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Health Practitioners Divided Over Proposed Expansion of Medical Marijuana
10/02/2009 5:30 PM ET   Reported By: Susan Sharon

Next month Maine voters will consider a measure that would expand the list of illnesses and conditions covered under the state's ten-year-old medical marijuana law. Question 5 on the ballot would also allow for the establishment of state-regulated  dispensaries where medical marijuana patients could safely access the drug. Though the issue has received sparse attention and there is no organized opposition, Maine's top law enforcement officials are against the idea.  But when it comes to the medical community, the dividing lines are blurred.

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Originally Aired: 10/2/2009 5:30 PM
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 Duration:
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Even though she's been diagnosed with multiple sclerosis and meets the criteria for medical marijuana under current Maine law,  "Jane" says she never considered trying to access the drug until this year.  In March,  Attorney General Eric Holder announced he would not prosecute marijuana distributors unless they violate both federal and state law. Maine is one of 13 states that has legalized medicinal marijuana, but at the federal level it is still illegal.

"You're in this kind of never-never land," "Jane" says. "You're allowed to have it and hopefully enjoy the effects of it but you can't legally purchase it."

"Jane" asked that we not use her real name and alter her voice to protect her identity. That's because as a wheelchair-bound MS patient, she's prescribed a range of medications that she believes make her vulnerable to theft on the black market.  

Under Maine law,  "Jane" and other medical marijuana patients who meet certain criteria, could grow a small amount of marijuana for their personal use.  But "Jane's" physical limitations make that virtually impossible.  For recently-diagnosed cancer patients undergoing chemotherapy or radiation, there's often not enough time to raise mature plants by the time they need it.  

That's one reason "Jane" supports Question 5. "I've looked at this bill and it struck me as being in some ways like the California law but not subject to the abuse. It has more restrictions and more oversight and what it would do is allow people who fit in the criteria to have a lawful way to get it and you would be assured that what you're getting is a safe product.  Right now you're on your own."

"Jane" says she has relied on the kindness of friends to get marijuana. But first she had to find a Maine doctor willing to treat her as a patient. There is no list. Names are shared by word of mouth.  And by all accounts there are only a few.

"I don't start with medical marijuana as the first choice for a medical condition. It's part of a whole assessment of what can be done for a given condition," says Dr. John Woytowicz, a family physician in Augusta who says he's treated about 50 medical marijuana patients, including "Jane" over the past ten years.

"And I put it very frankly to the patient that I would like to explore all opportunities and this could be one of the options as well. My experience is for the appropriate patient, it can be a good option for them, and most people have been benefitted by it with the minimal amount of side effects."

"Remarkably, the way I use it most is - I call it "funny butter on English muffins."  I just have an English muffin with this butter on it in the morning with my coffee and that's it, and it has made a remarkable difference," says "Jane" who says the difference includes a reduction in pain,  muscle spasms, being able to sleep better and a better quality of life.  

She used to have steroid injections every four to eight weeks and hated how they made her feel.  But since she began using medical marijuana "Jane" says she hasn't needed them.  "I have not had a steroid injection since then, and that's seven months without a steroid injection and steroid is terrible for your bones."

Dr. Woytowicz says he supports the medical marijuana dispensary idea because he thinks it will give medical marijuana more legitimacy, make it easier for doctors to incorporate it in their practices and make it safer for some patients who are currently buying it on the black market.   

But State Health Director Dr. Dora Anne Mills says it's wrong to have public health agencies oversee marijuana dispensaries. "And the referendum, if passed, would conflict with current federal law.  So to put a state agency in the position of dispensing a drug in an illegal way, and a harmful drug, I think would put us in a horrendous position."

"I would advocate for limiting access to marijuana and not to regard it as a medication," says Dr. Mark Publicker, an addiction specialist with Mercy Recovery Center in Westbrook.  He says the positive and negative effects of marijuana have not been thoroughly studied.  

But he says it's clear the use of the drug is not entirely benign. "There's no question it's a gateway drug.  It's stimulating the same pathways as the opioids.  There is literature showing that cannabis increases the risk of heroin addiction.  But the other issue is, it's keeping kids involved in the drug scene.  So the kids exposed to people that are selling and smoking are far more likely to be exposed to other drugs."

Supporters of Question 5 point out that similar arguments were made about legalizing marijuana for medicinal purposes ten years ago.  And they say Maine voters have already made their feelings about them clear.  

But Dr. Owen Pickus, who regularly treats Aids and cancer patients, says marijuana's acceptance has more to do with politics than medicinal value. And even though he has treated patients who use medical marijuana, he says he's taking a neutral stance on Question 5.  "I am uncomfortable prescribing medication to patients unless I know that the medication goes through an approval
process that the FDA is involved in.  This is not the way to handle the problem."

Pickus says he has only treated about 10 medical marijuana patients over the years.  Some say the fact that there are so few doctors and patients using the drug show that it's use is not being exploited ten years after it was first legalized in Maine.

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