Willamette Week | News| Health Care

DOCTOR'S ORDERS: Where does Measure 67 leave doctors?

When she voted to legalize medical marijuana early last November, Nancy didn't know there was a tumor growing in her right breast. A couple of weeks later, though, she found the lump that pushed her into a medical free fall. By early December she learned it was malignant. By Christmas she'd had a mastectomy and was headed for several grueling chemotherapy treatments.

The first session in early January left her reeling with nausea. Her doctor prescribed Compazine, which did little to control the nausea but still left her weak and exhausted. She knew she wouldn't be able to endure the next treatment, scheduled for this week, without a better way to control the side effects.

Nancy had heard that Zofran worked better, but at 20 bucks a pill she couldn't afford it. So she asked her doctor about marijuana.

Nancy's doctor wrote a letter stating that she had chemotherapy-induced vomiting, an acceptable condition for medical use of marijuana. The letter, he explained, should keep her from being arrested for possessing a small amount of the drug until the Oregon Health Department has a system in place for patients to register.

But Nancy still has a big problem. Although her doctor in effect wrote her a prescription, he couldn't tell her where to get it filled. Nancy, a Portlander in her early 40s, says she hasn't smoked dope since her teens. She has no idea how to get any now.

"I'm not a marijuana user," she says, "and the thought of buying drugs off the street freaks me out."

Nancy's story is becoming increasingly common as patients come up against one of the glitches in the medical-marijuana law. Even if they can find a doctor to approve their use of it (see "Doctors' Orders,"), there is no established center that provides marijuana.

When California voters approved medical-marijuana use in 1996, cannabis buying clubs sprung up around the state. Although some were genuinely geared toward patients, others became notorious hangouts for recreational users. The Oregon law was written to preclude the establishment of such clubs here.

That provision helped garner support for the measure, but it left a gaping hole in the new law. Many patients, like Nancy, are confused. She assumed the passage of Measure 67 meant that there would be a safe and stable supply of marijuana for patients like her. "I didn't grasp that they had no sanctioned way to get it," she says. "I thought there would be some alternative, getting it through a pharmacy or something."

Instead, she has learned, in order to follow the letter of the law, she has to grow it herself or be given a supply by another patient. Nancy doesn't know any other medical-marijuana users. As for growing her own, she's not in a position to wait for the plants to mature, even if she could somehow find some seeds.

In Nancy's mind she really has only one choice: the street. Because of her physician's letter, she's probably safe from prosecution, but anyone who sells or even gives her pot is in a legal gray area.

Where to get marijuana is a common problem, especially for older people who have never even seen a joint, says David Smigelski, spokesperson for Oregonians for Medical Rights.

Smigelski, a former WW reporter, says that while Measure 67 allows patients to grow up to six plants, getting the seeds or seedlings to plant is a problem OMR can't help with. "We're getting calls from people who have expertise in growing who are willing to help people," he says, "and we have people who want to know how to get seeds." But OMR won't play matchmaker. Smigelski says he doesn't know of any informal networks of patients that have sprung up to meet the demand. For now, he says, patients are going to have to fend for themselves.

Dr. Mary O'Hearn, an AIDS specialist at Oregon Health Sciences University, says doctors at her clinic have written three letters for patients who want to use medical marijuana, which stimulates the appetite and prevents the slow starvation that is a side effect of AIDS. She has no idea where those patients are getting their supply. "I haven't really talked to them about that," she says. "They seem to have access."

As much as it unnerves her, Nancy says she'll probably have to buy pot the same way everybody does: through the underground. She says she has a friend who knows someone who might be able to help. Faced with another round of chemotherapy, she doesn't have time to grow her own, and she has nowhere else to turn.

DOCTORS' ORDERS
Since Oregon's medical-marijuana law kicked in on Dec. 3, the folks at Oregonians for Medical Rights have received more than 400 calls.

"The most often-asked question is 'Where do I find a doctor?'" says David Smigelski, spokesperson for OMR, which ran the the Measure 67 campaign.

Measure 67 doesn't require doctors to prescribe pot in the same way they would prescribe penicillin. All a patient needs to be legal is a note from a physician stating that he or she has a condition that is covered under the medical-marijuana law.

Still, most doctors seem to be skittish about signing a letter. Some may fear being labeled as a "pot doctor." Others have legal concerns. Measure 67 did not legalize pot--it simply exempted patients from prosecution. It remains to be seen what consequences doctors may face.

The Drug Enforcement Agency has remained silent on Measure 67, but two years ago the feds threatened to yank the drug license of any California doctor recommending marijuana. A group of physicians sued and were able to get a stay order from a federal judge, which protects them from prosecution. Given that, the Oregon Medical Association has recommended that doctors don't do anything until May 1, when the new law requires that the Oregon Health Department have a patient registration system in place.
--PW

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Willamette Week | originally published January 27, 1999