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Three Views
Source: Portland Tribune (Oregon)
Web site: http://www.portlandtribune.com
Address: 620 SW Fifth Ave., Suite 400, Portland, OR
97204
Contact: letters@portlandtribune.com
Copyright: 2002 Portland Tribune
Fax: 503-226-7042
Pubdate: Friday, March 22, 2002
Newshawk: Phil Smith
Title: Three Views
Give people access, not red tape
John Sajo
My responsibility is to help sick people
Dr. Phillip Leveque
State fine-tunes its nascent system
Grant Higginson
The air still hasn't cleared over the issue of medical
marijuana, despite passage of a 1998 act. One doctor
feels the heat, while activists rally for improved
access
Give people access, not red tape
John Sajo
Marijuana is a safe, effective medicine. Patients who
can benefit from it should be able to get it.
Oregon voters were right to pass the Oregon Medical
Marijuana Act in 1998. Since then, evidence has
mounted showing that marijuana helps patients
suffering from a wide range of ailments. For many
patients, marijuana works better than more expensive
pharmaceutical drugs.
Some cancer patients report that marijuana is the only
thing that controls the nausea caused by their
chemotherapy. For some glaucoma patients, marijuana is
the only thing that keeps them from going blind. For
many chronic pain patients, medical marijuana allows
them to end or reduce their use of dangerous drugs
such as morphine and Vicodin. This allows them to
function far better, which is wonderful for them and
their families.
Since the act took effect, more than 3,500 patients
have been qualified to use medical marijuana by nearly
800 Oregon doctors. Oregon’s law has allowed these
patients to choose which medicine to use. There have
been no reports of any significant adverse reactions
to using marijuana as medicine.
The problem with the act is that it does not create a
supply of medical marijuana. Instead, it requires sick
and dying patients to grow their own medicine. This
hasn’t worked and never will. Some lucky patients have
a caregiver who can successfully grow marijuana for
them, but most patients have struggled unsuccessfully
with gardening and resort to the black market if they
can afford it.
Another problem with the act is that the health
department has failed to follow the law and imposes so
much red tape on participants that many patients avoid
the program.
The act requires the department to issue registry
cards within 30 days to patients who submit complete
applications. The department virtually never meets
this deadline, and patients have been arrested as a
result of not having a card. This is intolerable.
Other departmental decisions can only be characterized
as foot dragging. The level of service is unacceptable
for a program that is completely self-funding. Given
that marijuana seems to be useful for so many
conditions, it is disappointing that the department
has done nothing to document the positive results that
many patients are achieving.
The biggest problem with medical marijuana is the
federal government. Voters in 10 states have passed
laws legalizing medical marijuana, but Congress
refuses to budge from the outdated “reefer madness”
position that criminalizes all use.
The medical use of marijuana is not going to stop. Far
too many patients know that it helps them far too
much. It is time for our leaders to follow the people
on this issue.
The Life With Dignity Committee is sponsoring a
statewide initiative petition for the November ballot
that would expand the Oregon Medical Marijuana Act.
Soon, we will begin passing petitions and expect to
get the required 67,000 legal signatures to become
eligible for the November ballot.
This initiative will create licensed dispensaries,
regulated by the health department, where qualified
patients can purchase their medicine in a safe
environment.
The initiative also would make numerous other changes
in the Oregon Medical Marijuana Act that would cut
through some of the red tape that has denied patients
the choices they should have. Marijuana is medicine.
Patients should be able to get it.
John Sajo is the director of Voter Power and a chief
petitioner of the Life With Dignity petition.
*****
My responsibility is to help sick people
Dr. Phillip Leveque
The medical marijuana hullabaloo is not about patient
care. It is all about money! The money not spent on
expensive prescription drugs.
Marijuana is one of the safest medically active
substances known to man. It is easy to grow and safe
to use. But it isn’t taxed, legally sold, patented,
promoted or protected by big-money lobbyists and
multibillion-dollar out-of-state corporations, as are
big tobacco, alcohol and “legal” prescription drugs.
I’m just an old medical college professor with 30
years of teaching pharmacology and toxicology, turned
country doctor for 10 years, with far more education
on the effects of drugs than most.
Cannabis has often been called a miracle drug because
of its effectiveness in the treatment of pain and such
a wide path of diseases. It has been used in medicine
for at least 5,000 years. Marijuana is even mentioned
in the Bible, Exodus 30:23, when God ordered Moses to
make a holy oil, composed of myrrh, sweet cinnamon and
kaneh bosm (cannabis).
Marijuana is well-known and used in medicine
worldwide. It was one of the most widely used
medicines in America before being legally banned in
1937. Oregon voters approved medical marijuana in
1998. Eight states have followed.
Oregon patients can now apply to the state, for an
annual fee of $150, for a card authorizing their legal
use of marijuana for their own medical purposes. Every
application must be signed by a physician confirming
that, in his or her opinion, the applicant is
suffering from an ailment for which the state has
approved the use of marijuana for treatment.
Doctors do not prescribe medical marijuana. The state
approves all medical marijuana cards.
The state had anticipated only about 500 applications
but already has issued more than 3,500 cards and is
months behind in approving new applications. And now
the state has added more delay to its multifarious
approval processes by requiring a physician’s physical
exam of all applicants, which I now do. Why?
The state has approved marijuana in the treatment of
nine diseases, including cancer. All require a medical
specialist for detection, not just a regular physical
exam. Surely the state’s public health officer hasn’t
the time or staff with the expertise to review
thousands of physical exams.
I’m but one of nearly 800 doctors who have signed
medical marijuana applications. By far, I have
examined the most patients: Thus, the state has
singled me out, publicly attacked me and threatened my
license, even though the law says physicians cannot be
prosecuted for giving their opinion. Their goal is to
scare other doctors in an attempt to kill medical
marijuana in Oregon.
The state seems to be saying, “We don’t care what the
voters want,” while ignoring the real victims: the
forgotten thousands of Oregonians, the paraplegic vets
and others who medically need and want to use
marijuana “legally” as an effective alternative
medicine for the relief of their pain rather than
using expensive and often harmful prescription
painkillers. The state doesn’t care.
But, thank God, others do. And thanks to several brave
doctors, hundreds of dedicated advocates and the
majority of Oregon voters, there are now more than
3,500 Oregonians legally suffering less medical misery
than before. To which I say, “Hurrah!” For that is
what doctors should do.
Phillip Leveque, a doctor of osteopathy, says he has
signed more than 1,600 medical marijuana card
applications. He lives in Molalla.
*****
State fine-tunes its nascent system
Grant Higginson
In 1998, Oregon voters passed a law to protect
seriously ill patients from prosecution for using
marijuana as medicine.
The Oregon Medical Marijuana Act is 3 years old, but
strong feelings and confusion about it still exist. As
a public health officer in the state Department of
Human Services, I oversee the medical marijuana
program and want to clarify some facts.
The act grants legal protection to qualified patients.
Those who are registered for the Oregon Medical
Marijuana Program are issued a card to show they have
met requirements for the legal use of medical
marijuana.
To qualify for a card, an applicant must be an Oregon
resident and suffer from one of nine listed
debilitating medical conditions. An attending
physician must document the patient’s medical
condition and confirm that the patient may benefit
from medical marijuana.
The law allows patients to designate a primary
caregiver to legally assist in growing and
administering medical marijuana. The law includes a
petition process for adding new medical conditions to
the list when there is supporting scientific and
clinical evidence.
The act gave responsibility for creating the registry
system to the Department of Human Services. From the
beginning, our goal has been to operate a program that
is accountable to patients and the public. Here is how
we interpret the law:
Marijuana is a legitimate medication for some
patients, and both they and their physicians are
legally protected from prosecution for its use and for
discussing its use.
Medical marijuana use is restricted to patients who
have one or more of the medical conditions named in
the law.
The decision of whether to use marijuana as medicine
is made by the patient with his or her attending
physician.
Restrictions reduce the potential for abuse of the law
and ensure that medical marijuana is not diverted to
illegal purposes.
For two years, the program worked as intended. Almost
600 patients registered in the first year, and more
than 300 physicians participated. We added one medical
condition to the list.
In 2001, we discovered that an attending physician’s
signature had been forged on seven applications. We
immediately contacted law enforcement and conducted a
stringent internal review. This resulted in changes to
our management of the program.
We also found that there had been a sharp increase in
the number of patients and that one physician had
signed documentation for 1,642 people, about 40
percent of the applicants. The act states that the
attending physician must have “primary responsibility
for the care and treatment of the applicant.” We
questioned whether one individual could fulfill this
role for so many patients.
Subsequently, we filed new rules to better define
attending physician requirements:
The doctor must review the patient’s medical history,
conduct a physical exam, provide for follow-up care
and document this in the patient’s medical record. The
rules give the state authority to review medical
records when we question whether a legitimate
physician-patient relationship exists. Under these
rules, about 300 applications were denied because of
insufficient documentation.
Patients, advocates and policy-makers have expressed a
range of perspectives on these recent changes. Some
think that we are becoming too intrusive and erecting
barriers to qualified patients. Others think that we
should be more restrictive. Our goal is to achieve a
balance of providing quality service for patients the
act was meant to serve while ensuring that only
legitimate patients receive registration cards.
Grant Higginson is state public health officer at the
Oregon Department of Human Services.
__________________________________________________________________________
Distributed without profit to those who have expressed a prior interest in
receiving the included information for research and educational purposes.
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