The pot problem

Editor’s note: This is the first in a two-part series looking at a loophole in the medical marijuana industry that allows patients to possess and use the substance, but not obtain it unless they grow it themselves. Part two will be published in Monday’s TGI.

LIHUE — It has been just over 14 years since Hawaii made history.

At the time, the 50th state became the first in the nation to establish a medical marijuana program through legislation rather than ballot initiative.

But since then, an unresolved dichotomy has existed, according to a 69-page state Legislative and Reference Bureau report released last week.

State law allows for the possession, cultivation, use, distribution and transportation of marijuana for medical purposes, but it won’t allow a patient to obtain it unless they grow it themselves.

And growing marijuana is difficult to do, according to the report, because the current medical marijuana program, administered by the Department of Public Safety, neither supplies marijuana seeds or plants nor provides a source or means of obtaining them.

So what good is legal marijuana if there’s no real way to get it?

It is a complex matter that state lawmakers, county officials and anti-drug advocates continue to tussle with as a Medical Marijuana Dispensary System Task Force develops a list of recommendations to address these issues.

And it’s a controversial topic that can leave legislators on the fence as far as what to do.

Rep. James “Jimmy” Kunane Tokioka, D, Omao-Wailua Homesteads, said he will wait to see what residents say before he takes a position.

“Like the many other controversial bills that influence our district, our island and our state, the marijuana bill is something that I will send out in my questionnaire, my survey to the community, and respond accordingly,” he said.

Legislative loopholes

To qualify as a patient under the state’s medical marijuana program, a person must obtain a written certification from a physician.

This form, according to current laws, essentially affirms that a person has a debilitating medical condition and that the potential medical benefits of marijuana “would likely outweigh the health risks for the particular qualifying patient.”

These medical conditions include cancer, glaucoma, human immunodeficiency virus (HIV), acquired immune deficiency syndrome, or other chronic diseases that causes cachexia, severe pain, severe nausea, seizures, and severe and persistent muscle spasms.

Qualifying patients and authorized primary caregivers provide the information for a confidential medical marijuana patient registry with the state Department of Public Safety. Once the information is verified, the depart-ment issues identification certificates that allow a registered patient to use medical marijuana.

The problem, however, is that those same laws that permit the medical use are also silent on other crucial areas, including access, distribution, security and transportation.

“There is quite a bit of infrastructure that needs to be developed so that qualifying patients can receive their treatment as well as ensuring that the appropriate systems and agencies are in place to ensure public safety,” Rep. Derek Kawakami, D-Wailua Homesteads-Haena, wrote in an email.

Unlike other drugs, registered medical patients cannot pick up marijuana at their local pharmacy. That’s because federal laws only permit pharmacies to fill and dispense prescribed medications.

Since marijuana is classified a Schedule 1 controlled substance — one that has a high potential for abuse and is not accepted for medical use in treatment — physicians are not allowed to write prescriptions for it.

The federal government’s classification for marijuana also makes it difficult for research to be conducted on the drug, said Dr. Gerald McKenna, who runs the McKenna Recovery Center in Lihue.

“Most of the data that we have for the effectiveness of it is from people saying, ‘Oh yeah, I smoked it and it’s great. It makes me feel a whole lot better,’” McKenna said. “The placebo effect of drugs is extremely powerful, but I think what happened with medical marijuana in Hawaii is that the proponents of marijuana who were trying to legalize it managed to get it legal in Hawaii on the backs of medicine and I think that was wrong.”

Misuse and dangers

Some officials say there is still room for abuse within the current system.

“The intent of the law was for people with debilitating medical conditions. However, that definition has been mismanaged by some physicians who grant prescriptions for ‘pain management,’” said Theresa Koki, coordinator for Life’s Choices Kauai, a county-funded anti-drug program.

She said that before Hawaii moves one way or the other on the issue, it should be well researched on it.

“No matter what people think about the drug and the policies surrounding it, it is critically important to be well-versed in the science of marijuana use and addiction,” she said. “I sincerely hope that the legislative task force will include physicians and addiction specialists, as well as someone who can look at what worked in other states.”

Other addiction specialists say that not enough solid research has been done to confirm the veracity of medical marijuana claims.

McKenna, said he is strongly opposed to all of the medical marijuana bills as they are written. If marijuana is intended to be used for legitimate medical purposes, McKenna said the drug should be developed in a form that is safe for people to take, such as vapor through an inhaler.

“They are allowing people to smoke a drug that is a dangerous, dirty drug, and they are inhaling it into their lungs,” McKenna said. “For medicine to be encouraging people to smoke a drug in its dirtiest form, I think, is malpractice. I’m not opposed to marijuana being used for medical reasons, although the research is slim, especially American research, as to its effectiveness, but it could well be effective for any number of conditions.”

McKenna said he regularly treats people who are addicted to marijuana. Some of them, he said, have medical marijuana certificates but cultivate marijuana plants for personal and non-personal use.

“People who are alcoholic tend to not drink during the day until the very end of their addiction — they go to work every day, they try to maintain themselves, but they drink at night,” McKenna said. “People who are nicotine and marijuana addicts start off the day with (nicotine and) marijuana, they use it on their breaks, after lunch, after work, on the weekends, while they’re on vacation, and if they’re doing this for 10, 20 or 30 years and they try to stop, they don’t feel comfortable in their own skin. They have a very difficult time stopping.”

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Darin Moriki, county government reporter, can be reached at 245-0428 or dmoriki@thegardenisland.com.

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