Nearly every state that legally recognizes medical cannabis also maintains a list of qualifying conditions for which cannabis treatment is appropriate. Nearly all of those lists include terminal illness. Moreover, state laws tend to define terminal illness very narrowly.
Take Utah, for instance. Deseret Wellness, a Provo medical cannabis dispensary, says that the law in their state defines terminal illness as an incurable and fatal illness with a life expectancy of six months or less. Any patient expected to live six months or longer cannot get a medical cannabis card based solely on a determination of terminal illness.
Such a narrow definition may seem cold and heartless, especially if doctors are dealing with a patient whose terminal illness might not result in death for 10 to 12 months. Nonetheless, state lawmakers have no other choice but to come up with a narrow definition if they hope to minimize abuse.
Anything Could Be Terminal
Generally speaking, a terminal illness is defined as any illness with no known cure that normally results in the death of the patient. The reason medical science does not put a time limit on terminal illness is the simple fact that not all such illnesses lead to death within six months. People with some types of terminal illnesses can live well beyond the six-month point – even years in some cases.
This is not an issue where treatment and quality of life are concerned. But it is an issue for state lawmakers attempting to write medical cannabis regulations. Why? Because any incurable illness could be considered terminal without imposition of a hard and fast time limit. That would open the door to abusing a medical cannabis program.
Indeed, the majority of state medical cannabis programs are already in danger of abuse due to chronic pain being a qualifying condition. The thing about chronic pain is that it is extremely difficult to quantify. Leaving lawmakers out of it for just a minute, even doctors cannot truly know how much pain a patient is experiencing or for how long that pain has lingered. They can only trust patient reports.
Pain Is an Open Door
As uncomfortable as it might be to think about, chronic pain is an open door to medical cannabis misuse. A patient looking to get a medical cannabis card can talk to their doctor about chronic pain, whether or not they are actually experiencing it. The doctor has no way of verifying the patient’s claims other than trusting what they report.
Is it reasonable to assume that some patients claim chronic pain that doesn’t exist? Absolutely. This is not to say that every patient who claims chronic pain to use medical cannabis is lying. Rather, it is to suggest that the chronic pain qualification makes it easy to do so.
Along those same lines, not providing a hard and fast definition of terminal illness opens the door to doctors recommending medical cannabis even though a patient’s condition may not suggest imminent death. Lawmakers doing their best to avoid program abuse have to acknowledge as much and craft laws accordingly.
Different Definitions Exist
The icing on this whole cake is the existence of different definitions of terminal illness. States with medical cannabis programs define terminal illness differently. But beyond that, individual states may have different definitions based on what laws are intended to regulate. It may be six months for medical cannabis but 10 months for something else.
Clearly defining terminal illness is a necessary part of implementing medical cannabis laws. It may not be popular among patients, but lawmakers have very little choice.