Pubdate: Tue, 28 Jan 2014
Source: Baltimore Sun (MD)
Copyright: 2014 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Author: Jean Marbella, Justin George, Erin Cox
Page: 1

MEDICAL MARIJUANA STILL BEYOND REACH IN MARYLAND

Despite New Law, Nothing Has Been Done to Give Access

Barry Considine still has to buy marijuana illegally, as he has since
he first asked around a biker bar for it to help treat his post-polio
syndrome. Ken Kopper still fears another possession arrest for using
it to ease chronic pain resulting from a couple of car accidents.

And Gail Rand still can only watch from afar as a boy in Colorado who
has the same form of epilepsy as her 4-year-old son has become
seizure-free after regularly ingesting an oil derived from marijuana.

"There's a plant out there that can help my son, and he can't get it,"
said Rand, whose son Logan has an average of 10 seizures a day. "I'm
not willing to give up. Something has to help my child."

For patients hoping to legally use medical marijuana, the prospect
appeared closer than ever last year, when state legislators approved
its distribution through medical centers conducting research on the
drug. But regulations have not yet been approved for the program and
no hospitals have come forth to participate, leaving patients in the
same position they were in before the law was passed.

"The reality is: It's not working, it's not going to work," said Del.
Dan K. Morhaim, the Baltimore County Democrat who sponsored the
medical marijuana bill last year.

Morhaim said that even last year, it was clear that medical centers
were tepid at best about committing to the program. And after
discussing the issue with several institutions over the past year, he
sees no sign that they're warming to the idea.

"I was hoping that they would change their minds," he said. "It's
clear that they won't."

Johns Hopkins, the University of Maryland and Sinai Hospital say
they're still evaluating their positions or waiting to see the state's
regulations before making a final decision.

"Johns Hopkins is open to a conversation with the state about how a
medical marijuana program could be implemented, but right now, it
would be premature to commit to administering or participating in such
a program," said Kim Hoppe, a Hopkins spokeswoman.

Another potential participant, MedStar Health, "is not considering
participating in the medical marijuana program in Maryland," said
spokeswoman Ann C. Nickels. She declined to elaborate.

Some powerful lawmakers suggest in private that the state should push
public universities to embrace their role in helping the state's sick
get medical marijuana. Others plan to marshal support to rewrite the
law, expanding access to the drug beyond research centers.

Morhaim, the General Assembly's only physician, expects to introduce a
bill this week allowing physicians affiliated with a hospital or
university to recommend marijuana to patients - a plan that would
bypass academic centers and greatly increase the number of doctors who
can beome involved, he said.

Those who support medical marijuana have had an uphill battle in
Maryland - in the past, Gov. Martin O'Malley has opposed measures that
he said would put the state in violation of federal law. But advocates
find hope in something O'Malley said at the Annapolis summit on the
opening day of the legislative session - in response to a question
from Rand, who had noted the "limitations" of the current law and that
her son still had no access to a drug that might ease his epilepsy.

"Our hope is if there's something that's made this too cumbersome to
move it forward in the context of medical marijuana, we can fix that
this legislative session," O'Malley said. "If we need to fix it ... we
can take advantage of these next 90 days."

Rand, who lives in Annapolis, is particularly interested in gaining
access to a strain of marijuana known as "Charlotte's Web," which is
cultivated in Colorado and used by a number of children suffering from
epilepsy. It is low in THC, which produces the marijuana high, and
some parents and doctors say an oil extracted from it has greatly
reduced or even stopped epileptic seizures in children.

"These kids are not getting high," Rand said. "They aren't smoking a
joint."

Logan's seizures can sometimes be violent, causing him to fall and
injure himself as he did recently, requiring a trip to the emergency
room for stitches, Rand said. Doctors have tried various anti-seizure
medications, often powerful and with side effects, but only one has
proved even moderately effective, she said.

According to published research, there is anecdotal evidence that
marijuana can successfully reduce seizures, but more studies need to
be done on the issue.

Hospitals' reluctance

Given that research facilities in Maryland appear reluctant to
participate in the medical marijuana program, Rand hopes lawmakers
will consider other ways to get the drug to patients. "I'd like to be
able to get it from a dispensary," said Rand, the way other states
handle medical marijuana.

For now, members of Maryland's Medical Marijuana Commission continue
to work on regulations that will determine how the program would be
implemented and run. A draft is expected in the coming weeks, but
commission members, appointed five months ago by O'Malley, declined to
discuss their proposal.

Hospitals and state research centers rely heavily on federal funds,
making them wary of participating in a program to distribute a drug
that remains illegal under federal law. Proponents say research into
marijuana's efficacy can face multiple challenges - especially because
the federal government controls the supply of marijuana that can be
used in such studies.

"The hospitals don't want to take it because they're afraid that the
federal funding that they receive will be taken away," said Del.
Joseph Vallario, a Prince George's Democrat. He chairs a committee
that has killed other bills to loosen pot laws, but he considers
himself an unwavering supporter of medical marijuana.

The Obama administration has indicated that it will not prosecute
federal marijuana crimes if state laws have legalized the drug's use,
but that has not entirely allayed fears.

"The federal government still has regulations about this stuff, and
the hospitals have to weigh all those things to see whether they'd
fall into the criteria of what they could do," said commission member
Col. Harry Robshaw, chief of the Cheverly Police Department.

Eric E. Sterling, president of the Criminal Justice Policy Foundation,
a private nonprofit educational organization that focuses on criminal
justice issues and "failed global drug policy," said that wariness
might not be warranted. The federal government has never sued a state
to block a medical marijuana program since California adopted its
program in 1996, he said.

Still, Carroll County State's Attorney Dario J. Broccolino, also on
the commission, understands that it's uncharted territory for the
state, and hospitals have a right to take a wait-and-see stance. "I
can understand their timidity because it's the great unknown. They're
not going to commit to anything until all the regulations are published."

As a result, those the Maryland law was intended to help remain
stymied.

"For the day-to-day life of a patient in Maryland, nothing has changed
with this law," said Michael Liszewski, policy director for Americans
for Safe Access, a group that advocates for medical marijuana.

Advocates knew the passage of Maryland's law was not going to make the
drug immediately available - legislative aides estimated setting up
the program would take until fiscal 2016. And while the advocates
would have preferred a more expansive measure, Liszewski said it was
clear they would have to settle for something less than ideal.

Twenty states and the District of Columbia have a medical marijuana
program, but Maryland is among a minority that do not allow
dispensaries and the only one that ties it to research activities,
according to the National Conference of State Legislatures. A medical
marijuana user in Maryland can still be arrested for possession, but
showing medical necessity can be used as a defense.

Medical marijuana proponents take heart in polls that show increasing
support for their cause - a Goucher College poll in November found 90
percent of Marylanders back medical marijuana. There is a greater
comfort level with the drug, with some who now use it medicinally
having once used it recreationally.

Considine, 60, takes "several tokes" in the morning and later in the
day for the muscular weakness and fatigue that comes with post-polio
syndrome.

Stricken with polio before he was 2, the Halethorpe resident was able
to live a largely normal life, working in restaurants and later in
land title companies until 1998, when he developed post-polio syndrome.

He had used pot recreationally as a younger man, less so after he
married and had two children who are now in their 20s. Having retired,
he starts his day with coffee and "three tokes," which help the pain
and spasms of his afflicted muscles.

The former chef still cooks his family's meals, a once simple task
that saps his strength. "My back and legs are shot when I'm done,"
Considine said, and smoking more pot later in the day helps him get
the sleep that his doctor says is the best medicine for his condition.

He would smoke more, but the cost is prohibitive, so he limits himself
to about $75 to $150 worth of marijuana a month.

Debate broadens

In Annapolis, the debate has broadened this session and includes two
other pot proposals. One would legalize marijuana, regulate it and tax
it like alcohol; it is considered unlikely to pass this year. A second
would decriminalize the possession of small amounts.

Advocates for medical usage say that while they have no problem with
legalization of the drug for any purpose, such a measure alone
wouldn't address all their needs. For example, if marijuana were
subject to an excise tax, like alcohol, those who use it for medical
purposes would have to pay the same as those using it
recreationally.

Sen. Bobby Zirkin, a Baltimore County Democrat who is pushing to make
marijuana possession a civil offense without jail time, said the other
proposals still don't resolve the problems with Maryland's medical
marijuana system.

"The fix on medical marijuana is making sure that patients can
actually get it," Zirkin said.

"Of course, you don't want someone who has cancer thrown into jail.
The problem with our medical marijuana program is that patients can't
get it, and you shouldn't be sending them or their family members to
drug dealers to go get it."

Kopper, 42, of Catonsville fears being arrested again for possession
of the marijuana used to treat lingering back, joint and muscular pain
stemming from a couple of car accidents - including one in which a
fully loaded cement truck rear-ended him.

A 2003 state law allows those arrested for marijuana possession to
claim medical necessity for the drug, and he has used a letter from a
doctor in court. Having such a letter, though, doesn't prevent him
from being arrested or tried again.

"I cried for two hours straight," he said of being given probation
before judgment for one incident. "It could definitely have gone
another way."

Kopper said using marijuana keeps him from having to use more powerful
and addictive drugs such as opiates to manage his pain.

Tyler Kutner, 20, also has a doctor's letter but has not had to use
it. Still, Kutner, who uses marijuana to treat the muscle spasticity
that comes with cerebral palsy, said Maryland's current laws don't
protect medicinal users.

As "patients, as people who are buying off the street, that leaves us
very vulnerable," said Kutner, a freelance writer who lives in College
Park. Kutner uses pot and practices yoga to help loosen muscles. With
marijuana back on the General Assembly's to-do list, and with one
candidate for governor, Del. Heather Mizeur, supporting legalization,
Kutner said, "we're going to be lucky if we can squeak anything
through that has a shred of resemblance to what we want."

Some medical marijuana advocates fear their cause will get lost as the
focus turns toward legalization or decriminalization.

But Sen. Jamie Raskin, a Montgomery County Democrat leading the charge
to legalize pot, said that regardless of what happens on that front,
"we need to fix the medical marijuana law."

Similarly, Senate President Thomas V. Mike Miller, who supports
legalization, says the state needs to get its medical marijuana
program right first.

Morhaim's preference is to focus on medical, rather than recreational,
users. The discussion on legalization and decriminalization - as well
as civil rights, drug cartels and unfairly incarcerating people -
should wait.

"In this war on drugs," Morhaim said, "we have to get the sick and
dying off the battlefield."
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