Spring 2006
O'Shaughnessy's
Journal of the California Cannabis Research Medical
Group
|
30 Doctos, 24 Nurses Earn Credits
Continuing Medical Education at Patients Out
of Time Conference
By O'Shaughnessy's News Service
Given the cannabis-free curriculum provided by U.S. medical
and nursing schools, “continuing education” is not the
apt term, but more than 100 healthcare providers —including some
40 MDs— will receive credits for attending a conference on cannabis
therapeutics in Santa Barbara April 7-8.
The event was organized by Al Byrne and Mary Lynn Mathre of Patients
Out of Time, a Virginia-based advocacy group, with help from David
Bearman, MD, and students from Santa Barbara’s NORML chapter
led by Loren Vazquez.
--
continued below
At Santa Barbara Conference, Irvin Rosenfeld holds a can of
low-grade cannabis cigarettes sent him by the U.S. government.
Heidi Wunszh demonstrates a delivery system that's easier on
the lungs--the Volcano vaporzer. |
Donald Abrams, MD, was instrumental in arranging CME credits through
UC San Francisco. Continuing education units were arranged by the California
Nurses Association for RNs and LVNs; the National Pharmacists Association
for pharmacists; and Santa Barbara City College for family therapists
and licensed clinical social workers.
Unsealing the evidence
George McMahon, Elvy Musikka, and Irv Rosenfeld, who get their cannabis
through the federal government’s “compassionate use” program,
were videotaped opening their sealed cans to prove that the cannabis
provided by Mahmoud ElSohly —the only grower licensed by the
Drug Enforcement Administration— contains sticks and seeds.
ElSohly recently testified at a federal hearing that the DEA should
not grant a license to Lyle Craker, a botanist at UMass Amherst (and
potential competitor). The administrative law judge who heard the testimony
will get a tape of the can-opening and cigarette-shredding by way of
rebuttal evidence.
Activist Rick Doblin, PhD, orchestrated Craker’s application
in hopes of breaking the government’s monopoly and making cannabis
available to more researchers. He told the Santa Barbara audience that
he thought the administrative law judge is inclined to recommend that
Craker be licensed. If the recommendation is positive, Doblin foresees
a public campaign to pressure the DEA Administrator to grant the license.
(Administrative law judges don’t make rulings, they make recommendations
to the government agencies that employ them.)
Focus on Post-Traumatic Stress
Three speakers, including Al Byrne, discussed their use of cannabis
to cope with post-traumatic stress. “That’s what it is,” said
Byrne, “—not a disorder but a perfectly logical response
to terrifying events.” Byrne experienced unforgettable trauma
when he was in the Navy —first a training accident in which
he was seriously injured and seven men died, then combat in Vietnam.
Christopher Largen and Erin Hildebrandt were sexually molested in childhood.
Largen, a writer from Denton, Texas, contrasted the punitive treatment
of marijuana users in our society with the leniency shown sexual predators.
Hildebrandt, who had been abused by a teacher in elementary school,
runs a group called Parents Ending Prohibition based in Lafayette,
Oregon. She pointed out the inherent creepiness of making schoolchildren
pee in a cup, “even with the door closed or half closed.” It
breaks down the child’s sense of personal sanctity and provides
easy access for the potential predator.
In addition to the 100+ healthcare providers who signed up for continuing
education credits, about 150 patients and caregivers attended the
conference, which was sponsored by SBCC’s Center for Philosphical Education. “Doctors
have at least as much to learn from patients,” Bearman observed, “as
patients have to learn from doctors.”
The event was formally called “The Fourth National Clinical Conference
on Cannabis Therapeutics: The Mind-Body Connection.” The patient-doctor
connection was striking. An equality and level of involvement prevailed
that one wouldn’t find at a corporate medical conference (where
doctors are catered to by sales reps from drug companies and accompanied
by spouses uninterested in the talks).
Some 15 of the doctors present were associated with the Society of
Cannabis Clinicians or had otherwised evinced a special interest
in the field. By signing up for CME credits in Santa Barbara, another
25-30 were showing a willingness to learn and a certain amount of
courage.
Perhaps none will make cannabis a focus of their practice, but all
came away with enhanced understanding of the science and better able
to discuss the subject with their patients. It’s likely that
they’ll issue approvals with more confidence and alacrity in
the days ahead.
Intellectual conversions
One particularly significant intellectual conversion in Santa Barbara
involved Jeff Stone, a pharmacist from Riverside County who is a
member of the Board of Supervisors. Stone had voted against the licensing
of dispensaries last summer because he doubted that cannabis had
valid
medical applications. What he heard at the conference changed his
outlook. “There
is medical value to cannabis,” Stone declared to a Desert Sun
reporter upon returning home. As a politician he promised to “come
up with a plan that ensures we have legitimate purveyors of medical
marijuana.”
Stone’s turnaround, according to K. Kaufmann of the Desert Sun, “could
help expedite a county ordinance allowing medical marijuana dispensaries,
which could in turn serve as a model for Coachella Valley cities also
wrestling with the issue.” Stone visited two cannabis dispensaries
while in Santa Barbara.
--continued below
| BILL BRITT, in well-accesorized scooter, runs the Association
of Patient Advocates. Britt attends court cases involving medical
marijuana "on an almost weekly basis." He said, "Doctors
in Orange County have been so frightened that we had to bring doctors
down from Northern California to see our patients." |
 |
Also present at the conference was Barbara Roberts, MD, a senior
policy analyst at the National Office of Drug Control Policy under
Clinton
and Bush. She is joining Americans for Safe Access as a lobbyist.
ASA’s
Steph Sherer was introducing Roberts in Santa Barbara with a big smile
on her face. “ASA couldn’t have a better voice in Washington,” said
Sherer. Roberts didn’t look too sad, either, to be on the side
of truth and justice at last, in the warm afternoon sunshine, overlooking
the Pacific from the most beautiful city college campus in the U.S.
(If only they hadn’t plunked those “temporary” buildings
on the lawn...)
Standard of Care
On a panel of California doctors, Arnold Leff, MD, and Frank Lucido,
MD, offered practical advice for colleagues approving cannabis
use by patients.
Leff is a Santa Cruz practitioner whose specialties include family
medicine, AIDS, and geriatrics. Many members of the Wo/Man’s
Alliance for Medical Marijuana are among his patients, and he has
worked closely with organizer Valerie
Corral over the years.
Leff warned that a heroin epidemic would ensue if the marijuana prohibition
was enforced.
Leff’s involvement with marijuana dates back to the 1960s. As
a captain stationed at an Air Force base in Northeast Thailand, he
advised the brass not to send dogs into the Enlisted Men’s barracks
to search for marijuana. He predicted that a heroin epidemic would
ensue if the marijuana prohibition was enforced, and pointed out that
the officer’s quarters were never searched. For offering his
advice, Leff was reassigned to another duty station.
After returning to civilian life, Leff was hired by (President Nixon’s)
Special Action Office for Drug Abuse Prevention to deal with the heroin
epidemic he had anticipated. “It was the last time the White
House drug-abuse policy office was run by a physician,” Leff
noted. “Since then it’s been generals and administrators —even
under Clinton.”
Problems to bear in mind
Leff listed a number of problems that doctors entering the field should bear
in mind. “Non-uniform product. Contaminants which might produce potential
adverse effects. Therapeutic availability may be inconsistent. Marijuana is
an illegal substance and is now being grown by conglomerates that are not being
careful of the environment. Marinol is a uniform product that works for some,
but dosing is very tricky and it’s a costly drug.”
Leff thinks marijuana ought to be treated like other herbs available at health
food stores. “Given its safety, perhaps it should not have been medicalized.
But since it has been medicalized, the responsibility changes. Once a patient
walks through a physician’s door, a standard of care is required: appropriate
diagnosis and appropriate follow-up. There are difficulties confirming some
diagnoses in those who are mentally ill and those who use more dangerous substances...
It really is our responsibility, even if they come in with medical records,
to confirm that that diagnosis is correct.”
“We need to bring back a good doc for drug czar, instead of
generals.” —Arnold Leff, MD
Leff acknowledged that there are “poor quality patients who
share their meds, patients who sell meds inappropriately.” He
also mentioned “the issue of smoking in public and being respectful
of others... Since we have red benches [designated areas for cigarette
smokers] perhaps we also need blue benches.”
On the national political front, Leff does not expect the judiciary
to advance the cause of medical marijuana. “We need to make it
an important subject to Congress and the American people. If there’s
a congressional change in the near future, we need to make the most
of it. We need to bring back a good doc as drug czar instead of generals,
and, of course, reorganize and redirect the DEA the NIDA and the FDA.
We also need to change some treaties.”
Risk of Medical Board Scrutiny
Lucido did not try to sugar-coat the situation for prospective cannabis
consultants. He decried the commitment to prohibition of the California
Narcotics Officers Association, whose opposition to Prop 215 didn’t
end after the voters passed it.
The Medical Board of California (MBC) is controlled by law enforcement
and/or their legal staff who work closely with the Attorney General’s
office. “Doctors are afraid of the Medical Board — even
good doctors,” said Lucido.
“
The Board has initiated several inappropriate investigations of cannabis
recommending physicians, essentially all initiated by reports from
various categories of law enforcement.
“
My own inappropriate investigation came as a shock,” Lucido said,
given his confidence in his practice standards. In response he began
attending quarterly meetings of the Board and founded MedBoardWatch.Com
to report on their doings.
 |
DANIELE PIOMELLI, professor of pharmacology and director of the
Center for Drug Discovery in the UC Irvine School of Medicine,
is trying to develop a sythetic cannabinoid that will not affect
the brain but will block pain at the site of an injury. "Cannabis
offers fantastic ground to develop new compounds," he said, "and
medicine needs them." |
Activists are working ceaselessly to implement the law, Lucido said,
and “just last week the City of Emeryville, was forced to pay
a patient $15,000 for having taken the patient’s medicine.
“
In spite of the adverse Raich Supreme Court decision, I see victory
ahead for doctors and patients who can demonstrate responsibility and
credibility. Responsible doctors and their responsible patients will
be most protected.”
David Bearman, MD, recounted the case in which he ultimately prevailed
against the Medical Board for violating the privacy rights of his
patient by subpoenaing his medical records. A published decision
by The California
Appellate Court of the 2nd District said that the Medical Board didn’t
understand Prop 215; didn’t understand the law affecting privacy
rights; and lied about not investigating doctors solely for recommending
cannabis.
Bearman said that Joe Allen, the former district attorney of Mendocino
County, is filing a civil rights lawsuit in federal court on his
behalf, seeking $115,000 in damages for his ordeal.
“
We must move the media to seeing how cannabis actually improves the
quality of life for some —that with cannabis they can work, they
can drive, they can care for their kids,” said Bearman.
The Santa Barbara News-Press ran a front-page story April 8 focusing
entirely on a brief, “profanity-laced” talk by Montel Williams,
who urged his audience to expose politicians who smoke marijuana. Williams
said he was “tired of being out here all alone” —as
if the room wasn’t full of people who have taken risks to oppose
prohibition. The TV host’s talk was a sidebar to the conference
and should have been a sidebar in the paper.
The UC Santa Barbara NORML chapter, whose members helped stage the
conference, presented Tod Mikuriya, MD, with a plaque ‘in recognition
of a lifetime of work, courage and fortitude in fighting the insane
drug laws of our time and almost single-handedly reintroducing the
medicinal application of cannabis to over two generations of physicians.”
Mikuriya praised his longtime hero, W.B. O’Shaughnessy (see story
on page 25), and decried “non-medical forces that have insinuated
themselves into the practice of medicine in the most ungodly ways.
We see victims around us here today— Dr. Mollie Fry and her husband,
attorney Dale Schafer, have been forbidden from having appropriate
medication for the treatment of their conditions and have been forced
to take medication that is both sickening and diminishes their ability
to mount a defense.
“
Another patient of mine, Robert Schmidt, who founded Genesis 4:29,
was prevented from using cannabis or Marinol by federal prosecutors
and non-medical bureaucrats in the pre-sentencing program. They poisoned
him with Effexor, causing serious cardiac complications as well as
gross edema and an inability to focus on mounting a credible defense.”