Pubdate: Thu, 24 Sep 2015
Source: Tucson Weekly (AZ)
Copyright: 2015 Tucson Weekly
Contact:  http://www.tucsonweekly.com/
Details: http://www.mapinc.org/media/462
Authors: Jayson Chesler, Lex Talamo and Sean Logan, News21

AMERICA'S WEED RUSH

Part 1: While marijuana advocates look to legalize in Arizona, 
concerns remain about medical marijuana program

When Arizona voters approved medical marijuana in 2010, the 
traditionally conservative state did so tentatively: The "yes" 
campaign garnered 50.1 percent of the vote.

So what's happened since?

State officials now call Arizona's system a model for other states, 
and members of the pro-legalization campaign deem the system a big success.

"If you walk up to a person on the street and say, 'Did you know 
there are weed shops here?' most people that I've encountered that 
aren't really related to the medical marijuana world don't even 
know," said Carlos Alfaro, Arizona political co-director for the 
Marijuana Policy Project, the Washington, D.C.-based group that 
spearheaded Arizona's medical marijuana campaign.

"It has gone so smoothly and so well that there haven't been any 
major hiccups," Alfaro said.

However, opponents of marijuana legalization said the system is 
"cloaked in secrecy" and questioned whether Arizona is a model state, 
pointing to factors like its high number of medical marijuana 
cardholders. They also raise concerns about a lack of transparency 
and question whether the system has hindered drug cartels as 
supporters claimed it would.

Now, just five years after voters approved medical marijuana, 
pro-legalization groups have once again targeted Arizona as a state 
that could legalize recreational marijuana in 2016. A Marijuana 
Policy Project-backed campaign is gathering signatures for a ballot 
initiative to legalize weed for anyone over 21.

Some local marijuana advocates who oppose the project's initiative 
have broken away from that effort and are pushing a competing 
initiative that would call for fewer restrictions for consumers and 
for potential recreational dispensary owners.

And opponents to marijuana legalization are pushing back at public 
events, on billboards and in local media. Two of the state's biggest 
anti-drug advocates, Yavapai County Attorney Sheila Polk and Maricopa 
County Attorney Bill Montgomery, have formed a group to combat any 
attempts at marijuana legalization in 2016.

Critics: Medical marijuana cards too easy to obtain

Prescott resident Sally Schindel said she became involved in opposing 
marijuana legalization after her son committed suicide, leaving a 
note that said marijuana killed his soul and ruined his brain. Since 
the death of her 31-year-old son, Schindel has become treasurer for 
Arizonans for Responsible Drug Policy, the political action committee 
working to defeat any recreational legalization efforts.

Schindel, whose son had a medical marijuana card, said she doesn't 
oppose medical marijuana itself. But she said it's too easy to obtain a card.

As of June, more than 76,000 people had active medical marijuana 
cards in the state, according to a monthly report from the Arizona 
Medical Marijuana Program. Arizona has 14 qualifying conditions to 
get a card, ranging from cancer and hepatitis C to severe and chronic 
pain. Patients must provide a doctor with 12 months worth of medical 
records before they can get a written certification and obtain a card.

Will Humble served as the director of the Department of Health 
Services and oversaw implementation of the system. Humble, who now 
works for the University of Arizona, had at one point estimated only 
20,000 people would likely qualify for medical marijuana cards 
because of the state's stringent rules.

Humble said the program's regulations attempted to capture the 
essence of what voters had approved in 2010.

"I think we did a decent job of putting together a set of regulations 
that makes it easy for a 'real' cardholder, a person who is 
legitimately seeking marijuana for a medical reason," Humble said, 
"while at the same time, making it inconvenient for the recreational 
user to get a card."

Critics of the system said that listing severe and chronic pain as a 
qualifying condition opened the door to legal use by individuals who 
want to use marijuana for recreational reasons. In Arizona, 90 
percent of the state's cardholders listed chronic pain as at least 
one factor on their applications. And most of them were male, ages 18 
to 30, according to the Arizona Medical Marijuana Act 2014 End of Year Report.

Ed Gogek, author of "Marijuana Debunked: A Handbook for Parents, 
Pundits, and Politicians who Want to Know the Case Against 
Legalization," said he doubts the majority of Arizona's cardholders 
legitimately need medical marijuana. Gogek told News21 via email that 
nationwide, most pain patients are female, and older in age, while 
the average Arizona medical marijuana cardholder claiming pain is 
young and male.

"The best explanation for such skewed numbers is that most medical 
marijuana recipients are drug abusers who are either faking or 
exaggerating their problems," Gogek wrote in a 2012 New York Times op-ed.

Gogek, an addiction psychiatrist who lives in Prescott, Arizona, said 
during a phone interview that several of his patients told him they 
received medical marijuana cards after going to a doctor and making up a story.

"It's very unlikely that even a majority of these patients are 
genuine," Gogek said. "What's going on is drug dealing under the 
guise of medical care."

Humble said the system's weakest links are a handful of physicians 
who issue a disproportionate share of certifications, and the limited 
ability of the Department of Health Services to hold those physicians 
accountable.

"There's really very limited disciplinary actions that (the 
department) can take against any physicians who are signing 
certifications without fully complying with the requirements," Humble 
said. "That enforcement is left up to those licensing boards."

More than a dozen businesses in the Phoenix area advertise online to 
potential patients: "No records? No problem!" or "Get a medical 
marijuana card for only $99."

According to department reports, fewer than 500 of the state's more 
than 27,000 eligible physician certifiers actually wrote certifications.

Naturopathic doctors, whose medical practices emphasize prevention 
and holistic treatments, wrote more than 75 percent of the total 
certifications. These doctors issued an average of 275 patient 
certifications per year compared to an average of 21 certifications 
per doctor of medicine.

Dr. Craig Runbeck, former executive director of the Arizona 
Naturopathic Physicians Board of Medical Examiners, said naturopathic 
doctors are more comfortable writing certifications because of 
naturopathy's inclusion of plant-based medicines.

"Marijuana is an herb, something we are trained to deal with," 
Runbeck said. "Compared to the side effects of many narcotics, 
marijuana is a safer alternative."

State medical boards have filed multiple complaints against 
naturopathic physicians since medical marijuana became legalized. 
Runbeck said several naturopathic doctors originally reprimanded by 
the Arizona Naturopathic Physicians Medical Board did not understand 
how to correctly use the state's controlled substances database, 
which allows physicians to see if patients have prescriptions to 
other controlled substances. Doctors must access the system before 
writing certifications for medical marijuana.

In 2012, the board reprimanded Dr. Christine Strong for failing to 
physically examine eight patients before certifying they qualified 
for medical marijuana and writing four certifications for chronic 
pain that the patients' medical records did not support, according to 
a disciplinary report from the medical board. Strong said the board 
absolved her after she made changes to her practice, including 
learning to use the database correctly and keeping clearer patient charts.

As a naturopathic doctor now working at the Cannabis Patient 
Evaluation Center in Tempe, Strong continues to write certifications.

"It doesn't always take away the pain completely, but it changes 
patients' response to the pain," Strong said. "But there's still a 
stigma. Patients are still feeling harassed."

This is from a continuing series from America's Weed Rush, an 
investigation of marijuana legalization in America, a 2015 project of 
the Carnegie-Knight News21 program produced by the nation's top 
journalism students and graduates.
- ---
MAP posted-by: Jay Bergstrom