Pubdate: Mon, 1 Dec 2008
Source: Alternatives (Eugene, OR)
Issue: Winter '08 - '09, Issue 48
Column: Physicians' Perspective
Copyright: 2008 Get Real Inc.
Author: Rick Bayer
Note: Rick Bayer, MD is board-certified in internal medicine, a 
fellow in the American College of Physicians, and practiced in Oregon 
for many years. Co-author of Is Marijuana the Right Medicine For You? 
A Factual Guide to Medical Uses of Marijuana, he was the filing chief 
petitioner for the Oregon Medical Marijuana Act in 1998, and manages that includes a medical cannabis/marijuana bibliography
Bookmark: (Marijuana - Medicinal)


Cannabis or marijuana has been an important herbal medicine used by 
many cultures for thousands of years. Though federal law prohibits 
use of this herb, 14 states have now passed medical marijuana (mmj) 
laws over the last decade. These laws protect more than 20% of all Americans.

The first state to modify criminal penalties was California in 1996. 
Oregon voters were close behind, passing the Oregon Medical Marijuana 
Act (OMMA) in 1998. Since state laws do not change federal laws, 
marijuana remains illegal until Congress changes federal laws or a 
new President issues administrative orders.

The Oregon Medical Marijuana Program (OMMP), part of the Department 
of Human Services (DHS), administers the OMMA. If an Oregonian has a 
debilitating condition as defined in the OMMA, s/he applies by having 
her/his physician certify the qualifying condition and that mmj 
"might help". To learn about the OMMP and the law (ORS 
475.300-475.346) go online to the website

Debilitating conditions include cancer, glaucoma, wasting (cachexia) 
caused by HIV infection or other conditions, severe pain, severe 
nausea, seizures, or persistent muscle spasms like those caused by 
multiple sclerosis. The only condition added by DHS since 1998 is 
agitation from Alzheimer's disease.

The most commonly reported debilitating condition is severe pain. 
Note: our legislature feels doctors are not proficient in controlling 
pain. Therefore, the Oregon Medical Board requires as of January 2, 
2009 that licensed doctors receive special continuing education on 
treating pain and end-of-life care.

OMMP issues a one-year permit to qualified applicants whose 
identifying information is entered into a confidential data base at 
DHS. The permit allows limited exceptions to state law for growing 
and possessing cannabis. Although legal for a patient to pay expenses 
related to his/her grower's supplies and utilities, selling cannabis 
remains a crime. Since there is no allowance for patients to sell to 
each other when growing a garden is not practical, some patients have 
limited access to medicine.

The OMMA is not a substitute for reform. Rather, it is a bridge to 
the time when the feds reschedule marijuana to allow patients to 
purchase it by prescription.

By October 2008, over 20,000 patients had registered with the OMMP. 
Adding legitimacy are the 3000 Oregon physicians who participate in 
the OMMP. These physicians likely represent the majority of Oregon 
doctors who routinely manage patients with terminal and chronic 
illness. Perhaps this degree of participation indicates the Oregon 
medical community is committed to improving pain and symptom control.

Patient fees pay for administration of OMMP so it never costs 
taxpayers a dime. In fact, the OMMP contributed nearly $1 million to 
the state General Fund in 2005.

In spite of a poll showing 76% of Oregonians support "seriously ill 
patients to use and grow their own medical marijuana with the 
approval of their physician", the OMMA still faces opposition from 
law enforcement and some politicians. A ballot initiative amending 
the OMMA to allow dispensaries to sell mmj failed in 2004. Perhaps 
this means Oregonians like the OMMA as is, but do not want commercial 
sales to further provoke federal authorities. The federal Drug 
Enforcement Agency (DEA) is very nasty about dispensaries in 
California, even threatening landlords with property forfeiture if 
renting to dispensaries.

Some in Oregon wish to retry a dispensary initiative. My opinion 
about amending the OMMA is we need federal changes first. Otherwise, 
we will have the DEA repeating the California raids in Oregon. 
Rescheduling marijuana so patients can obtain it by prescription 
would be ideal. Calling the DEA off their pursuit of medical 
marijuana patients--particularly in states where mmj laws 
passed--would be a good start.

This 2009 legislative session also challenges the OMMA. In 2007 and 
2005, Republicans and Associated Oregon Industries attempted to 
codify discrimination against OMMA registrants who work. Some 
businesses pursue federal contracts--good business--but then ignore 
actual employee impairment, and fire Oregonians simply for being OMMA 
registrants--bad business. Oregon law says medical marijuana must be 
treated like other medicines. Our legislature, citizens, and courts 
have to decide what is fair. Decent people do not discriminate 
against the sick and disabled. But, it takes vigilance because some 
seek to transform greed into a virtue.

The OMMA is challenged by citizen initiatives too. During Oregon's 
2008 election cycle, Kevin Mannix filed an initiative to repeal the 
OMMA, but he never collected signatures. With endless money flowing 
from Loren Parks to Kevin Mannix, there is potential for a blizzard 
of negative ads against the OMMA. There are many businesses including 
law enforcement, pharmaceuticals, and drug testing industries that 
directly profit from mmj prohibition.

Fourteen states including Oregon, Washington, California, Alaska, 
Arizona, Colorado, Hawaii, Maine, Nevada, Maryland, Montana, Rhode 
Island, New Mexico, and most recently, Michigan have mmj legislation. 
That is over a quarter of all states and covers, as noted at the 
beginning of this article, over 20% of US population. The conflict 
between state and federal laws has resulted in a series of court 
battles concerning states' rights, medical necessity, and drug policy 

Ten years after the OMMA passed, many patients have benefited. All 
Oregonians save money by less marijuana prosecutions and a 
patient-funded OMMP that contributed to the General Fund. Most 
importantly, the OMMA puts Oregon closer to a more humane world where 
the sick can access pain and symptom control without the heartless 
bludgeon of reefer-madness prohibition.
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MAP posted-by: Richard Lake