Pubdate: Fri, 13 Jul 2001 Source: Register-Guard, The (OR) Copyright: 2001 The Register-Guard Contact: http://www.registerguard.com/ Details: http://www.mapinc.org/media/362 Author: Tim Christie Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal) Bookmark: http://www.mapinc.org/find?164 (Measure 3 (OR)) DOCTOR DEFENDS HIS USE OF MEDICAL MARIJUANA LAW Not long after Oregon's groundbreaking medical marijuana law took effect in 1999, word began to spread among advocates and patients about an old doctor outside Portland who was willing to sign applications for qualified patients if they couldn't get their regular doctor to sign. Before long, advocacy groups all over the state were referring prospective patients to Dr. Philip Leveque, a 78-year-old doctor of osteopathy from Molalla, south of Portland in Clackamas County. Leveque saw as many patients as he could and signed up those who in his opinion had an ailment for which marijuana could help and which was permitted under the provisions of the new law. Sometimes he traveled throughout the state; other times he would consult with patients over the phone after they mailed their medical records to him. With an application signed by a physician, a patient qualifies for a wallet-sized card from the state that permits the patient to grow marijuana for medical purposes. To date, Leveque has signed more than 890 such applications, accounting for 40 percent of the 2,227 medical marijuana cards issued by the state Health Division. The Register-Guard first reported on the doctor last Friday but did not name him at his request. After later news reports identified Leveque, he said he was deluged with more than 50 messages on his answering machine from prospective medical marijuana patients. In interviews last month and this week with The Register-Guard, Leveque defended his aggressive medical marijuana practice, arguing that all doctors should be willing to sign for qualified patients. "I'm not happy to sign their applications, but it is a moral obligation to sign their applications," he said. "I got the D.O. degree to help people. If I am not helping people, I am abandoning my medical principles, totally abandoning them." In the view of medical marijuana advocates, Leveque is a courageous physician who has helped hundreds of sick people who had nowhere else to turn. "On the surface it's a shock that one doctor has done 40 percent" of the applications, said John Sajo, director of Portland advocacy group Voter Power, which has referred hundreds of patients to Leveque. "In reality he is providing a needed service and from my perspective probably saving people's lives." "I've seen firsthand how Doc Leveque operates," said Todd Dalotto, a founder of Compassion Center, a Eugene-based patient advocacy group. "He's not just a Dr. Feelgood. ... He's doing a valuable service. He's a hero." Dalotto estimated that Leveque has signed between 100 and 150 cards for Eugene-Springfield residents. Last month, in a single day in Eugene, Leveque signed up 12 patients who couldn't get signatures from their doctors. Robert Walker of Brookings, a retired fisherman and founder of the Southern Oregon Medical Marijuana Network, said he has referred 113 patients to Leveque. "I'm proud of what that man has done and I'm proud of what I'm doing," Walker said. "This man is helping a lot of sick and injured people." But Leveque's practices have put him under scrutiny from the state Board of Medical Examiners, a probe that could cost Leveque his medical license. "I'm being investigated by the Board of Medical Examiners for helping some very, very sick and disabled people who can't get help from anybody else," he said. In an April 12 letter to Leveque, a copy of which he provided to The Register-Guard, the board alleged he authorized the use of medical marijuana for a female patient "despite her multiple diagnoses of methamphetamine dependence, cocaine abuse, marijuana abuse, borderline personality disorder, post-traumatic stress disorder and depression." The board further alleged that Leveque didn't examine the patient, diagnose her condition, confer with her primary physician nor document his care in medical charts. Leveque points to language in the medical marijuana law that specifically bars the Board of Medical Examiners from disciplining a doctor who signs for a patient, so long as the doctor signed after considering the patient's medical history and current medical condition, and discussed marijuana's potential risks with the person. "I thought I was covered like a blanket on this deal because that's exactly what I do," he said. "I get previous doctors' diagnoses. I demand a personal medical history of these people." Bruce Johnson, the board's assistant executive director, wouldn't confirm the Leveque investigation nor answer questions about his case. But he said, "If a licensee of ours didn't follow the law and someone complained, then we would take a look at that." Leveque has been in trouble with the Board of Medical Examiners before, starting soon after he first got his license to practice medicine in Oregon in 1977 when he was 54. In 1981 and 1984, after board investigations, Leveque voluntarily agreed to stop prescribing drugs to patients. In 1986, he was placed on a 10-year probation, ordered to close his private practice and barred from prescribing drugs because of what the board said was improper treatment of pain. Leveque confirmed that the board placed him on probation. "I had the largest practice in south Clackamas County and other doctors would dump their chronic pain patients on me and knew I would take care of them." He first heard about using marijuana to treat pain when he was under pressure to limit the amount of pain medication he prescribed. "The patients said, `That's OK doc, we're using marijuana, and it's just as good as your stuff,' " Leveque said. A World War II combat veteran, Leveque started signing applications for veterans after the medical marijuana law passed. Veterans Affairs doctors can't sign because federal law bars the use of marijuana for medical purposes. Voter Power first heard about Leveque after meeting some of the veterans he signed for, Sajo said. Before long, advocacy groups around the state began recommending Leveque as the go-to doctor for patients who couldn't get their own physicians to sign. Walker and Dalotto said they've watched Leveque work and contend he was not a pushover. "I could vouch for the fact that he conducted that business in a very professional manner," Dalotto said. "By having someone screen the patients before they come in and looking over their medical records, we have very few cases of people just trying to get a note for their hangnail or something. All the patients I've seen come through Eugene have been seriously ill." Walker attended sign-up sessions Leveque conducted in McMinnville and Roseburg. "People who didn't have medical records with them, he told them flat out, sorry, that's not the way it works," he said. Leveque and advocates contend the real issue is not that one doctor signed so many medical marijuana applications, but rather that so many of Oregon's 12,000 doctors won't sign them. About 540 doctors have signed applications or provided chart notes for their patients. After Leveque, the next busiest doctor has signed 71 applications. Some doctors won't sign for fear of running afoul of the Drug Enforcement Agency, which has the career-killing power to pull doctors' licenses to prescribe federally controlled drugs. Others are uneasy advising patients to use a drug that has no recommended dosage, widely varying potency and is most often delivered by sucking carcinogen-laden smoke into the lungs. "The reason Doc Leveque is signing 40 percent of the notes is that (other) doctors aren't getting the message that it's OK to sign the notes," Dalotto said. "Something needs to be done to reduce the fear of doctors signing notes for patients - that's the bottom line problem." A spokesman for the Oregon Medical Association, Jim Kronenberg, has said he disagrees that most doctors are afraid to sign medical marijuana applications. Most doctors have specialized practices in which they aren't likely to encounter patients whose conditions qualify them for the medical marijuana program, he said. - --- MAP posted-by: GD