In public policy circles, you sometimes hear people throw the “conflict of laws” phrase around. When they do, they often sound very proud of themselves. It seems they can’t help but confuse identifying a problem, with actually resolving one.
A conflict of laws occurs when two principles of law, both roughly equal in nature, come into conflict one another. They can be thought of as two competing values, but these two values are not moral judgments, but rather political or policy ones. This is what has happened in a contested driving ban case involving the Department of Health, the Howard Center and David Ballard.
Ballard, a registered medical marijuana patient who suffers from ALS, was charged with an alcohol-related DUI following an evening out. He had a blood-alcohol content of 0.083 percent, which is three one-thousandths above the legal limit.
Ballard successfully completed Vermont’s driver’s license reinstatement program, CRASH, administered in Chittenden County by the Howard Center. Howard Center therapist, Barbara J. Mayhew-Belatski, determined that he “appear[ed] to be at low risk with regards to alcohol.”
A key question the Department of Health requires CRASH administrators to determine is the likelihood of potential reoffense for those referred to the program. In this capacity, Howard Center’s CRASH administrators are offering a clinical judgment.
However, Mayhew-Belatski offered an additional judgment now central to the legal dispute, that his continued medical cannabis use prevented her from determining the same low risk of reoffense she ascribed to his alcohol use. It is that medical cannabis use that has prevented his license reinstatement and prompted the civil suit, not alcohol.
With respect to marijuana use, Ballard received the most benign DSM-V diagnosis he could receive — cannabis use disorder (CUD), mild type. According to Howard Center’s diagnosis, Ballard is reliant on cannabis, and that reliance is clinically significant.
While this diagnosis may accurately describe his relationship to cannabis, Ballard’s use is necessary to treat a medical condition, and he is acting in accordance with the medical advice he has received. There is no evidence that he is misusing his medication, which remains under a doctor’s supervision, as it did the entire time he participated in the CRASH program.
One can’t help but wonder, if he was similarly prescribed any number of opiate-based medications commonly prescribed for ASL symptoms, would that same CRASH administrator have identified a reliance on opiates. More importantly, would prescribed opiate use have similarly prevented his right to a driver’s license reinstatement? Most likely not.
As a clinical matter, a diagnosis should be free from agenda or stigma. It is simply intended to reflect current medical circumstances. By comparison, the assessment protocol Howard Center’s CRASH program uses is stuck in a bygone era, continuing to reflecting a time when all cannabis use was considered criminal.
Howard Center’s position on cannabis use in relation to the CRASH program is neither supported by medical evidence nor current road safety data. Howard Center has been given effective free reign by Vermont’s Department of Health to subjectively and prejudicially withhold Ballard’s driving rights, based on organization biases against medical marijuana.
In the absence of a legislative solution to the CRASH problem, the Department of Motor Vehicles and Agency of Human Services have quietly opposed change. Both departments benefit from the decision-making latitude informed by the current circumstances. What remains is a vacuum of clarity, riled by competing values and outdated laws that are ill-fitting for a modern system of care and public safety policy.
And so, we await the outcome of Ballard’s suit against Vermont’s Department of Health. His case may be a first for the state, but not likely the last. We are left to hope that the result, whatever it may be, will provide some legislative motivation to compassionately police the intersection between medical cannabis and public safety.
Editor’s Note: Steve May is a licensed independent clinical social worker specializing in addiction medicine, a member of the Vermont Coalition to Regulate Marijuana Advisory Board, and a member of the Richmond Selectboard.