A small group of California doctors have made a specialty of evaluating whether a patient has a condition with symptoms that might be eased by cannabis. They call themselves “cannabis consultants.” They keep abreast of the cannabinoid-therapeutics literature. They are not nonplused when patients with unusual conditions claim benefit. And they have written perhaps 40% of the more than 100,000 letters of approval issued by California doctors to date.
In 1998 Tod Mikuriya, MD, organized about a dozen colleagues into the California Cannabis Research Medical Group. The CCRMG employs your correspondent to produce a journal, O’Shaughnessy’s, named in honor of the Irish-born physician who, stationed in India by the British, introduced cannabis to Western medicine.
The Autumn 2004 O’Shaughnessy’s has an eye-opening report by Pat McCartney on the meetings between California and federal officials immediately after Prop 215 passed, explicitly to block its implementation. The Robert Wood Johnson Foundation, a non-profit with drug-company ties (Johnson & Johnson) participated as did the Center for Alcohol and Substance Abuse at Columbia University (offering to provide money and expertise for prohibitionist counter-moves to Prop 215).
The issue also contains a detailed history of the persecution of Mikuriya by the state medical board. The board recently resolved not to investigate doctors solely on the basis of a tip that the doc recommended cannabis. But the punishment of Mikuriya–investigated solely on the basis of tips from cops–will not be revisited. The Medical Board demands that doctors conduct “good faith” examinations of patients; “good faith” is exactly what they’re not showing in this instance.
To order individual copies of O’Shaughnessy’s, send $3 to the CCRMG, p.o. box 9143, Berkeley CA 94709. For bulk rates contact firstname.lastname@example.org
The current issue was produced with input from the Medical Marijuana Patients Union, and just in time for distribution at the MMPU’s “Law & Medicine Working Together” conference in Fort Bragg Aug. 14.
The doctors’ panel consisted of four CCRMG members: Mikuriya, Philip Denney, Marian Fry, and Frank Lucido, plus Phillip Leveque, down from Oregon. Between them they had approved cannabis use by more than 35,000 patients. And then there was Carol Wolman, MD, who had come from the nearby town of Albion, and was not known far and wide as a cannabis consultant.
Wolman, 63, is a graduate of Radcliffe and Harvard Medical School, a board-certified psychiatrist, and a Fellow in the American Psychiatric Association. Here’s what she had to say to about 150 people in the Dana Gray Elementary School auditorium.
Today is my day to come out of the closet. I have never been a vociferous marijuana advocate, and have not before spoken publicly about the trials I have endured as a result of carrying out Prop 215. To make a long story short, in January 2001 I was targeted by the Medical Board for investigation because of a letter written to them by the DEA, alleging that I sold drugs to strangers over the phone. This is untrue, and the allegation was not pursued. The Board felt “obliged” to investigate me anyway, and kept looking until they found something. I am currently on probation.
Identifying myself publicly as a targeted physician is scary. I fear retaliation from the Board. I’m here because I feel a responsibility to Prop 215 patients and to other doctors who have been harassed.
I am basically a trusting soul, and it took me a long time to realize that the motivation behind this investigation is not purely a concern for my competence as a physician. I am extremely self-critical and somewhat masochistic, and easily took on whatever guilt and punishment the Board handed me.
I am also a timid soul, and hesitate to stand up for myself. My attorney, John Etchevers, is experienced in these cases, and told me that no physician ever wins against the Board, and that they turn vindictive toward docs who challenge them. So I went along with their program.
When I met Dr. Mikuriya over the internet, and started sharing stories with him, I realized that my case if part of a pattern of Medical Board hostility toward MDs who uphold Prop 215. It gave me a new perspective. We are all afraid of being labeled paranoid nowadays, but not acknowledging that one is being persecuted is much crazier than a little suspiciousness.
I realized I would feel better about myself and get better results if I accepted that I have 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. When I was invited to participate I this panel, I knew the time had come to speak out.
I have always considered marijuana to be a safe, efficacious medication with few side effects, short or long term Unlike the pharmaceuticals I am pushed to prescribe in order to meet the “community standard,” cannabis has been around for thousands of years and its effects are well understood. There are no surprises like that with Zyprexa, a widely used medication, which turns out to cause extreme weight gain and diabetes.
An article in the British Medical Journal, June 19, 2004, reports that Bush has plans to screen the whole US population, especially children, for “mental illness,” and treat those with behavioral and/or emotional problems with pharmaceuticals. His administration has recommended Prozac for workers unhappy with their jobs. These drugs are fairly news and have serious, sometimes lethal side effects. Prozac, for instance, is associated with an elevated suicide and homicide rate. Yet marijuana, which many people use to improve impulse control and mitigate anxiety and depression, is illegal, according to the feds.
Unlike alcohol, marijuana is not associated with increased traffic accidents, crimes, or shortened life expectancy. Why is it illegal? The official hostility to marijuana is not only due to its widespread availability and lack of controllability by the drug companies. The establishment considers it dangerous because it is a mind expander. The “amotivational syndrome” attributed to marijuana is actually due to an enlightened view of the evils of society and an unwillingness to join the rest of the mice on the treadmill.
Prop 215 is fairly liberal in its description of what marijuana can be recommended to treat, and I keep within the specifics as much as possible. Many of my psychiatric patients suffer from chronic pain, migraines, anorexia or arthritis, conditions which are mentioned in Prop 215 as indications for cannabis therapy. When it first passed, I gave a number of my patients written recommendations, on my prescription form.
As it became known throughout the community that I was one of the few MDs who was willing to provide this service, I was swamped with calls and visitors. Within a few months, I adopted a strict policy: I would only issue permits to people seeing me on a regular basis.
Some of the requests I received were highly suspicious. An elderly gentleman called from Sacramento. Two bikers stopped by on their way through town. A friend of a friend insisted that I would provide marijuana. I wondered if some of these people were undercover agents; now I am sure they were. I still get such calls occasionally.
Although the whole process of review and sanctions has been extremely painful and expensive, I refused to be intimidated. I continue to make marijuana available to appropriate patients, and am very grateful to Tony Craver and Norm Vroman for their support and enlightened approach to Prop 215. We are fortunate, here in Mendocino county, that law enforcement understands the medicinal properties of the herb.
I especially want to thank Sheriff Craver for his letter of support, along with many of the local docs, pharmacists, and mental health professionals. My family has been wonderful throughout this ordeal, and my faith in Jesus has sustained me.
As a psychiatrist, I find the use of marijuana to be a valuable adjunct to psychotherapy. It promotes introspection, and enables people to withstand psychic as well as physical pain, the pain associated with traumatic memories, shame and guilt over wrongdoing, far of persecution, etc. There it aids in integration of the personality. It also dampens aggression–many of my patients with impulse-control problems reach for a joint when they feel like becoming violent.
If more people in the US used marijuana, we might see through the lies of the politicians, renounce war, acknowledge our collective guilt towards native Americans and indigenous people in other lands, come to grips with the threat of nuclear weapons, global warming, and start people sensible. We might even give up our dependence on oil!
Perhaps this is a pipe dream. Still, there must be some reason why this innocent and useful herb is outlawed, while destructive chemicals like alcohol and nicotine are tolerated, even encouraged. The antidepressants and antipsychotics so widely used these days are psychically castrating. They promote weight gain, reduced sex drive, and complacency with the current state of affairs. Marijuana, on the other hand, promotes insight and a willingness to confront the powers that be. No wonder they are threatened by it!
It is high time I spoke out to defend the right of doctors to recommend medical marijuana without fear of indirect retribution, not covered by court decisions, such as we on this panel have experienced. This herb should be widely available. It is cheap, efficacious for many ills both physician and mental, and has fewer short and long term side effects than many pharmaceuticals. There should be a Prop 215 in every state, and every physician should feel free to implement it.
The all-day conference was held in the auditorium of the Dana Gray Elementary School. It was well organized and well attended (c. 250 people). In addition to the doctors’ panel there were patients’ and law-enforcement panels. The district attorneys of Mendocino and Humboldt Counties, Norm Vroman and Paul Gallegos, came out for defining the legal limit of how much marijuana a patient or caregiver can grow in terms of area (100 square feet), not plant numbers.
Vroman revealed that Ram Dass (who is recovering from a serious stroke and had spoken as a patient) was his “guru,”and that over the years he has read and re-read everything Ram Dass has written. Antonia Lamb introduced Sheriff Tony Craver with a song composed in his honor that rhymed “cream of the crops” with “cream of the cops.” Craver said that Norm Vroman was his guru! “Never in all my years have I seen anything like this,” said Phil Leveque, the embattled Oregon doctor, who was amazed and delighted to be in such a cannabis-friendly milieu. Even Gallegos said it was unusual to be in a crowd where nobody thought he was too lenient.
FRED GARDNER can be reached at email@example.com