Pubdate: Fri, 25 Apr 2014
Source: San Francisco Examiner (CA)
Copyright: 2014 SF Newspaper Company LLC
Author: Ahimsa Porter Sumchai
Note: Dr. Ahimsa Porter Sumchai is an expert in conventional and
alternative therapies, and runs a private practice in West Portal.


Senate Bill 1262 was introduced to the state Senate on Feb. 21 by
veteran legislator Sen. Lou Correa, D-Santa Ana. It is a medical
marijuana bill designed to regulate physicians, dispensaries and
cultivation sites via rigid government oversight.

Sponsored by the California Police Chiefs Association, SB 1262
promises to "provide a clear road map for the responsible
implementation of Proposition 215 in California since voters approved
it in 1996."

The Compassionate Use Act of 1996 (Health and Safety Code 11362.5)
ensures that seriously ill Californians have the right to obtain and
use marijuana for medical purposes when the use is deemed appropriate
and recommended by a physician.

As a licensed physician with a registered medical practice in San
Francisco, I have reviewed the wording of SB 1262. The bill is highly
punitive, clearly seeking to punish doctors who recommend medical
marijuana. SB 1262 concerns me most because it duplicates and violates
existing state and federal statutes that clarify physicians' role in
recommending medical marijuana.

In Conant v. McCaffrey (2002), the federal government was enjoined by
the 9th U.S. District Court in San Francisco from punishing physicians
for recommending medical marijuana. That ruling affirms physicians'
First Amendment right to make recommendations.

SB 1262 requires the Medical Board of California to audit any
physician who recommends medical marijuana more than 100 times a year.
On April 2, the U.S. Supreme Court struck down limits on federal
campaign donations under the auspices of First Amendment rights to
free speech. Thus, a U.S. Supreme Court precedent was set that can be
legally interpreted to defend a physician's free-speech right to
authorize as many patients to use medical marijuana as deemed
medically necessary.

SB 1262 establishes requirements for prescribing and record keeping
for physicians who recommend medical marijuana in a bill sponsored by
law enforcement officials lacking medical training -- and often a
college degree!

Guidelines and accepted standards for recommending medical marijuana
were developed by licensed California physicians and adopted by the
Medical Board of California on May 7, 2004.

SB 1262 violates the California law that protects the privacy of
patient medical information, the Confidentiality of Medical
Information Act, as well as federal law protecting health information,
by mandating that physicians report to the Medical Board all medical
marijuana recommendations along with private patient records. The
Health Insurance Portability and Accountability Act (HIPAA) requires
patient authorization for disclosure of patient health information.
HIPAA is a federal regulation and the state Medical Board has no
authority to evaluate HIPAA violations.

SB 1262 mandates a training and certification requirement for any
doctor who recommends medical marijuana, with a $5,000 fine for

I support SB 1262's efforts to establish standards for quality
assurance and testing of marijuana cultivated for medical use. The
prohibited use of nonorganic pesticides and the security of
cultivation sites will promote cultivation of pharmacological-grade
strains analyzed by uniform lab standards for reliable dosing.

SB 1262, however, duplicates Guidelines for the Security and
Non-Diversion of Marijuana Grown for Medical Use, developed for the
California Department of Justice in 2008 by then-Attorney General
Jerry Brown. The 10-page Department of Justice summary of all
applicable law does not require redundant language in a Senate bill to
be enacted by Gov. Jerry Brown.

As a profession, physicians are capable of regulating their practice
standards without law enforcement oversight, and SB 1262 is opposed by
the California Medical Association, which issued guidelines for
physicians recommending medical marijuana at:

On May 7, 2004, the Medical Board adopted accepted standards for
recommending medical marijuana that include:

* History and good-faith exam

* Treatment plan and objectives

* Informed consent

* Periodic annual review

* Consultation

* Proper record keeping

* A physician who recommends medical marijuana for a minor must offer
parents or legal guardians full informed consent, and should do so
with the approval of the treating pediatrician as a professional courtesy

The American Academy for Pain Medicine issued guidelines for medical
marijuana at its March 2011 meeting.

A Digest for Medical Marijuana Clinics is a 20-page document that
affirms, "Medical marijuana evaluation clinics are engaged in the
practice of medicine, and physicians are responsible for their patients."

Marijuana remains listed in Schedule 1 of the federal Controlled
Substances Act and has no accepted medical use. The lack of dose
response-curve research conducted in large-population controlled
trials coupled with the lack of standardized cannabinoid profiling and
potency, pesticide and microbiological testing make it difficult for
the physician to offer dosing recommendations for medical marijuana
short of the adage "Start low, go slow."

The federal government recently patented the unique cannabinoid
cannabidiol for its neuroprotective benefits in stroke and trauma. The
American Public Health Association, American Academy of HIV Medicine
and many other medical institutions join Americans for Safe Access --
the largest national member-based organization of patients, medical
professionals, scientists and concerned citizens promoting safe and
legal access to medical marijuana for therapeutic uses and research --
in promoting safe and legal access.

According to the April issue of Culture Magazine, 72 percent of
Republicans believe cannabis has legitimate medical properties.
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MAP posted-by: Matt