Last week governor Rauner passed a measure that allowed patients with prescriptions to Opioids to be able to substitute Medical marijuana for them instead. The bill was approved by the state legislature a few months earlier and had bipartisan support.  I hailed the new law as a a step in the right direction for progressive health laws, albeit an incredibly small one. I had in mind that it was a refreshing expansion of the Illinois medical marijuana program which has been one of the most conservatively and ineptly run in the country. I also believed that it was giving people something they wanted, as the majority of Cook County is in favor of legalization and the expansion of the medical marijuana program. Finally, I thought that even though studies were inconclusive about medical marijuanas utility for people addicted to painkillers and that it could not be the major factor in recovery, it could still be a small one and provide people struggling with more access to it and therefore more options. There are a number of issues however with those assumptions that in further thinking about, I thought would be worth a follow up. My biggest concern is more a question that i’m still not sure of the answer to. For people with this Opioid exemption, does being given access to medical marijuana mean that they are not able to get any amount of painkillers? If so, that would be wrong and I would be against that. The medical marijuana exemption should be about providing access and therefore options for a patient who may be struggling with opioid addiction but not a wholesale different treatment plan. Patients on opioids can’t just be forced to stop them cold turkey and then be given medical marijuana like that is the solution. Patients should be able to have both access to the pain meds they need and medical marijuana that may give them an option that can decrease their dependency on those meds. That “instead” is part of the language used in the bill is worrying and something I should’ve picked up upon originally. The very nature of the word substitution should’ve tipped me off that this could be a concern and I mostly ignored it out of laziness. Furthermore, who is allowed to initiate this substitution? If the patients doctor is allowed to look at the patient’s file and determine that they should be given medical marijuana instead of opioids, that would be wrong as well and directly the opposite of putting the people’s voices at the center of health policy. If the patient is the only who can initiate this, then that would be better as it would at least give the person a choice. However, Like I said before, this shouldn’t have to be an either/or. Does a person who is on Opioids who also desires a medical marijuana card and is eligible for it, then have to give up their prescription to opioids? Again, this would be wrong and completely counter to what people have been asking for. It seems like this leaves the possibility for doctors and the state to hold patients opioid access hostage if they desire a medical marijuana card. Those questions need further evaluation and a follow up that I will hopefully provide in the near future.