BOSTON (AP) - Massachusetts public health officials approved final regulations Wednesday for the use of medical marijuana, paving the way for the voter-approved law to take effect.
Still, it will likely be at least several more months before the first marijuana dispensaries open in the state.
In November, Massachusetts became the 18th state to legalize marijuana for medical conditions, including cancer, Parkinson's disease and HIV. The law also allows the state to license up to 35 dispensaries to provide marijuana for patients who have been certified by their physicians.
But the ballot question that was approved by nearly two-thirds of Massachusetts voters provided only a framework for the program, leaving it up to state health officials to develop specific rules and procedures.
The 52 pages of regulations that were approved unanimously by the state Public Health Council will allow patients approved for medical marijuana to receive up to 10 ounces as a 60-day supply, though some acutely ill patients could receive more with permission from their doctors.
In addition to the medical conditions specified in the law, officials agreed to let doctors use discretion in recommending medical marijuana for other, unspecified conditions that are considered "debilitating" in nature.
"We wanted to make sure that our ballot measure was implemented in a way that allowed folks who needed it to get the marijuana, but was very clear that folks who didn't need it, shouldn't," said Dr. Lauren Smith, interim commissioner of the Department of Public Health.
Massachusetts carefully reviewed other medical marijuana programs in the U.S., Smith said, to avoid copying states where people are sometimes certified for marijuana by doctors they barely know and with little examination to determine if the treatment is warranted. To that end, the rules require that a "bona fide" doctor-patient relationship exist before a doctor can recommend marijuana for a patient.
Before approving the final regulations, the council changed the official title of the dispensaries from medical marijuana treatment centers to "registered marijuana dispensaries." The change, while largely symbolic, reflected the view of some doctors on the panel that marijuana has never been proven to be a medical treatment.
"Marijuana is a lot of things, but it is not medical in its nature, to my knowledge," said Dr. John Cunningham of the University of Massachusetts-Amherst, who proposed the change in wording.
The regulations call for operators of marijuana dispensaries to test for contaminants including pesticides, mold and mildew, to ensure safety of the drug. The testing must be done by independent, third-party labs with no financial connection to the dispensary, and lab technicians would be given special permission to legally possess marijuana at their facilities.
Patients registered under the medical marijuana program would obtain their 60-day supply of the drug from one of the licensed, nonprofit treatment centers, but the rules also allow - in narrow hardship cases - for patients to cultivate the drug at their home if circumstances prevent them from getting marijuana from a treatment center.
The final rules loosened rules for medical marijuana for youth.
Children under 18 who have conditions likely to be fatal within two years would be eligible for medical marijuana, a change from an earlier recommendation that defined a "life-limiting" illness as six months. Also added was an override provision in which two physicians could certify a child with a debilitating, though not necessarily terminal condition for medical marijuana.
The Massachusetts Medical Society criticized the new provision, citing scientific studies that showed marijuana had "toxic effects on the still-developing brains of young people."
One regulation adopted would ban the sale of any marijuana product that is packaged to look like candy.
The new rules officially go into effect on May 24, but Smith said that because of the rigorous application and licensing procedures involved, it was likely the first dispensaries would not begin operating before the end of the year. The law allows some patients to grow their own supply of marijuana during the interim period.
Some operators could also face obstacles to establishing facilities in local communities.
Attorney General Martha Coakley has ruled that while towns cannot explicitly bar medical marijuana treatment centers from being established within their borders, they can impose zoning restrictions on the dispensaries.