Pubdate: Tue, 13 Feb 2001
Source: Honolulu Star-Bulletin (HI)
Copyright: 2001 Honolulu Star-Bulletin
Contact:  P.O. Box 3080, Honolulu, Hawaii 96802
Fax: (808) 523-8509
Feedback: http://starbulletin.com/forms/letterform.html
Website: http://www.starbulletin.com/

FEAR STYMIES DEMAND FOR MEDICAL MARIJUANA

Patients wanting to use medical marijuana aren't knocking any doors 
down to apply under the law passed by last year's Legislature.

Only 27 people statewide have registered to use marijuana for medical 
purposes since the program began operating Dec. 28, said Keith 
Kamita, head of the Narcotics Enforcement Division, state Department 
of Public Safety.

They include six on Oahu, four on the Big Island and 17 on Kauai.

"There is a lot of nervousness," says Pamela Lichty, board president, 
American Civil Liberties Union of Hawaii Foundation.

"'Paranoia' might not be too strong a word."

A patient referred to the Star-Bulletin by Lichty, for example, would 
identify himself only as "Green Throat" because of concerns about 
federal arrest.

Hawaii is the only place in the country allowing medicinal use of 
marijuana that requires applicants to register somewhere other than a 
health department, Lichty noted.

The Narcotics Enforcement Division handles the registry here.

Kamita said the process takes five to seven days and is set up with 
the physician basically in control.

If the doctor feels marijuana is necessary for a patient, he or she 
fills out forms developed for the registry.

The narcotics division verifies the information and sends the doctor 
a certificate to sign and present to the patient.

Certificate 'Isn't Worth Much'

Kamita said mainland doctors have called wanting to certify someone 
for medical marijuana over the Internet or telephone. Anticipating 
that, he said, the law requires the doctor to be registered in 
Hawaii, and out-of-state registration is not honored. Lichty said it 
was estimated originally that 300 to 500 islanders might qualify for 
medical marijuana, based on Oregon's experience.

About 700 people are participating in Oregon's program, which has 
been running since May 1999, and laws in the two states are similar, 
she said.

However, Hawaii patients are running into several obstacles.

Physicians are reluctant to participate because they are unclear 
about the relationship between federal and state laws, she said. "And 
the Hawaii Medical Association has not encouraged their participation 
or educated its membership."

Also, patients cannot get marijuana legally, even if they are 
authorized to use it for debilitating medical conditions.

"Green Throat" said the registry identification certificate 
authorizing a patient to use marijuana "isn't worth much."

"It doesn't really give a patient access to medical marijuana. Most 
of us are in the same situation as last year."

He said he thought he could "go shopping" for marijuana in San 
Francisco, but was told he cannot fly with pot.

Authorized patients are allowed to grow their own marijuana, but it 
takes at least six months to get flowers or buds, "Green Throat" 
said. "And there is nowhere we can legally get seeds."

The state House committees on Health and Public Safety and Military 
Affairs have passed a bill (HB 707) to the Judiciary Committee that 
eliminates some loopholes and tightens the law.

Does State Law Protect Docs?

Among provisions, it adds new definitions for "adequate supply" and 
"registry identification certificate," calls for criminal background 
checks of potential patients and caregivers, and mandates information 
on the location of marijuana owned or controlled by the patient or 
caregiver.

Advocates of medical marijuana said the bill is premature, but public 
safety chief Ted Sakai said it addresses concerns raised during 
hearings on rules for the program.

The measure was revised after he and Lichty agreed to some changes, 
such as removing the physician's name from the patient's 
identification card.

"Green Throat" also protests putting the address for growing 
medicinal marijuana on the dollar-size identification card.

"To put the location of the grow site right on the card to show to 
people is ridiculous," he said, adding that it is like saying, "'Go 
ahead and arrest me, you federal agents.' It's self-incrimination."

As far as access to marijuana for authorized use, Sakai said the law 
would have to be changed to address that. "We're simply enforcing the 
law passed."

He said it is designed to protect patients because they can show 
their identification card if a policeman stops them and asks why they 
have marijuana.

Kamita noted that the narcotics division has a 24-hour hot line to 
respond to enforcement officers if they stop somebody and want to 
verify a medical marijuana certificate. "We have had a few calls 
already from police."

Sakai is encouraging people who need medical marijuana to apply for 
it, pointing out that Gov. Cayetano advocated it to relieve pain and 
suffering. "The most important step is to get his physician to 
authorize," Sakai said. "State law will protect physicians who sign 
off on this."

More than 300 physicians are participating in Oregon, and there have 
been no problems, Lichty said.

In a newsletter to members last August, however, the Hawaii Medical 
Association pointed out that federal law still prohibits possession 
or use of marijuana.

While exempt from state criminal penalties, physicians who recommend 
marijuana to patients are in danger of losing their federal license 
to prescribe controlled substances and could be subject to federal 
penalties, the HMA said.

Court Ruling Protects Doctors:

A federal judge in the 9th Circuit, which covers Hawaii, recently 
ruled that the government cannot penalize doctors who recommend 
marijuana by revoking their licenses to dispense medicine.

The Conant v. McCaffrey case stemmed from a federal class-action 
lawsuit on behalf of physicians and seriously ill patients who need 
medical marijuana.

Dr. Philip Hellreich, Hawaii Medical Association president, said the 
HMA is not telling physicians not to recommend marijuana. "We're 
saying, if you do do that, we can't guarantee absolutely there are no 
risks as far as the feds are concerned."

"Ninth Circuit notwithstanding, physicians realize it is against 
federal statutes." The 9th Circuit decision can be appealed, he 
pointed out.

"It's not true that we're anti-marijuana. We're just pro-scientific 
study," Hellreich added.

Large, controlled studies are under way at the National Institutes of 
Health and elsewhere to see if marijuana is effective for medical 
purposes, he said. "If those studies come out that it is effective 
... I'll be for it."

"The best delivery system" also is an issue, he said. Whatever the 
results of the studies, he said, physicians will never support 
smoking as the route to using medical marijuana because it is 
damaging to health.

The studies are evaluating methods of administering marijuana orally, 
by patch and aerosol sprays, he said.

Note: With U.S. and state laws at odds, doctors are afraid to take 
part, and patients cannot acquire pakalolo legally.
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