S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   10001
 
                           I N  A S S E M B L Y
 
                                May 1, 2024
                                ___________
 
 Introduced by M. of A. KELLES -- read once and referred to the Committee
   on Health
 
 AN  ACT  to amend the public health law, in relation to establishing the
   endocannabinoid system awareness program
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  The  public health law is amended by adding a new section
 3309-c to read as follows:
   § 3309-C. ENDOCANNABINOID SYSTEM AWARENESS PROGRAM. 1. THERE IS HEREBY
 ESTABLISHED WITHIN THE DEPARTMENT THE ENDOCANNABINOID  SYSTEM  AWARENESS
 PROGRAM  WHICH  SHALL  EDUCATE  HEALTH  CARE PRACTITIONERS REGARDING THE
 ENDOCANNABINOID SYSTEM AND HOW IT INTERACTS WITH OTHER BODILY SYSTEMS.
   2. THE COMMISSIONER, IN CONSULTATION WITH THE DEPARTMENT OF  EDUCATION
 AND THE OFFICE OF CANNABIS MANAGEMENT, SHALL ESTABLISH STANDARDS, REVIEW
 AND  APPROVE  COURSE WORK OR TRAINING ON THE ENDOCANNABINOID SYSTEM, AND
 PUBLISH INFORMATION RELATED TO SUCH STANDARDS, COURSE WORK  OR  TRAINING
 ON  THE DEPARTMENT'S WEBSITE. THE COMMISSIONER, THE DEPARTMENT OF EDUCA-
 TION AND THE OFFICE OF CANNABIS MANAGEMENT MAY CONSIDER EXISTING  COURSE
 WORK  OR  TRAINING,  INCLUDING  COURSE  WORK  OR TRAINING DEVELOPED BY A
 NATIONALLY RECOGNIZED  HEALTH  CARE  PROFESSIONAL,  SPECIALTY,  PROVIDER
 ASSOCIATION  OR  NATIONALLY RECOGNIZED PAIN MANAGEMENT ASSOCIATION, WHEN
 ESTABLISHING SUCH STANDARDS AND REVIEWING OR APPROVING SUCH COURSE  WORK
 OR TRAINING.
   3.  THE  COMMISSIONER  SHALL SET THE FOLLOWING MINIMUM HOURS OF COURSE
 WORK AND TRAINING REQUIRED TO SATISFACTORILY MEET  THE  CRITERIA  ESTAB-
 LISHED PURSUANT TO SUBDIVISION TWO OF THIS SECTION:
   (A) EVERY PERSON LICENSED UNDER TITLE EIGHT OF THE EDUCATION LAW SHALL
 ON  OR  BEFORE JULY FIRST, TWO THOUSAND TWENTY-FIVE AND ONCE EVERY THREE
 YEARS THEREAFTER, COMPLETE THREE HOURS OF COURSE WORK OR TRAINING ON THE
 ENDOCANNABINOID SYSTEM WHICH HAS BEEN APPROVED BY THE DEPARTMENT.
   (B) EVERY PERSON WHO SHALL RECEIVE A LICENSE ON OR AFTER  JULY  FIRST,
 TWO  THOUSAND  TWENTY-FIVE  UNDER  TITLE EIGHT OF THE EDUCATION LAW, AND
 EVERY MEDICAL RESIDENT, SHALL COMPLETE  SUCH  COURSE  WORK  OR  TRAINING
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD14857-01-4
              

 A. 10001                            2
 
 WITHIN ONE YEAR OF GAINING SUCH STATUS AND ONCE EVERY THREE YEARS THERE-
 AFTER.
   4. THE COMMISSION SHALL CONSIDER THE FOLLOWING COURSE WORK OR TRAINING
 TOPICS  AS  SATISFACTORILY  MEETING  THE  TRAINING STANDARDS ESTABLISHED
 PURSUANT TO SUBDIVISION TWO  OF  THIS  SECTION  AND  SHALL  INCLUDE  THE
 FOLLOWING TOPICS AND ACCOMPANYING SUBTOPICS:
   (A) THE ENDOCANNABINOID SYSTEM, INCLUDING THE FOLLOWING SUBTOPICS:
   (I) THE HISTORY OF TETRAHYDROCANNABINOL (THC) PHARMACOLOGY;
   (II) THE CLINICAL EFFECTS OF THE ENDOCANNABINOID SYSTEM;
   (III) LIMITATIONS OF AVAILABLE RESEARCH ON THE ENDOCANNABINOID SYSTEM;
   (IV)  UNDERSTANDING  HOW  THE  ENDOCANNABINOID  SYSTEM IS DEPENDENT ON
 LIPID-BASED PHARMACOKINETICS AND PHARMACODYNAMICS;
   (V) THE COMPONENTS OF THE ENDOCANNABINOID SYSTEM;
   (VI) SPECIFIC ENZYMES USED BY THE ENDOCANNABINOID SYSTEM;
   (VII) LIGANDS OF THE ENDOCANNABINOID SYSTEM RECEPTORS;
   (VIII) LIGANDS OF THE CB1 AND CB2 RECEPTORS;
   (IX) DYNAMICS OF THE ENDOCANNABINOID SYSTEM RECEPTOR EXPRESSION;
   (X) THE LOCATION AND FUNCTION OF CB1 RECEPTORS, AND HOW SUCH RECEPTORS
 EXPRESS THEMSELVES IN BODILY SYSTEMS;
   (XI) SPECIFIC IMMUNE SYSTEM FUNCTIONS OF THE  ENDOCANNABINOID  SYSTEM;
 AND
   (XII)  SPECIFIC  PHYSIOLOGIC  FUNCTIONS RELATED TO THE ENDOCANNABINOID
 SYSTEM;
   (B) CANNABINOIDS, CHRONIC PAIN AND OPIOIDS,  INCLUDING  THE  FOLLOWING
 SUBTOPICS:
   (I)  COMPARISONS BETWEEN THE EFFICIENCY OF NON-OPIOID AND OPIOID DRUGS
 FOR CHRONIC BACK PAIN;
   (II) THE MAGNITUDE OF THE PRESCRIPTION OPIOID OVERDOSE EPIDEMIC;
   (III) HOW CONCOMITANT USE OF OPIOIDS AND BENZODIAZEPINES HAVE  ADVERSE
 IMPACTS ON HEALTH;
   (IV)  THE  MECHANISMS  BY  WHICH  CANNABINOIDS  IMPACT THE NOCICEPTION
 SYSTEM AND SPASTICITY;
   (V) RECEPTORS INVOLVED WITH CANNABINOID EFFECTS ON PAIN MODULATION;
   (VI) GENERAL SAFETY AND ADVERSE EFFECTS BETWEEN OPIOIDS, NON-STEROIDAL
 ANTI-INFLAMMATORY DRUGS, AND CANNABINOIDS;
   (VII) COMMON CONDITIONS IN WHICH MEDICAL  CANNABIS  SHOULD  BE  RECOM-
 MENDED;
   (VIII) NEGATIVE SIDE EFFECTS OPIOID SPARING HELPS REDUCE;
   (IX) THE ADDITION OF CANNABINOID MEDICATION TO CHRONIC OPIOID THERAPY;
 AND
   (X)  WHICH  FORM OF CANNABIS A PATIENT SHOULD USE WHEN TAPERING FROM A
 SLOW-RELEASE OPIOID;
   (C) PHARMACOGENETICS AND CANNABIS, INCLUDING THE FOLLOWING SUBTOPICS:
   (I) HOW TO IDENTIFY PATIENT ACCESS ISSUES AND  STRATEGIES  ON  HOW  TO
 EXPLAIN PHARMACOGENETICS ARE NO LONGER AS EXPENSIVE;
   (II) DESCRIPTION OF THE VARIATION OF ALLELES;
   (III)  IDENTIFYING  THE  PRINCIPAL  ORGAN RESPONSIBLE FOR METABOLIZING
 MEDICATIONS;
   (IV) THE IMPORTANCE OF HOW THC IS METABOLIZED;
   (V) HOW CANNABINOIDS ACT AS DRUG METABOLIZING ENZYMES;
   (VI) HOW CYTOCHROME P450 (CYP) MONOOXYGENASES ENZYMES INTERACT WITH  A
 COMPREHENSIVE METABOLIC PANEL AND THE LIVER;
   (VII) HOW TO INTERPRET GENOTYPE INFORMATION FOR PATIENT CARE;
   (VIII) THE CLINICAL APPLICATION OF CANNABIS WITH OPIOIDS;
   (IX) WHICH CLINICAL CONDITIONS SUPPORT THE NEED FOR PROPOXYPHENE TEST-
 ING;
 A. 10001                            3
 
   (X) THE POTENTIAL RISK OF CANNABIS DEPENDENCY; AND
   (XI) THE HISTORY OF PSYCHOSIS INDUCED BY THC USE; AND
   (D)  FOOD  AND  DRUG ADMINISTRATION (FDA) APPROVED CANNABINOID MEDICA-
 TIONS, INCLUDING THE FOLLOWING SUBTOPICS:
   (I) IDENTIFYING THE CURRENTLY APPROVED FDA CANNABINOID DRUGS;
   (II) THE HISTORY BEHIND THE FIRST SYNTHETIC THC MEDICATIONS ORIGINALLY
 APPROVED BY THE FDA TO TREAT CLINICAL CONDITIONS;
   (III) THE CLINICAL CONDITIONS FOR WHICH THE  FDA  APPROVED  THE  PLANT
 EXTRACT ISOLATE OF CBD;
   (IV)  THE  TWO  THOUSAND SEVENTEEN REPORT BY THE NATIONAL ACADEMIES OF
 SCIENCES ON THE CLINICAL USE OF CANNABINOIDS;
   (V) PHARMACOKINETICS OF NABILONE AND THC ANALOGUES SUCH AS DRONABINOL;
   (VI) CONDITIONS THAT DRONABINOL HAVE BEEN USED FOR THAT  ARE  NOT  FDA
 APPROVED AND COMMON SIDE EFFECTS; AND
   (VII) EDUCATION ON HOW NABIXIMOLS ARE ADMINISTERED.
   5.  EVERY PERSON LICENSED OR IN THE PROCESS OF BEING LICENSED PURSUANT
 TO SUBDIVISION THREE OF THIS SECTION SHALL ATTEST TO THE DEPARTMENT THAT
 SUCH LICENSED PERSON OR PERSON IN THE PROCESS OF  BEING  LICENSED  SHALL
 HAVE  COMPLETED  THE  NECESSARY COURSE WORK OR TRAINING REQUIRED BY THIS
 SECTION ON A FORM PRESCRIBED BY THE COMMISSIONER.
   6. THE DEPARTMENT SHALL ESTABLISH A PROCEDURE FOR  ALLOWING  LICENSEES
 AN  EXEMPTION  FROM  THE  REQUIREMENTS  OF  THIS SECTION IF ANY LICENSED
 PERSON ESTABLISHES THAT:
   (A) THE LICENSED PERSON OR PERSON IN THE  PROCESS  OF  BEING  LICENSED
 CLEARLY  DEMONSTRATES  TO THE DEPARTMENT'S SATISFACTION THAT THERE WOULD
 BE NO NEED FOR SUCH LICENSED PERSON TO  COMPLETE  SUCH  COURSE  WORK  OR
 TRAINING; OR
   (B)  THE  LICENSED  PERSON  OR PERSON IN THE PROCESS OF BEING LICENSED
 COMPLETED COURSE WORK OR TRAINING DEEMED BY THE DEPARTMENT TO BE  EQUIV-
 ALENT TO THE COURSE WORK OR TRAINING APPROVED BY THE DEPARTMENT PURSUANT
 TO SUBDIVISION TWO OF THIS SECTION.
   7. NOTHING IN THIS SECTION SHALL PRECLUDE SUCH COURSE WORK OR TRAINING
 ABOUT  THE  ENDOCANNABINOID  SYSTEM  FROM COUNTING TOWARD THE CONTINUING
 EDUCATION REQUIREMENTS UNDER TITLE EIGHT OF THE  EDUCATION  LAW  OR  THE
 CONTINUING  REQUIREMENTS OF A NATIONALLY ACCREDITED MEDICAL BOARD TO THE
 EXTENT ACCEPTABLE TO SUCH BOARD.
   § 2. The public health law is amended by adding a new  section  3309-d
 to read as follows:
   §  3309-D.  ENDOCANNABINOID SYSTEM WORK GROUP FOR PUBLIC AWARENESS. 1.
 THE COMMISSIONER OF PUBLIC HEALTH  SHALL  ESTABLISH  AN  ENDOCANNABINOID
 SYSTEM  WORK  GROUP  (REFERRED  TO IN THIS SECTION AS THE "WORK GROUP").
 SUCH WORK GROUP SHALL BE ESTABLISHED NO LATER THAN ONE  YEAR  AFTER  THE
 EFFECTIVE  DATE  OF  THIS  SECTION. SUCH WORK GROUP SHALL BE COMPOSED OF
 EXPERTS WITH SIGNIFICANT KNOWLEDGE AND EXPERTISE RELATED TO THE ENDOCAN-
 NABINOID SYSTEM, AND SHALL INCLUDE, BUT  NOT  BE  LIMITED  TO,  CONSUMER
 ADVISORY  ORGANIZATIONS,  HEALTH  CARE  PRACTITIONERS AND PROVIDERS, AND
 PHARMACISTS AND PHARMACIES. MEMBERS OF SUCH WORK GROUP SHALL RECEIVE  NO
 COMPENSATION  FOR  THEIR  SERVICES  BUT  SHALL BE ALLOWED THE ACTUAL AND
 NECESSARY EXPENSES IN THE PERFORMANCE OF THEIR DUTIES PURSUANT  TO  THIS
 SECTION.
   2.  THE  WORK  GROUP  SHALL  REPORT  TO THE COMMISSIONER REGARDING THE
 DEVELOPMENT OF RECOMMENDATIONS AND MODEL COURSES FOR CONTINUING  MEDICAL
 EDUCATION,  REFRESHER COURSES, AND OTHER TRAINING MATERIALS FOR LICENSED
 HEALTH CARE PROFESSIONALS RELATED  TO  THE  ENDOCANNABINOID  SYSTEM  AND
 CONTINUING  EDUCATION  REQUIREMENTS FOR PHARMACISTS RELATED TO THE ENDO-
 CANNABINOID SYSTEM.  SUCH  RECOMMENDATIONS,  MODEL  COURSES,  AND  OTHER
 A. 10001                            4
 
 TRAINING  MATERIALS  SHALL  BE  SUBMITTED TO THE COMMISSIONER, WHO SHALL
 MAKE SUCH INFORMATION AVAILABLE FOR USE IN MEDICAL EDUCATION,  RESIDENCY
 PROGRAMS,  FELLOWSHIP  PROGRAMS,  AND IN CONTINUING MEDICATION EDUCATION
 PROGRAMS NO LATER THAN JANUARY FIRST, TWO YEARS AFTER THE EFFECTIVE DATE
 OF THIS SECTION.
   3.  NO LATER THAN JANUARY FIRST, TWO YEARS AFTER THE EFFECTIVE DATE OF
 THIS SECTION, THE WORK GROUP SHALL PROVIDE OUTREACH  AND  ASSISTANCE  TO
 HEALTH  CARE  PROFESSIONAL  ORGANIZATIONS  TO  ENCOURAGE  AND FACILITATE
 CONTINUING MEDICAL EDUCATION TRAINING PROGRAMS FOR THEIR MEMBERS RELATED
 TO THE ENDOCANNABINOID SYSTEM.
   4. ON OR BEFORE SEPTEMBER FIRST, ONE YEAR AFTER THE EFFECTIVE DATE  OF
 THIS  SECTION,  THE  COMMISSIONER  OF  HEALTH,  IN CONSULTATION WITH THE
 OFFICE OF CANNABIS MANAGEMENT, THE COMMISSIONER  OF  THE  DEPARTMENT  OF
 EDUCATION,  AND  THE EXECUTIVE SECRETARY OF THE STATE BOARD OF PHARMACY,
 SHALL HAVE THE AUTHORITY TO ADD ADDITIONAL MEMBERS TO THE WORK GROUP  AS
 APPROPRIATE  TO PROVIDE GUIDANCE IN FURTHERANCE OF THE IMPLEMENTATION OF
 THE WORK GROUP'S EFFORTS.
   5. THE WORK GROUP SHALL BE RESPONSIBLE FOR DEVELOPING A PUBLIC  AWARE-
 NESS  CAMPAIGN TO BE PROVIDED TO THE COMMISSIONER OF HEALTH, SUCH PUBLIC
 AWARENESS CAMPAIGN SHALL INCLUDE INFORMATION  AND  RESOURCES  ABOUT  THE
 ENDOCANNABINOID  SYSTEM  AND  BE AVAILABLE ON THE DEPARTMENT OF HEALTH'S
 WEBSITE WITH ACTIVE WEBLINKS TO MATERIALS FOR THE PUBLIC TO ACCESS.
   6. THE COMMISSIONER SHALL HAVE THE POWER TO DIRECT THE WORK  GROUP  TO
 CONSIDER  AND  RESEARCH  ANY  ISSUE ON THE ENDOCANNABINOID SYSTEM DEEMED
 RELEVANT UNDER THEIR DISCRETION.
   7. THE COMMISSIONER SHALL REPORT TO THE GOVERNOR, THE TEMPORARY PRESI-
 DENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY  NO  LATER  THAN  TWO
 YEARS  AFTER  THE EFFECTIVE DATE OF THIS SECTION AND ANNUALLY THEREAFTER
 ON THE WORK GROUP'S FINDINGS  IN  REGARD  TO  ITS  CONTINUING  EDUCATION
 EFFORTS,  THE  STATUS  OF  THE  PUBLIC AWARENESS CAMPAIGN, AND ANY OTHER
 ISSUES DEEMED  RELEVANT  BY  THE  COMMISSIONER  ON  THE  ENDOCANNABINOID
 SYSTEM.
   § 3. This act shall take effect immediately.