Pubdate: Thu, 22 Sep 2011
Source: Boulder Weekly (CO)
Copyright: 2011 Boulder Weekly
Contact:  http://www.boulderweekly.com/
Details: http://www.mapinc.org/media/57
Author: Jefferson Dodge

BAD MEDICINE

A Boulder man's claim that Boulder Community Hospital reversed its 
position on allowing him to use his medical marijuana on the premises 
has raised questions about how closely medical staff follow hospital 
policies prohibiting cannabis use on site.

The man, who asked to have his name withheld because he fears 
retribution, asserts that he and his wife were told by a BCH nurse in 
April that he could smoke medical marijuana at the west end of the 
BCH parking lot as long as he did it discreetly in his car. But he 
claims that hospital staff backed off that stance after he used 
cannabis in the parking lot during a Sept. 12 13 hospital stay.

The man says that when he left the hospital to smoke in the parking 
lot, security guards thought he was leaving the premises against the 
medical advice of his doctor, and BCH staff discharged him as a 
result. He maintains that he needed to smoke the marijuana because he 
was nauseous and vomiting at the time, and he is allergic to the 
other medicines the hospital administers for such symptoms.

The man did provide Boulder Weekly with a letter from BCH outlining 
concerns about the number of times he has been coming to the 
emergency room for chronic pain and vomiting, with requests for 
narcotic pain medication. The letter states that BCH will provide him 
with hydration and anti-nausea medication, but will no longer give 
him narcotic pain medication unless he is suffering from an "acute 
medical condition."

Celanie Pinnell, a communications specialist for BCH, told Boulder 
Weekly that the hospital complies with federal law, under which 
marijuana is an illegal controlled substance, and as a result, no 
type of marijuana is permitted on the premises, including the parking lot.

And yet the patient who was discharged on Sept. 13 claims that his 
BCH doctor signed off on his medical marijuana card and is well aware 
that cannabis is among the medications he takes regularly.

The situation raises questions about how hospital doctors deal with 
what Pinnell acknowledges is a gray area - the legitimate use of 
marijuana as a medicine by patients of a facility that is required to 
treat it as an illegal drug.

Citing federal privacy laws, Pinnell would not comment on the man's 
specific case, but she says no BCH employee can authorize marijuana 
use, and smoking of any kind is prohibited on the entire BCH campus.

When asked whether it would be incorrect for a nurse to tell a 
patient that he could smoke medical cannabis in his car in the 
parking lot, Pinnell would not comment. She did say that hospital 
staff are educated about the cannabis prohibition during their 
initial training, and it is widely known that it is a non-smoking campus.

Pinnell says that no one employed by BCH may sign off on a medical 
marijuana card, although doctors who have their own practices outside 
the hospital may do so.

"If it is a hospital health care professional, no," Pinnell says. "If 
they are an employee of the hospital, they would have to abide by federal law."

As for how BCH doctors deal with patients who use cannabis, she says 
that is between the doc-tor and the patient.

"It might be kind of tricky," she acknowledges. "It's all very new."

In response to a question about whether BCH employees are expected to 
report what the hospital considers illegal drug use, Pinnell says 
that if a patient is registered with the state as a medical marijuana 
user with the state, there shouldn't be a need for BCH doctors or 
nurses to report cannabis use.

"I'd imagine they'd be on the phone a lot," she says with a laugh.

According to Pinnell, BCH does prescribe Marinol, a synthetic drug 
that is chemically similar to marijuana and offers similar benefits.

Niles Utlaut, an ophthalmologist whose office is located in the 
hospital, told Boulder Weekly that he didn't know what the BCH policy 
is on medical marijuana, but it doesn't apply to him anyway since he 
is not employed by the hospital.

Utlaut says that while cannabis does mildly reduce eye pressure, he 
only recommends it to patients as a last resort, after they have 
tried all other therapies. Still, he says, from a philosophical 
standpoint, if a patient has severe, chronic pain or is terminally 
ill, "if they think it helps, why the hell not let them use it?" 
Timothy Tipton of Denver, a court-certified cannabis expert and 
patient advocate, says he knows of no hospitals in the area that 
permit the use - or even possession - of medical marijuana in their facilities.

About six years ago, he says, a card-carrying medical marijuana 
patient brought her cannabis with her to Exempla Lutheran Medical 
Center in Wheat Ridge, and when she learned of their policy 
prohibiting it, she called Tipton to come get the medicine because he 
was certified as her caregiver. When he arrived, he says, "security 
got their underwear all up in a bind about it, and the police came 
out because they didn't want me to take possession of her marijuana."

Things have improved somewhat since then, Tipton says, citing another 
patient who brought his cannabis with him when he was admitted into 
Porter Adventist Hospital for surgery last summer. Hospital staff 
simply stored the marijuana with his other belongings, "so there 
wasn't a major freakout like there used to be," Tipton explains.

That patient, Larry Shurtleff, told Boulder Weekly that while 
hospitals are not as understanding of cannabis as they should be, 
"there's really not much they can say about it," because it's legal 
under state law.

Tipton, who is an instructor for the Cannabis Therapy Institute, 
calls cannabis "the most benign substance on the planet" and says 
other drugs prescribed by hospitals - not to mention the ailments 
themselves - are much worse for one's health.

"The intake of synthetic drugs into the body is not something you 
want long term," he says.

Tipton notes that for non-smoking medical campuses, there are 
alternatives to smoking, from edibles to e-cigarettes that rely on 
cannabis oil and emit only vapor, do not smell and deliver 200 doses 
per cartridge.

He says medical marijuana patients can sometimes get away with using 
cannabis by going to a smoking area at a medical campus, and one 
patient "would go the next block over in the alley to smoke his 
joint." Tipton even recalls a patient at BCH who used to go to his 
girlfriend's van in the parking lot to medicate.

He says he sees similar issues in nursing homes, many of which do not 
permit cannabis on the premises. Those that do have started requiring 
patients to medicate in the privacy of their own rooms, so that they 
don't disturb - or tempt - fellow residents. According to Tipton, at 
one assisted living center, a medical marijuana patient was eating a 
cannabis cookie when she was assaulted by another resident who wanted it.

Inquiries into cannabis policies at other local medical facilities 
such as Longmont United Hospital and Kaiser Permanente did not yield 
replies by deadline.

"It still hasn't reached the point where patients can medicate in the 
hospital," Tipton says. "I think it's very sad that the traditional 
medical community hasn't educated itself on this.

"We've had nurses who wigged out completely over hard candy."
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MAP posted-by: Keith Brilhart