This article is republished from?Kentucky Health News, a publication of the?Institute for Rural Journalism and Community Issues?at the?University of Kentucky.

State Senate President Robert Stivers suggested Monday night that he might be willing to approve medical marijuana in Kentucky on a very limited basis, to relieve patients’ pain at the end of their lives. But he cast fresh doubt on whether relief actually comes from cannabis, or rather from expectation that it will.

“I am working with others see how we could get to a ‘yes’ to take care of those who are at the end of life,” Stivers said on KET’s “Kentucky Tonight.” It was the first sign of compromise on the issue from Stivers, who has been the major obstacle to medical-cannabis bills passed by the state House.

“I’ve seen family members go through cancer treatments; in no way do I want to be unsympathetic,” Stivers said as he began discussing the issue. After repeating his desire to see more research on it and making other points, he said the use of cannabis in palliative care can easily be defended under the old “choice of evils” principle of English common law. In such cases, “I don’t think you would ever be arrested; I don’t think you would be convicted,” he said.

A Manchester attorney, Stivers briefly noted without explanation a National Geographic story published online Jan. 6. It cited a study that found “67 percent of the relief from pain reported by people treated with cannabinoids was also seen among those who received a placebo,” Meryl Davids Landau wrote for the magazine. “This suggests that the pain reduction was not due primarily to compounds found in cannabis but to people’s expectations that it would help. And that positive expectation was based in part, say the authors, on over-enthusiastic media coverage. Reputable studies so far have not found that cannabinoids sufficiently reduce pain, which led the International Association for the Study of Pain in 2021 to decline to endorsethese drugs.”

Even as he cast new doubt, Stivers suggested what a medical-cannabis system could look like. He said the state could require names of all owners of cannabis dispensaries to be public, “to prevent abuse,” and have a computer network to monitor cannabis prescriptions and how the drug is ingested, saying marijuana smoke has 50% more carcinogens than tobacco smoke.

Last year, after the Senate again declined to take up a House bill that would have legalized medical marijuana, Stivers pushed through a bill for cannabis research at the University of Kentucky. “There’s indicators out there that certain things are helped,” he said on KET. “Let’s research the issue.”

After last year’s legislative session, Gov. Andy Beshear named a group to study the issue, then used his pardon power in an executive order allowing people with a medical provider’s statement saying they have at least one of 21 specified medical conditions to possess up to eight ounces of cannabis for medical purposes in Kentucky, if bought legally in another state.

Cannabis is not legal in Indiana and Tennessee, and the medical-cannabis laws of Ohio and West Virginia do not apply to out-of-state residents. Missouri and Virginia have passed laws to legalize cannabis for recreational use, but the Missouri law is not expected to take effect until at least February, and Virginia is not expected to have cannabis dispensaries until next year. That means Illinois is the only bordering state where Kentuckians can use Beshear’s order.

Beshear, a Democrat seeking re-election, says the better alternative to Illinois would be passage of a medical-cannabis law by Kentucky’s Republican-controlled legislature. But leaders in the two chambers disagree on which one should deal with the legislation first; House leaders say it should start in the Senate, since their chamber has passed it twice, but Senate Majority Floor Leader Damon Thayer of Georgetown says the House should still go first. Stivers did not give his opinion on that point during the KET program, which touched on several legislative issues.

Some Democratic House members want the legislature to offer voters a constitutional amendment on the issue, but Stivers said some of the UK research “will be back before the constitutional amendment could even go on the ballot” in November 2024.