Minutes from March 11, 2005 Meeting
Attending: Dr. Akbar, Dr. Bannister, Dr. Cotsirilos, Dr. Ellis, Dr. Hergenrather,
Dr. Lucido, Dr. Mikuriya, Dr. O’Connell, Dr. Toy, Fred Gardner, Dale Gierenger,
John Trapp, and Michael Trapp
Introductions, accomplished round table.
Review and approve agenda, so approved.
Review and approve minutes, minutes approved.
O’Shaugnessy’s Journal – Fred Gardner
The Reich case special issue was presented & distributed, with much praise
by all. 15,000 issues were printed. Mr. Gardner discussed printing problems
and the need for an art director/layout person. He also discussed distribution
and the need to highlight patient education as a caregiver function of dispensaries.
O’Shaugnessy’s is also available on the CCRMG website in partial form and most
distribution will be completed in the next three weeks. Subscriptions will
no longer be taken as Mr. Gardner is only committing on an issue-to-issue basis.
He is aiming for a Summer issue after the Reich decision and one for the ICM
meeting in the Fall. Fundraising was discussed and there was a clear consensus
to make O’Shaugnessy’s a financial priority, as this is the only forum for
this type of information. Dr. Denney spoke on medical marijuana at a medical
school and there was support for a speaker’s bureau to raise funds and awareness.
Dr. Bannister announced his annual benefit for his legal defense fund on June
3-5 and offered to make CCRMG a beneficiary next year if it makes a profit.
Medical Board Updates – Frank Lucido
Dr. Lucido gave updates on the 11/5/04 and 2/18/05 regular Medical Board meetings
as well as the 1/21/05 special meeting of the Board on the enforcement monitors
and the 2/22/05 meeting between the Medical Board leadership and Senator
Figeuroa’s committee all of which are posted on www.medboardwatch.com. The
1/21/05 special meeting involved the entire Board including division of licensing.
The largest problem was identified as the length of time to pursue cases.
The enforcement monitors, “independent contractors” directed by the Medical
Board legal staff, are promoting “vertical prosecution” where more investigations
will be moved to the Attorney General’s office. The Dr. Lucido made public
comment that this change would eliminate doctor participation in investigations.
Despite several objections presenters cited “unanimity of opinion” and urged
the Board to “focus on the concept and not the details” and the plan was
accepted. During Senator Figeuroa’s all public comment went against the enforcement
monitor’s proposals. One complainant testified that prosecutions were too
slow to remove bad doctors, but not cannabis physicians which is a “witch
hunt”. Dr. Lucido raised the issue of the “revolving door” between the Medical
Board, Attorney General’s office, law enforcement, and possibly the DEA.
Dr. Mikuriya handed out and discussed copies of the city of Sunnyvale’s Planning
and Management System (PAMS) and it was discussed as a model of quantifiable
goal based planning and accountability. Dr. Mikuriya has contacted Senator
Figeuroa’s office to try to schedule a meeting to discuss and Dr. Lucido
will join him in those efforts.
California Research Programs Update – Dale Gieringer
Mr. Gieringer, advisory board member to CMCR, reported that there has been
little progress on the research programs. Most studies are still recruiting
patients at a rate of one or two a month because of the sharply defined populations
and California patient’s ability to get higher quality cannabis than is available
in the studies. Some studies may be completed by the end of the year. Dr.
Abrams pilot study on Aids-Neuropathy should have some preliminary results
and his vaporisor study is going quickly and there should be some results
this summer. The office staff is extremely cautious and there will be no
press releases until studies are published. Mr. Gieringer suggested an epidemiological
study based on the huge pool of existing medical marijuana patients and one
researcher was interested, but office staff did not take it up. CMCR has
used up their funding with only money set aside for existing studies. The
University of Massachusetts is seeking approval to grow marijuana for research
purposes, as NIDA cannabis is inadequate. There was also discussion on Ramonaban,
a cannabis antagonist drug and Dr. Mikuriya reported on his submission of
objections to the FDA from CCRMG. Dr. Bannister discussed 300 pain patients
who have an average pain reduction of 4 on a 10-point scale from using cannabis.
An epidemiological study was discussed, with MPP being a potential funding
source, and Mr. Geiringer agreed to work on a proposal if an experience epidemiologist
were willing to work on the project.
Data Collection and Research – Jeff Hergenrather
Some doctors are using new forms with a clause allowing non-identifying information
to be used for data analysis of cannabis using patients. Approximately 3,000
patients have completed the latest version of the shared forms. The Health
and History Questionnaire has not yet been posted on line, but will be shortly.
The coding of ICD-9s was encouraged, as this is the only readily usable data
without massive data entry. The International Cannabinoid Research Society
is accepting abstracts until 4/1/05 for their meeting in Leyden on 9/5/05.
Dr. Hergenrather wants to do a paper next year.
DBAs SCC and CCRMG
DBAs were obtained for both names. John Trapp put out a call for submissions
for a statement of purpose for SCC to be posted on the website.
Outreach to Cannabis Clinicians beyond California – Tod Mikuriya
Dr. Mikuriya discussed Dr. Wolman’s and Dr. Sterner’s cases which were both
DEA investigations. Dr. Mikuriya met with the attorney in the Sterner case
and learned urinalysis and a psychiatric interview were stipulated. Dr. Fry
settled her case, pleading at the state level, and was given a $1,500 fine
and ordered to take a record keeping class. The DEA agent in the case was not
forthcoming under cross-examination and the DEA physically removed patient
records and submitted them to the Medical Board. Dr. Bannister completed his
probation. Dr. Mikuriya has changed attorneys and is continuing with his appeal.
MedicoLegal Practice Standards – Frank Lucido
Minimum Practice Standards/Credentialing – Dr. Mikuriya
Dr. Lucido reported he sent out an email and published in O’Shaugnessy’s on
practice standards. He discussed his own standards, highlighting the need to
avoid association with dispensaries. Chains and franchises were discussed.
For example, UMCC in LA has three doctors’ offices at their dispensary and
advertises on youth oriented radio stations. Medi-Can was de-listed from the
Cal-NORML website of cannabis physicians. No dispensaries in the Bay area have
on-site doctors. Dr. Hopkin’s case was discussed as another example. One of
his marijuana patients was on trial and Dr. Hopkins exercised his 5th Amendment
rights after the DA stated he was handing out marijuana recommendations like
candy. MedicoLegal practice standards will help protect patients while Minimum
Practice Standards will help protect doctors from the Medical Board. Only CCRMG/SCC
has the credibility and standing to move on credentialing. There was some discussion
on what the process for credentialing would be. Levels of membership, some
demonstration of knowledge of the law and facts on marijuana, and the need
to bar cross referrals, real and hidden, were all discussed. A Credentialing
Committee, headed up by Dr. Lucido, was created. Dr. Bearman was proposed as
a member as well as an attorney (Panzer and Figeuroa were suggested). There
was also some discussion on the voluntary state ID card. The law requires confidentiality
but the process being created involves a secure website the police can access
as well as the state sending out the ID cards further eroding confidentiality.
SCC took a position of maximum confidentiality and Dr. Hergenrather was empowered
to create and distribute a draft position for SCC on this issue.
The next meeting will be held on Friday June 17, 2005 at 11:30 am 513 El Cerrito
Bring your own bag lunch.
The meeting was adjourned.