Pubdate: Sat, 09 Feb 2002 Source: New York Times (NY) Copyright: 2002 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Sam Howe Verhovek OREGON DOCTOR STANDS OUT IN MARIJUANA PRESCRIPTIONS MOLALLA, Ore., Feb. 6 - There are 8,300 active doctors in Oregon. Of these, 777 have authorized at least one patient to use marijuana, under terms of a voter-approved medical-marijuana law. There are 272 who have authorized more than one patient; several have approved a handful; one is up to 61, another 65. Then there is Dr. Phillip E. Leveque. With 1,718 such authorizations, Dr. Leveque, a 78-year-old semiretired osteopath in this Portland suburb, has granted 49.7 percent of Oregon's medical-marijuana cards since the law went into effect in May 1999. So lopsided are the numbers that Dr. Leveque has drawn the attention of Oregon medical authorities, who pledge to crack down on him for "repeated negligence" in granting the marijuana approvals, some for patients he never saw. The state's Board of Medical Examiners said this week that it would issue a formal complaint, asserting that some of those he has approved to use marijuana did not qualify under the law. Regulators say they have no quarrel with the law, just with the standard of care used to diagnose ills and treat patients by Dr. Leveque, who had previously been on probation for inappropriately prescribing drugs to chronic-pain patients. Dr. Leveque's patients, including military veterans who say they were unable to gain approval to use marijuana for pain relief from doctors in the Veterans Administration system, say he has the courage that other doctors lack to approve the drug for chronic and debilitating pain. With his soft voice, thin mop of white hair and bushy mustache, Dr. Leveque exudes the calm of a Marcus Welby with his patients. But he turns angry when questioned about the current investigation. "They're trying to say that you can just call up this doctor in Molalla and get your medical card so that you can smoke pot and get stoned and watch `Sesame Street' all day," he said. "That's just not true." Dr. Leveque added that he had turned away plenty of people seeking the card for the wrong reasons. "I had one patient who came in with a fractured finger trying to get a card, and I just damn near broke out laughing," he recalled, adding, "I told him to get out of the office." Indeed, Dr. Leveque's supporters point out that there is no scandal in his top ranking as a marijuana-card authorizer. Several groups around the state that promote the use of medical marijuana say they screen patients who appear to qualify, and then refer them to Dr. Leveque. "We've more or less recruited Leveque to do this," said John Sajo, the director of Voter Power, an advocacy group in Portland that worked to get the law passed. "A lot of these people's doctors are telling them, `Oh, go and get some marijuana, just get it on your own, but I don't want to sign for the card,' " he said. "Dr. Leveque is willing to help them follow the law." The Board of Medical Examiners disagrees. In January, it voted to begin a process that could lead to disciplinary action against Dr. Leveque, possibly including a fine, suspension or revocation of his license, or probation. The doctor has a history of trouble with the state. In 1987, he was put on 10 years' probation for inappropriately prescribing drugs to patients with chronic pain. It also recently ordered him to undergo physical and psychological exams to determine his fitness to practice, which he said he would undergo. Kathleen Haley, executive director of the board, said that it did not have "sufficient evidence" at the time of the January vote to suspend Dr. Leveque's license but that the board had put him on notice that it may soon reach such a conclusion. "Is this person practicing medicine the way it should be practiced?" Ms. Haley said. "By issuing a complaint notice, the board is saying no." State files also show the board has notified Dr. Leveque that he is under investigation for authorizing a medical-marijuana card for a teenager without first examining her. Dr. Leveque disputed the state's assertions and noted that the law originally did not require that he see patients before authorizing their cards. Many patients lived hours away, he said, and were in acute pain, making office visits difficult. Dr. Leveque said he sympathized with his patients because he himself was in constant pain because of nerve damage from prostate surgery and automobile accidents. "I'm physically disabled myself," he said. But Dr. Leveque said he did not use marijuana. "If I did so," he said, "I would be a target for every cop in the state." Under the law, state residents who have a "debilitating medical condition," including cancer, glaucoma, AIDS or severe cramping or other pains, can apply for a card, which allows them to grow or possess small amounts for a fee of $150. Oregon is one of eight states with such laws. Dr. Leveque's patients include Jack Dalton, 59, who was shot down while piloting a Marine helicopter in Vietnam. Mr. Dalton said he suffered from frequent spasms and chronic pain. Other doctors prescribed morphine and an array of other pain-killing drugs, he said. The marijuana, he said, works best. "This is not as harsh, it's not as invasive," he said, gesturing to a marijuana cigarette he was lighting up. "You don't end up with the kinds of stomach problems other drugs cause." Mr. Dalton and many other supporters of Dr. Leveque say they believe that his care is not at issue, just the fact that he is making use of a law some regulators do not like. "They say it's not about the marijuana," said Mr. Sajo of Voter Power. "That is a ludicrous statement. Of course this is about the marijuana." - --- MAP posted-by: Jo-D