Dr. Sexton serves as Executive Medical Research Director at the Center for the Study of Cannabis and Social Policy in Seattle, WA.

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1 Washington State Healthcare Provider Education: Medical Use of Marijuana Jointly provided by the Postgraduate Institute for Medicine and Scitent, Inc. Released 03/15/2018 Available for credit until 03/14/2020 The estimated time to complete this activity is 4 hour(s). Faculty Ethan Russo, MD Dr. Russo is a neurologist and Medical Director of PHYTECS. Michelle Sexton, ND Dr. Sexton serves as Executive Medical Research Director at the Center for the Study of Cannabis and Social Policy in Seattle, WA. Sunil Aggarwal, MD, PhD, FAAPMR Dr. Aggarwal currently serves as a Palliative Medicine Physician Consultant at MultiCare Auburn Medical Center and the MultiCare Regional Cancer Center, an Associate Medical Director of MultiCare Hospice, and a physician at SageMED in Bellevue, WA.

2 Target Audience This activity is intended for healthcare providers interested in the endocannabinoid system and the use of medicinal cannabis for patient treatment. Educational Objectives After completing this activity, the participant should be better able to: List key dates in the history of Washington State s medical marijuana program Explain Washington s regulations regarding marijuana Recognize who is allowed to authorize medical marijuana in Washington Describe the requirements for providing an authorization Identify Washington s Guidelines Related to the Authorization of Marijuana Describe key components of Washington s Authorization Database Discuss the purpose of the Recognition Card Outline the steps involved in obtaining a card Discuss the endocannabinoid system Explain basic pharmacology of cannabinoids Describe when the use of medical marijuana may be contraindicated List common delivery methods for medical cannabis Recognize issues in integrating medical marijuana into medical practice Discuss actions by healthcare practitioners that do and do not violate laws in Washington State regarding medical marijuana Discuss common legal issues that healthcare practitioners may encounter in their practice regarding medical marijuana Discuss marijuana s illegality under federal law Review key legal cases regarding medical marijuana Recognize possible liability issues a healthcare practitioner of medical marijuana might face Discuss possible issues regarding Medicare/Medicaid and medical marijuana Identify what conditions qualify for medical marijuana use in Washington State Joint Accreditation Statement In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Scitent, Inc. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

3 Physician Continuing Medical Education The Postgraduate Institute for Medicine designates this enduring material for a maximum of 4 AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity. Continuing Nursing Education The maximum number of hours awarded for this Continuing Nursing Education activity is 4 contact hours. Pharmacotherapy contact hours for Advance Practice Registered Nurses will be designated on your certificate. Designated for 1 contact hour of pharmacotherapy credit for Advance Practice Registered Nurses. Disclosure of Conflicts of Interest The Postgraduate Institute for Medicine requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME/CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. Faculty Ethan Russo, MD, discloses that he receives salary from PHYTECS, receives consulting fees from ICCI, receives some reimbursement for CME activities, and has received NIH grant funding. Michelle Sexton, ND, discloses that retains stock options in Abbatix Bioceuticals. Sunil Aggarwal, MD, PhD, FAAPMR, has nothing to disclose.

4 Planners and Managers The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, BSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose. The planners and managers from Scitent have nothing to disclose. Instructions for Obtaining Credit During the period March 15, 2018 through March 14, 2020 participants must: Read the learning objectives and disclosures. Study the educational activity. Complete all questions, including the course. You must receive a score of 75% or better to earn a certificate. You will have an unlimited number of attempts to successfully complete the questions. Complete the Evaluation to rate the course and to record your participation. Upon passing the post-test and completing the activity evaluation, your credit certificate will be available immediately to print for your records. You may view or print your certificate at any time in the future. Computer System Requirements System Requirements 1024 x 768 Minimum Monitor Resolution Sound Card & Speakers or Headphones Browser Requirements Internet Explorer 9 or higher Firefox 23 or higher Chrome 9 or higher Safari 5.1 or higher Opera 12 or higher Javascript must be enabled Adobe Acrobat Adobe Acrobat Reader (latest version) Available for free at downloads

5 Mobile Phones & Tablets Apple ios 5.0 or later on ipad/iphone Android 4.0 or later on phone or tablet Note: Some TMCI courses require Adobe Flash. For iphones and ipads, we recommend using the Puffin web browser. It is a free download on the itunes or Android store. Disclosure of Unlabeled Use This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Disclaimer Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities. For inquiries about this activity, please contact PIM at inquiries@pimed.com