Pubdate: Thu, 11 Dec 2008 Source: Traverse City Record-Eagle (MI) Copyright: 2008 The Traverse City Record-Eagle Contact: http://www.record-eagle.com/opinion/local_story_128175513.html Website: http://www.record-eagle.com/ Details: http://www.mapinc.org/media/1336 Author: Tom Carr Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal) Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization) THE HELPING WEED? MEDICAL MARIJUANA IS VOTED IN, BUT NOW WHAT? TRAVERSE CITY -- Don't light up yet. Not all area doctors plan to begin writing prescriptions for medical marijuana just because Michigan voters said in November that they can. "I don't see myself prescribing this unless I saw a way that it was better implemented," said Karen Meyer, a pain specialist. Physicians cited dosing and distribution concerns, better familiarity with available pharmaceuticals and a lack of clear guidelines, so far, as reasons they may shy from recommending cannabis to their patients. Still, they acknowledge the popular recreational drug is likely useful for many who are seriously ill. Voters overwhelmingly approved Proposal 1 on Nov. 4. It became law on Dec. 4 and allows doctors to recommend patients to the Michigan Department of Community Health for identification cards allowing them to grow marijuana to treat problems including chronic pain, AIDS, cancer, glaucoma and nail patella. Under the law, a doctor will recommend a patient apply to the state. People may also apply to grow it and dispense it to patients as a legal "caregiver." Patients will be allowed to begin applying to the state on April 4. There's one problem. Getting the starter seeds or plants will likely require an illegal purchase. "We can not and will not advise on where to get it," Community Health Department spokesman James McCurtis said. "That will be something that they will have to decide, but distributing marijuana is illegal," he added. "We're looking at somewhat of a gray area and it's going to be challenging for law enforcement and for attorneys and courts." That's one thing that bothers retired obstetrician/gynecologist George Wagoner of Manistee. Wagoner has been often quoted in support of the new law after giving it to his late wife Beverly, who died last year of ovarian cancer. He obtained marijuana for her to treat nausea and vomiting that kept her from eating. He said two "breaths" from a homemade pipe or four from a vaporizer eased her symptoms without making her feel high. Still, he didn't like having to buy it illegally. "I was forced to break the law," he said. "I didn't like that and my wife didn't like it." Meyer and some other physicians have too many reservations to begin recommending it anytime soon. Ophthalmologist Robert Foote doesn't plan to use the drug in glaucoma treatments. He's read some studies indicating that while pot may relieve some of the pressure of glaucoma, it may also cause changes in blood pressure that could cause long-term damage to the eyes. "I'm usually open-minded," Foote said. "I have people using herbs, but when it's proven that the herbs don't work, I recommend otherwise." Other pharmaceutical drugs treat the disease as well or better and they don't impair the patient's ability to work or drive, he added. The new statute does not protect patients from employer discipline or criminal prosecution if they use it while or before working or driving. Meyer had patients start asking her for prescriptions the day after the election. "It puts the doctor in a tight situation, having to decide who should get this and who shouldn't," she added. Yet she and proponents of medical marijuana say that's already a problem with prescription painkillers, particularly opiates like Oxycontin and Vicodin. "That's a valid concern," said Dan Bernath, a spokesman for the Marijuana Policy Project in Washington, D.C. "Any painkiller has the potential for abuse," he said. "In any situation like that, it's up to a doctor's medical opinion." As for dosing concerns, he said patients know very quickly if marijuana is working or not. And unlike with opiates, he said marijuana poses "no risk of overdose death." "There's never been an incidence of death from overdose of marijuana in 5,000 years of use," he said. "There's never been a medically documented case." What the law does and doesn't do: - - Allows patients with a doctor's written recommendation to apply to the state Department of Community Health for an identification card. The agency will begin taking applications on April 4. - - Allows possession of up to 2.5 ounces of usable marijuana by a patient or his or her designated "caregiver." - - Permits the possession of up to 12 plants per patient in an enclosed, locked area. The law does not: - - Require an employer to allow the use of marijuana at work. - - Allow people to drive under the influence of marijuana. - - Require government agencies or private insurers to help pay for medical marijuana. - - Allow patients to smoke marijuana in public places. The state has created a Michigan Medical Marijuana Web site with questions, answers, forms, legal updates and more. Go to www.michigan.gov/mdch and click on the medical marijuana link. Sources: Michigan Department of Community Health and Michigan Secretary of State. - --- MAP posted-by: Larry Seguin