Pubdate: Fri, 06 Jun 2014
Source: Boston Globe (MA)
Copyright: 2014 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Authors: Kay Lazar and Shelley Murphy

MASS. DOCTORS TELL OF US WARNINGS OVER TIES TO MARIJUANA DISPENSARIES

Choice of Disassociating or Losing Federal Prescription Rights

US Drug Enforcement Administration investigators have visited the 
homes and offices of Massachusetts physicians involved with medical 
marijuana dispensaries and delivered an ultimatum: sever all ties to 
marijuana companies, or relinquish federal licenses to prescribe 
certain medications, according to several physicians and their attorneys.

The stark choice is necessary, the doctors said they were told, 
because of friction between federal law, which bans any use of 
marijuana, and state law, which voters changed in 2012 to allow 
medical use of the drug.

The DEA's action has left some doctors, whose livelihoods depend on 
being able to offer patients pain medications and other drugs, with 
little option but to resign from the marijuana companies,where some 
held prominent positions.

The Globe this week identified at least three doctors contacted by 
DEA investigators, although there may be more.

"Here are your options," Dr. Samuel Mazza said he was told by Gregory 
Kelly, a DEA investigator from the agency's New England Division 
office. "You either give up your [DEA] license or give up your 
position on the board . . . or you challenge it in court."

Mazza, chief executive of Debilitating Medical Conditions Treatment 
Centers, which won preliminary state approval to open a dispensary in 
Holyoke, said the DEA investigator's visit came shortly after state 
regulators announced the first 20 applicants approved for provisional 
licenses for medical marijuana dispensaries.

Mazza said he returned from vacation in February to find a DEA 
business card on the door to his home and several messages on his 
answering machine urging him to contact the agency immediately.

The quiet DEA crackdown comes even as the US House of Representatives 
approved a measure last week that would restrict the DEA from raiding 
medical marijuana operations in states where it is legal. Senate 
action is pending.

Tensions between federal and state officials have flared as 22 
states, including Massachusetts, have legalized medical marijuana, 
many since 2010.

A spokesman for the DEA in Boston on Wednesday referred calls to 
agency headquarters in Washington.

A DEA spokeswoman in Washington declined to answer questions Thursday 
about the doctors' assertions that they are being asked to choose 
between their drug prescribing licenses and their ties to 
dispensaries. The spokeswoman would not say whether the action in 
Massachusetts is part of a national policy or limited to the state.

Physicians, dentists, and other health care providers who prescribe 
or administer narcotics and other controlled substances are required 
to register with the DEA, which tracks use of the drugs and strips 
federal licenses of those who fraudulently prescribe the medications.

At least two physicians resigned their medical officer positions with 
planned medical marijuana dispensaries in the past two weeks after 
visits from the DEA, including Dr. Carl Fulwiler.

The psychiatrist was part of the executive management team of the 
William Noyes Webster Foundation, which was granted preliminary 
approval for a dispensary in Dennis, and resigned his position last 
week, according to a person with direct knowledge of the situation. 
Fulwiler did not return calls seeking comment.

Another physician who asked that his name not be used for fear of 
reprisal said two DEA investigators arrived unannounced at his office 
last month.

"DEA agents can be quite direct when they want to make an impression 
on you," the doctor said.

"My terrified secretary asked what to do with them, and I said I'd 
see them in five minutes after I finished what I was engaged in," the 
physician said.

During a polite, 15-minute conversation, one of the officials asked 
"probing" questions about the dispensary's proposed operations, while 
the other furiously took notes, the doctor said.

"The gist was to get me to either relinquish the DEA license, if I 
insisted on continuing with the dispensary, or give the license up 
'temporarily' while involved with the dispensary," he said.

The investigator told the physician that if he gave up his DEA 
license, he could later apply to have the license reinstated if he no 
longer was involved with the dispensary. But, the doctor recalled, 
the investigator said there was no guarantee the license would be restored.

Otherwise, the investigator explained, the doctor could divorce 
himself from any association with the dispensary.

"I had no choice but to choose the last option," said the physician, 
who resigned his position at the dispensary.

Valerio Romano, a Boston attorney who represents several 
dispensaries, said the DEA's action may further delay dispensaries 
from opening.

When state regulators selected companies in January for provisional 
licenses, they said they expected most would open by this summer. But 
since then, problems have surfaced, including misrepresentations and 
conflicts of interest involving several of the companies. State 
officials have acknowledged they did not check the veracity of the 
companies' statements in their applications.

State regulators say they are now conducting extensive background 
checks of dispensary applicants, and Romano said those checks may be 
prolonged now that some dispensary companies will be searching for 
new medical officers to fill positions vacated by physicians who 
recently resigned.

"In the end, what all of this means is more delay for patients," Romano said.

Dave Kibbe, a spokesman for the state Department of Public Health, 
which issues dispensary licenses, said in a statement Thursday that 
the companies are not required to have medical personnel on their 
management teams, and that the doctors' resignations would not cause 
delays in the state program. But Kibbe said the departures may cause 
delays for individual dispensaries.

"When registered marijuana dispensaries experience changes in 
leadership, they are required to notify [the health department]," he 
said. "Any new [dispensary] personnel must go through a comprehensive 
background check as part of the department's standard process."

Dr. Walter Panis, chief medical officer for Alternative Therapies 
Group, which was granted preliminary approval by state health 
officials to open a medical marijuana dispensary in Salem, said he 
has not been contacted by the DEA, but expressed concern after 
learning other doctors had been given an ultimatum.

"The dispensaries need good medical information and how else are they 
going to get it except through physicians that are able to give that 
information?" said Panis, whose role in the dispensary will be to 
educate staff about medical marijuana and patient treatment.

Panis, a neurologist, said he needs his DEA license to prescribe 
certain medications. He said he would consult a lawyer if given an 
ultimatum by the DEA, but would probably withdraw from the dispensary 
if forced to make a choice.

"I'd probably resign, but I don't want to do that," Panis said. "I 
wouldn't want to jeopardize my ability to practice medicine. 
Practicing medicine is the soul of my life."

Mazza, the physician associated with the Holyoke dispensary, said 
that when he returned the DEA's urgent messages in February, he was 
put on a speaker phone with three DEA officials.

"You are chairman of an organization that is going to distribute a 
product that is against federal law," Mazza said the DEA officials told him.

The DEA investigators were "quite congenial" but adamant, according 
to Mazza, that he couldn't keep his DEA license to prescribe 
controlled substances if he maintained his position at the dispensary.

Even though Mazza has held his DEA license for 40 years, he said it 
was easier to surrender it than to engage in a legal battle. Mazza, 
who works part-time for the federal government, performing surgeries 
at the VA Medical Center in Northampton, said he doesn't need the DEA 
license for that job.

"It was easy for me because I really didn't need the license 
anymore," Mazza said. "If I did need the license and was still in 
private practice as a general surgeon, I'm not sure what I would have 
done. I probably would have relinquished my position as CEO [of the 
dispensary]."
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MAP posted-by: Jay Bergstrom