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Pot Shots

Dr. Wolman Martyred; O’Connell Goes on the Record

by FRED GARDNER

Mendocino psychiatrist, and sometime CounterPunch contributor, Carol Wolman, MD, one of four openly pro-cannabis doctors placed on probation by the Medical Board of California, is the first to be barred from granting approval to cannabis-using patients. Wolman, 64, a graduate of Radcliffe and Harvard Medical School, has been writing a commentary on the Bible emphasizing the pacifism and fairness of Jesus. The MBC began investigating her in 2001 following a complaint by a DEA agent that turned out to be groundless. When the Board found another reason to place her on probation, Wolman concluded that she’d been "targeted… whether for marijuana, peace activism, or simply because I serve a MediCal population, and the state wants to get rid of MediCal docs." [See CounterPunch 8/18/04]

In its April 2005 "Action Report," the Medical Board published the following re Wolman’s license status: "Violated the terms and conditions of his [sic] board-ordered probation by failing to enroll in a clinical education program and failing to pay cost recovery and probation monitoring fees. Revoked, stayed, given an additional year of probation… with terms including, but not limited to, obtaining a practice/billing monitor; prohibited from ordering prescribing dispensing, administering or possessing any controlled substances except those on Schedules III, IV, and V and the ADD medications Ritalin and Adderal; and prohibited from issuing an oral or written recommendation or approval for marijuana."

Asked why she accepted such an onerous deal, Wolman told a colleague, "The Medical Board presented it to me after I completed the PACE [Continuing Education] program and regained my license (which was suspended because I failed to complete PACE within the first 6 months of probation- couldn’t afford it). I was told to sign it or lose my license again. I had no attorney -I was more broke than ever after borrowing $10,000 for PACE, which was a joke- and not being able to work for two months. I approached several to ask for help with the marijuana clause, but none was willing to take on the situation pro bono." The Medical Board is the state agency that licenses doctors and other healthcare practitioners. Twelve of its 21 members are MDs appointed by the governor to four-year terms. The Board’s staff includes about 100 career investigators and more than 100 office workers. As in other government agencies, there are complicated power relations between those formally in charge (who come and go over the years) and those who do the day-in, day-out work (and will unto retirement).

Tod Mikuriya, MD, and about two-thirds of his colleagues in the Society of Cannabis Clinicians have been investigated by the Board and forced to live under a shadow of fear while mounting costly, time-consuming responses. None of the complaints against Mikuriya (or any of the SCC doctors) came from patients or loved ones or caregivers acting on behalf of patients; they all came from law enforcement officers, and not one even alleged harm to a patient! Nevertheless, the Board called in the Attorney General to formally charge Mikuriya with violating a vaguely defined "standard of care." His record keeping was deemed inadequate by an administrative law judge and he is currently on probation.

In response to this pattern of persecution, Frank Lucido, MD, one of the cannabis specialists investigated by the Board, began attending quarterly meetings of the Board and writing them up in the SCC journal, O’Shaughnessy’s, and on a website, MedicalBoardWatch.com. Lucido has been trying to teach the Board members some of the things they didn’t learn about cannabis in medical school. To this end he asked Tom O’Connell, MD, to address the Spring meeting, which was held at the Embassy Suites hotel near the San Francisco airport. (God knows how much business gets conducted in such venues. The businessmen and women fly in, check into the hotel, hold their important meetings, and fly back to headquarters. Good thing we have an infinite supply of fuel and all those humble, brown-skinned people to keep the buffet refilled.)

O’Connell, 72, has silver hair which he wears shoulder-length, dark eyes, and a serious manner. He had a full career as a thoracic surgeon (including 13 years in the U.S. Army) then came out of retirement to start examining people seeking approval to medicate with cannabis. O’Connell’s data show that many of the seemingly able-bodied young men who patronize Bay Area cannabis clubs are self-medicating for stress and depression and, in the process, reducing their use of alcohol and tobacco. His manner, in addressing the Board, was colleague-to-colleague.

Dr. O’Connell’s Commentary:

After I began screening cannabis applicants in late 2001, the discovery that nearly all were already chronic users who had originally tried it during adolescence -at about the same time most had also tried alcohol and tobacco- led me to develop a structured interview aimed at a better understanding of that same self-medication phenomenon. Over three thousand such encounters have now been recorded and enough data from over 1200 structured interviews has been analyzed to permit the admittedly startling conclusions I will share with you this morning:

1) Demographic data amply confirm that a vigorous illegal "marijuana" market didn’t begin until cannabis was first made available to large numbers of adolescents and young adults during the ‘hippie’ phenomenon of the late Sixties.

2) The subsequent sustained growth of that illegal market, although difficult to measure precisely, is widely acknowledged. Those same applicant demographics also suggest that the continued growth has resulted from chronic use by an unknown fraction of the teen initiates faithfully tracked by annual federal surveys since 1975.

3) The striking temporal association between initiation of cannabis on the one hand, and tobacco and alcohol on the other, first noted by researchers in the early Seventies was confirmed; however, the "sequence" they also noted in which cannabis was usually the third agent tried no longer obtains. All three are now tried at similar ages, and in random order.

4) Those findings, together with an almost universal acknowledgement of similar emotional symptoms, suggests that rather than acting as a "gateway" to other drugs, cannabis has, since the late Sixties, become a third agent tried unwittingly along with alcohol and tobacco by troubled adolescents– and for similar emotional symptoms.

In other words, what the three agents have in common is an ability to treat symptoms of adolescent angst and dysphoria; and thus function as self-medications.

5) That interpretation is further supported by several other findings developed by systematic inquiries into their family and school experiences -plus their initiations of a menu other illegal drugs- including both psychedelics and "street" drugs.

6) There is also startling yet conclusive evidence that once they had settled on cannabis as their self-medication of choice, this population then dramatically diminished its consumption of both alcohol and tobacco in sustained fashion. Federal statistics gathered since 1970 also show a gradual parallel decrease in the consumption of both– plus some related improvements in health outcomes.

7) The bottom line seems to be that in addition to its better-known ability to relieve several somatic symptoms, cannabis has also been a beneficial psychotropic medication for many of its chronic users since their adolescence.

This unique clinical evidence also suggests that cannabis was a benign and safe anxiolytic/antidepressant long before any pharmaceutical agents were even available for those purposes, and that it still outperforms most of them in both efficacy and safety.

This evidence further suggests that current attitudes toward cannabis are not only profoundly mistaken; but that continued aggressive prohibition inflicts great damage on both individuals and society.

My primary reason for sharing this information with you at this early phase is precisely because it is so radically at odds with both official policy and popular beliefs; a collateral reason is to point out that gathering such data wasn’t even possible until 215 was passed.

Finally, because the ‘medical marijuana’ laws passed by other states have been so restrictive, the acquisition of such data has only been possible in California.

FRED GARDNER can be reached at journal@ccrmg.org