License to ill

Shedding light on a growing controversy

What was once referred to as getting "high" or "stoned" has begun to be replaced with a new and unusual sounding phrase: getting "medicated." It is not just the language that has changed over the last few years. California's controversial medical-marijuana legalizing initiative, Proposition 215, also changed laws.

It may be easier to change laws than attitudes and prejudices. Getting to the bottom of the quagmire of issues and attitudes surrounding the proposition, medical marijuana and doctors who recommend its use conjure images of the Greek myth of Sisyphus. Zeus forever condemned the son of Atlas, Sisyphus, to the dark and gloomy underworld of Tartarus for divulging divine secrets. The Judges of the Dead, who weren't plagued with a backlog of cases or the formality of due process, speedily sentenced Sisyphus to roll a huge block of stone up and over a particular hill. Every time Sisyphus would push the stone to the hill's summit, the incredible weight would force it back down, and he would have to begin again. Sisyphus, with his body bathed in sweat, is still trying.

Trying to change attitudes about marijuana seems equally challenging. When lobbyists drafted Proposition 215, they wanted "seriously ill Californians" to "have the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the person's health would benefit from the use of marijuana." When many Californians voted and passed the initiative, which became known as The Compassionate Use Act of 1996, they had people like Angela Ashby in mind.

Ashby, 27, was born with arthrogryposis, a rare, crippling and painful disease that caused some of her joints to fuse together and ultimately left her confined to a wheelchair. A former Kendallville, Ind., resident, she found the Hoosier state's health-care system and conservative attitudes towards marijuana less than adequate for her condition. She was aware, from an early age, of the pain-relieving effects of marijuana and illegally smoked it, despite the risks. Her physician prescribed conventional medications -- including pills for pain relief -- but Ashby found the side effects, which included painful stomach problems, no relief at all. She continued to smoke marijuana, and eventually a caregiver turned her into the police when a "roach" was observed in her ashtray.

"There is zero tolerance," Ashby says about her encounter with the Indiana police. Subsequently, a court sentenced her to six months probation. "They had no mercy whatsoever." There are some people with mercy in Indiana, however. Her probation officer, she admits, didn't test her for drugs. Ashby's husband had learned about Proposition 215 during a previous visit to the West Coast, and they decided to leave their Kendallville home, family and friends for a better (if only less-restrictive) life in California.

Angela Ashby depends on the medicinal properties of marijuana to help her cope with arthrogryposis, a painful disease that even the best of Western medicines can't help. photo by Jarrod Valline

ng the Humboldt Medical Cannabis Center in Arcata. She spoke with Corey McGonigal, physician coordinator for the center. McGonigal also has a show that airs on the local community-access TV station, channel 12. The show is called "McG's How to Make Hash," and it demonstrates a step-by-step procedure for making hash, a concentrated and processed form of marijuana.

"I did that because that information is hard to get," says McGonigal. "It is like a magician giving away his secrets." He also wanted to show non-users there aren't chemicals in the hash product. McGonigal, who gets a lot of comments on the show, says, "It's all about information."

Not everyone can smoke "joints," and hash eliminates a lot of the harsh non-psychoactive materials, he says. He has plans to release "McG's How to Make More Hash" soon. The new video will describe an alternate method for processing the marijuana.

For someone to get access to medical marijuana through the center, they have to become a member. McGonigal's job is to screen potential members by gathering a client's personal or family physician's records -- establishing a valid necessity for seeking a doctor's recommendation for marijuana. Skeptic's most common complaint or concern about the recommendation process is the belief anyone can get a recommendation for anything. Ultimately, a physician determines a patient's need for use. Each of the doctors who work in conjunction with the center has different requirements for establishing need.

"I'll turn someone away for something bogus," insists McGonigal. When the preliminary paperwork is completed, a $200 first-time fee is collected and an appointment is scheduled with one of the doctors. A yearly renewal fee is $100. There are fee exemptions for low-income applicants, explains McGonigal, and for some "who just have to have treatment."

Ashby and her husband are struggling financially and are living out of their truck at Clam Beach County Park. In her case, she was able to swap the initial fee for volunteering at the center -- providing clerical duties in the office. There is often a two- to three-week wait for an appointment with one of the doctors, since they travel from outside of the local area to make their consultations.

Dr. Philip A. Denney, a family practitioner in the Sacramento area with 25 years experience, works with the Humboldt center and sees patients in Arcata "from time to time." Denney specializes in occupational and "legal" medicine, the term he uses to describe medical-marijuana recommendations. Denney was responsible for recommending cannabis for Ashby.

"My goal is to keep people out of the criminal system," says Denney. His choice to recommend cannabis to his patients hasn't led to any problems in the year he has been doing it. But he says "the federal government has put the fear of God" into doctors by threatening to revoke their DEA permits to prescribe medications. "The state of California has entrusted me with the decision to prescribe," he says. "It is not the court's business to look over my shoulder."

"The police believe this is a big hoax," Denney says about Proposition 215. "(It) allows them to act in ways they wouldn't normally act in enforcing the laws. Some think it is 'Cheech and Chong' medicine."

Still, there are prevailing concerns that people who do not have a serious medical need for marijuana seek a recommendation for the purpose of growing illegally. One anonymous Humboldt County resident, who does not have a "serious" need for medical marijuana and is a holder of a medical-marijuana recommendation, says he was "tired of paying for weed." His recommendation for asthma, a valid but not serious condition, was obtained from Dr. Tod H. Mikuriya and the Humboldt Medical Cannabis Center. He was spending $300 to $400 a month for marijuana purchased "on the street." Now he has a recommendation, he grows a few marijuana plants in his closet and supplies his own for smoking. He estimates he makes an additional $1,000 every three to four months from selling the surplus. He described the initial paperwork process at the center as a "long form" that "covered all the basic information," such as why there was a necessity for a recommendation.

Mikuriya is one of the foremost authorities on the uses of medical cannabis and has published literature on the subject extensively. The consultation with Mikuriya took only 20 minutes. Compassionate doctors are faced with difficult to prove and subjective medical conditions -- and loopholes obviously exist.

Despite heavy legal penalties for violations of the law, there is a big temptation for "easy money" some find difficult to resist. Denney admits he favors shutting down the black market, but contends that illegal growers do provide a source of medicine to the legal clubs. There are 30 cooperatives in California where people can get access to legal cannabis, Denney says, and some clubs go through 50 pounds of marijuana a week.

Many local doctors, whose attitudes are deeply rooted in the conservative, rural community, are reluctant to speak about the medical-marijuana issue. Some feel, perhaps as Denney describes, a fear of repercussions from the federal government. Dr. Jay Davis, who practices medicine at Humboldt State University's student health center and Mad River Community Hospital, offers another, more practical explanation.

"Time is money," Davis says. And most doctors will not comment because "15 minutes is a patient." He has served on several committees involved with implementing the medical-marijuana law into the county. He says relatively few illnesses benefit from medicinal marijuana, and there are better, more highly refined, drugs available for pain relief -- such as morphine. He believes marijuana should be decriminalized, taxed, and regulated like alcohol and tobacco.

"There is no reason to make it illegal," says Davis. "Give me one reason." He cites an eye-opening speech delivered to the California Judges Association's 1995 conference by Charles H. Whitebread, professor of law at the University of Southern California. The speech was derived from a book Whitebread co-authored, titled The Forbidden Fruit and the Tree of Knowledge: An Inquiry into the Legal History of American Marijuana Prohibition. In his speech, Whitebread argues marijuana was demonized in the early 1900s and subsequently made illegal because of racial bias and misinformed politics.

However politics and biases have played a part in marijuana's current legal status, proponents of decriminalization and the medical use of marijuana have no choice but to conform to existing laws. Ambiguities in the wording of Proposition 215 have caused other legal problems too. The U.S. Supreme Court is scheduled to hear arguments, March 28, to decide on the ruling of lower federal courts. The case involves the Oakland Cannabis Buyer's Cooperative, which was shut down by federal marshals Oct. 19, 1998. The cooperative challenged the order, but the 2,200 members were forced to seek their medicine elsewhere. The center has been reopened but is unable to dispense medicine. A series of appeals has left the matter in legal limbo.

"(Proposition 215) was very badly drafted -- especially the part about the caregiver," says Gregory Allen, president of the Humboldt center. Allen represents about 1,600 members. He sees little harmony between the county officials responsible for handling the enforcement of the medical marijuana laws and policies -- the sheriff, the district attorney and the board of supervisors.

Allen is very encouraged by the county's plan to begin, in March, application procedures for the issuing of identification cards, "which can be readily verified by law enforcement to establish a valid affirmative defense," according to the Humboldt County Public Health Department application form. There is a yearly $40 fee for the card, and applicants must sign a release that allows the county to verify with their doctor a proof of a valid recommendation. Allen sees it as legal protection from law enforcement agencies, which he says have not complied with the law and have seized legal marijuana. He intends to obtain the county's identification card.

"If the sheriff is screwing up," litigation lawyer Allen says. "The sheriff is going to cost the county a lot money." He continues: "We're talking about a revolution here. To make this successful, people have to realize the paradigm shift -- that the police are working on our side."

Like the myth of Sisyphus, there may always be an up-hill battle to change deeply rooted attitudes about marijuana, from all sides of the issues.

"It is hard to stop looking over your shoulder when you have done it all your life," says Allen. There are other legal issues too, such as the ambiguity of the application itself, which states the county identification cards "may or may not be valid in a jurisdiction other than the unincorporated area of Humboldt County."
HSU Police Sgt. Ray Fagot says "the local laws conflict with federal laws," and the cards would not be honored on the HSU campus. Fagot says students caught smoking are usually advised to stop and not arrested, although they may be referred to Student Affairs. If a student with a valid recommendation could demonstrate that there was no alternative, UPD might setup a controlled area for someone to medicate, explains Fagot. But students would have to go through Disabled Students Services first.

There are a lot of formalities, paperwork, and fees for those who wish to get a doctor's recommendation for the use of marijuana, but no guarantees. Getting "high" has been replaced, in some cases, with getting "medicated." But the fact remains, marijuana is a controversial topic. Caught somewhere in the middle of the medical-marijuana controversy are the seriously ill and the doctors who compassionately recommend its use, as well as the law officials charged with enforcing ambiguous and poorly-drafted laws. Like Sisyphus, they are all doing their part to push the heavy stone of prejudices and deeply entrenched attitudes up and over the hill.