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By David Tarnas

Friday, March 17, 2000

Patients need
medical marijuana

WHILE the issue of medical marijuana is clearly subject to debate, your March 9 editorial opposing its approval began from an inaccurate premise. You quote Dr. John McDonnell of the Hawaii Medical Association explaining how doctors who "prescribe" marijuana would risk losing their licenses, and that the six states which have passed laws to permit medical use -- Alaska, Arizona, California, Maine, Oregon and Washington -- have found that doctors "will not prescribe marijuana."

This is a half-truth. With the exception of Arizona (where the law is indeed not working), those states' laws use the term "recommend" or "written documentation" for the paperwork, which the physician would supply to a qualifying patient.

As in the Hawaii legislation, the term "prescribe" was avoided because federal law does ban prescribing marijuana. States may pass drug laws that differ from federal laws, and this is exactly what the West Coast states and Maine have done.

When the federal government threatened physicians in California with loss of their licenses after the passage of Proposition 215 in 1996, the 9th U.S. Circuit Court of Appeals found that a doctor's right to recommend cannabis to a patient was protected by the First Amendment.

While McDonnell and the Star-Bulletin speculate about what might happen if our Legislature were to pass a bill, there are programs up and running in several jurisdictions and it makes sense to examine their experience.

Oregon's program began in December 1998. Oregon has a registry system housed with the Department of Health (as do Hawaii's proposed bills).

A March 10 report from Kelly Paige, director of the Medical Marijuana Program there, says nearly 500 patients use the program and nearly 300 physicians participate -- from private and public settings including HMOs like Kaiser. This is a far cry from Dr. McDonnell's dire prediction that doctors will not become involved.

Naturally, any physician who doesn't want to recommend marijuana to his or her patients need not do so, and is protected by Hawaii's proposed measures.

Patients would not have to "buy marijuana from street dealers" under the pending bills, as McDonnell asserts. The Hawaii bills would permit patients to cultivate their own limited supply. Again, this is working well in Oregon, Alaska, Washington and elsewhere.

Your editorial speaks of how other drugs have been "thoroughly studied," but this is especially true of marijuana, which has received intense scrutiny over the last 60 years. It is disingenuous to repeat the mantra "more research is needed" when there are at least 70 modern peer-reviewed studies of marijuana as medicine.

Finally, you conclude that "legalization for medical purposes would lead to wider illegal use by people who don't need it to relieve pain." This conjecture is contradicted by a survey conducted by the National Institute on Drug Abuse (NIDA) in California and Arizona after those two states passed their first initiatives.

Despite doing an extra large sampling designed to test this very theory, NIDA found that the usage rate of marijuana among adolescents in those states was actually lower than the national average.

THE bottom line is that patients in Hawaii are now using medical marijuana to obtain relief from the effects of cancer chemotherapy, AIDS Wasting Syndrome, multiple schlerosis and other serious conditions. Many others would like to try marijuana to relieve their symptoms but fear arrest or job loss.

Everywhere that medical marijuana has been put to a vote, it has passed. A poll conducted last month by Oahu-based QMark found that 77 percent of Hawaii voters support it, too. We should not be distracted by vague predictions about what might happen, but instead look at the experiences of our sister states.

We should encourage our legislators to follow the will of the people on this compassionate issue and approve medical use of marijuana this session.

David Tarnas is a former state representative from
North Kona and South Kohala on the Big Island.

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