis usage for intractable epilepsy. In June 2019, the House passed Bill 3703 which included over a hundred medical conditions that qualified for the described treatment. Six months later, a list of incurable neurodegeneration diseases was added to the allowed usage of cannabis (Longhorn Law, 2020). This suggests that further expansion of the Texas Compassionate Use Act is possible.

What is the historical context (e.g., has the policy been debated previously)?

The last debate that involved discussing the usage of medical cannabis for chronic pain happened in June 2019. Later, more medical conditions were added to the legal list, but migraines were not included (Sechler, 2019).

What are the experiences of other jurisdictions?

Several other states have successfully implemented the Comprehensive Medical Cannabis program (National Conference of State Legislatures, 2021). None of the states have canceled or shortened the established expansion regarding the use of medical cannabis.

What is the value-added of the policy?

Making cannabis legal for migraine treatment could help chronic headache sufferers lead a more comfortable life. The productivity of related individuals is likely to increase as well since they would control the migraines better.

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What are the expected short, intermediate, and long-term outcomes?

Complex migraines mimic seizure-like episodes by causing tightening of the muscles in the body, loss of consciousness, and, possibly, neurological defects in the brain and nervous system. Some patients are on disability due to the unpredictability of the episodes. They could experience immediate relief from cannabis therapy (Gibson et al., 2020). This effect could be followed by an increased quality of life over several weeks and significant productivity and creativity growth as a long-term outcome.

What might be the unintended positive and negative consequences of the policy?

The unintended positive effect of adding this diagnosis to the Texas registry list for the Compassionate Use Act is that several other debilitating conditions that decrease patients’ quality of life where cannabis has proven effective can be considered due to the precedence set. The unintended negative effect could be the misuse of cannabis as prescribed by the registered physician.

References

Gibson, L. P., Hitchcock, L. N., Bryan, A. D., & Bidwell, L. C. (2020). Experience of migraine, its severity, and perceived efficacy of treatments among cannabis users. Complementary therapies in medicine, 56, 1-6. Web.

Legal Information Institute. (n.d.). Legislation. Cornell Law School. Web.

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Longhorn Law. (2020). Cannabis and the Texas Compassionate Use Act. Web.

National Conference of State Legislatures. (2021). State medical marijuana laws. Web.

Texas State Law Library. (n.d.). Texas’s Compassionate-Use program. Web.

Ritter Spencer PLLC. (2020). Understanding Texas’s Compassionate-Use program. Web.

Sechler, B. (2019). Texas Senate votes to ease medical cannabis restrictions. Statesman. Web.

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