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April 3rd, 2002 Chris Lydgate | News Stories
 

Sense and Sinsemilla

Is "green medicine" a lifesaving therapy or just a great way to get over on the Man?

     
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Ken Brown's world collapsed on Nov. 6, 1991, at approximately three o'clock in the afternoon, when he was on his way to the hardware store for a 49-cent plumbing fixture.

While he sped north on a busy stretch of Highway 101 toward the coastal town of Florence, an Audi full of teenagers locked in a high-speed drag race hurtled toward him from the opposite direction. Without warning, the Audi zig-zagged across four lanes of traffic, veered into an embankment, flipped over twice and crash-landed on top of Brown's 1971 Datsun station wagon--flattening it down to the door handles.

"It was like...being hit by a meteor," Brown remembers.

The occupants of the Audi crawled from the wreckage relatively unscathed. Brown was not so lucky: The collision broke his neck in three places, crushing his spinal cord at vertebrae C2, C3 and C4. When he regained consciousness, 13 days later, he was lying in a hospital bed in a tangle of tubes, his lungs ventilated by the mechanical whoosh of a respirator. He tried to sit up, but his legs wouldn't move. He tried to lift his arm, but his biceps wouldn't contract.

He was paralyzed from the neck down.

Ten years later, lying in a Tigard rest home, Brown's hairless body has the texture and color of a Vietnamese salad roll--a translucent pinkish white with the hint of the blue veins beneath. He breathes through a tube sticking out of his Adam's apple. Tasks as mundane as taking a sip of Diet Coke can be accomplished only with the help of an attendant holding a cup and straw to his mouth.

To cope with the intense pain that accompanies his paralysis, Brown takes massive amounts of morphine. He also uses pot. "The marijuana is...10 times better than...the legal drugs," Brown explains, in gravelly phrases that come in three-second bursts dictated by the mechanical ventilator. "It amplifies the morphine.... I hardly ever spasm.... It's pure bliss."

Brown, 51, is a registered cardholder in the state medical-marijuana program, which gives him the right to eat cannabis-laced brownies. Two months ago, however, the Oregon Department of Human Services told Brown's attorney that his attendant could no longer feed him his marijuana--a seemingly obscure decision that has had far-reaching consequences, limiting patients' access to marijuana and plunging the 3-year-old program into confusion. In response, Brown and other advocates have launched an initiative to overhaul the program and shake loose some of its most odious restrictions--relax them so much, opponents say, that marijuana would become legal in everything but name. (For more on the initiative, see "License to Chill," page 27.)

The battle over the initiative, which hits the streets this week, provides a tantalizing glimpse into the evolution of medical marijuana in Oregon. Despite its original intent--to let patients with severe or terminal illness smoke pot without fear of prosecution--the program has created a hazy netherworld at the ragged frontier between state and federal law, where legitimate patients rub elbows with seasoned stoners seeking refuge from the War on Drugs.

Ever since Oregon became the first state to decriminalize possession of small amounts of cannabis in 1973, hempheads have mounted at least half a dozen attempts to legalize it. They all failed--until the medical-marijuana movement gained momentum in the late 1990s.

Oregonians may not have been ready to end the prohibition on pot, but they were receptive to the idea that severe or terminal illnesses--particularly cancer, AIDS and glaucoma--could be treated with a home-rolled joint instead of an avalanche of expensive pills, each carrying a small-print portfolio of side effects.

In 1998, with the backing of three deep-pockets libertarians--currency speculator George Soros, University of Phoenix founder John Sperling and Ohio insurance executive Peter Lewis, who together contributed $140,000--advocates launched Measure 67, the Oregon Medical Marijuana Act.

OMMA was billed as a practical and compassionate measure. Only patients with specific conditions would qualify--and only with their doctor's permission. Patients would grow their own weed and smoke it in the privacy of their own homes, hidden from public view. Those too sick to grow pot could ask their caregivers to do it for them. No money would change hands. The campaign, led by a grandmother with multiple sclerosis under the rallying cry, "Protect dying and suffering patients," proved persuasive: Oregon voters approved Measure 67 by 54.6 percent.

In reality, however, the majority of patients aren't terminal cancer victims, but aging baby-boomers with much vaguer complaints.

A WW analysis of data provided by the state Department of Human Services shows that relatively few of the 1,700 current cardholders suffer from marquee diseases: 3 percent have cancer; 3 percent are HIV-positive; 2 percent have glaucoma; and 1 percent have cachexia, or wasting syndrome.

In fact, the overwhelming reason patients sign up for the program is pain: fully 53 percent of cardholders report "severe pain" as their primary medical condition, citing causes as varied as arthritis, migraine, carpal-tunnel syndrome, menstrual cramps and fibromyalgia (see chart, page 23).

The prospect of a bunch of middle-aged patients demanding marijuana to cope with their arthritis is likely to prompt skeptical spluttering. Nonetheless, the case of Ken Brown would still the harshest critic.

Brown suffers from severe pain that requires up to 300 milligrams of morphine a day. Not only does the morphine make him woozy, but the high doses cause constipation so intense that his feces must be extracted by hand. With marijuana, however, Brown can reduce his dose to as little as 35 milligrams.

Pot also relieves the spasms that convulse his entire body for minutes at a time. "It's like a bear hug...I can't take air in," he explains. "It's frightening.... You don't know when it'll end...."

Brown was one of the first patients to sign up for the medical-marijuana program, and he quickly discovered the law's drawbacks. The state of Oregon may be willing to let him consume cannabis, but under federal law, marijuana is still a Schedule I substance. The managers of his previous group home in Eugene worried that if federal authorities got a whiff of Brown's marijuana use, they'd dispatch hordes of inspectors to shut the place down. Brown moved to a more accommodating home in Tigard, but the paranoia continues--the administrator of his new home asked WW not to mention its name for fear of official reprimands.

Physically unable to grow his own marijuana, Brown hooked up with a registered caregiver from Portland, who drove to Tigard once a week with a Tupperware container full of marijuana-laced brownies. But this, too, ran afoul of the law--the box contained more than one ounce of pot, the maximum allowed--so his caregiver had to make frequent trips with smaller amounts.

Then there was the issue of who would actually administer the brownies. Brown can't feed himself, so volunteers had been. In February, the Department of Human Services told Brown's lawyer that, although his home provides round-the-clock nursing staff, only his registered caregiver could legally hoist a plastic fork and feed Brown his psychoactive treats.

For Brown, that means a few mouthfuls of medicine in a 24-hour cycle. "I'm just so...sick of this," he says. "If you trooped...a cross-section of Oregon...voters in here and asked...if they intended...all these restrictions...what do you think...they would say?"

The decision that only Brown's registered caregiver could give him pot sent a bolt of paranoia through medical-marijuana patients across the state. Most patients have come to rely on a shadowy network of other patients and caregivers for their medicine--a network whose legality is now under fire.

Dapper in a brown jacket, blue jeans and a fancy watch, Clifford Spencer, 49, stubs out a Marlboro, grabs a black leather briefcase, and strides toward his next house call. By day, Spencer is a salesman (He requested WW not publish his field.). His spare time, however, is devoted to volunteer work--dispensing "green medicine," like an old-time country doctor.

Spencer is a true believer in the healing power of pot. He wipes tears from his eyes when he recalls a friend, dying of AIDS, who begged him for a joint. A former teacher and social worker, Spencer was one of Oregon's first cardholders as a result, he says, of back problems. "I have severe chronic pain," he says. "But looking at me, it's not obvious."

Spencer may be a patient, but he is also a registered caregiver for two other patients. In fact, he runs a whole medical-marijuana network, dispensing a bewildering cannabis pharmacopoeia, including strains such as 'Dam (short for Amsterdam), Sellwood Thunder, Northern Lights and Juicy Fruit, in addition to extra-strength brownies, cookies and banana bread.

A tireless herb evangelist, Spencer coaches patients through their paperwork, recruits caregivers, and works with group homes to set up protocols and help navigate the maze of local, state and federal rules.

Spencer begins each visit with a little bedside chat. "How's the nausea?" Spencer asks David (not his real name), a 36-year-old AIDS patient with sad dark patches under his eyes. Diagnosed with full-blown AIDS two years ago, David has trouble maintaining his weight.

"Not too good," David sighs.

"I'm a little concerned about the vomiting," Spencer says, scribbling in his notebook. "Would you consider trying a brownie before bedtime?"

After a discussion of the relative merits of eating, smoking and vaporizing cannabis, Spencer reaches into his case and pulls out a Ziploc bag containing 12 grams of 'Dam, complete with receipt.

According to Spencer, different strains have different medicinal properties. This particular batch was grown hydroponically, to avoid bacterial contamination that could threaten David's weakened immune system.

Over the past three years, the meaning of the term "caregiver" has undergone a subtle shift. The caregiver is seldom a full-time attendant, armed with a bedpan, who has a couple of plants in the backyard; increasingly, it is a semi-professional horticulturalist who may grow plants for several patients at once.

Growing pot may not be rocket science, but it's not like growing tomatoes, either. To avoid those pesky seeds and create the coveted sinsemilla, marijuana is grown under carefully controlled conditions. But indoor gardens require space, equipment and expertise. Outdoor gardens produce only one harvest a year--and are vulnerable to midnight raids by neighborhood stoners.

"The reality is that most patients can't grow their own medicine," says caregiver John Sajo, the director of Voter Power, a group of medical-marijuana patients and advocates.

Spencer insists--with a straight face--that most of the caregivers he works with do not smoke marijuana. (For the record, he also claims that the psychoactive properties of pot are a "negative side effect.")

But many caregivers--who cannot legally be paid for their labors--do divert a portion of their crop for themselves. Two years ago, Portland Police officers raided Sajo's home, which has a medical-marijuana basement garden. Police did not molest Sajo's plants, but they did note "several dozen" half-torched roaches in his bedroom.

Advocates shrug off the issue. "Is there maybe some usage by caregivers?" asks Leland Berger, Voter Power's attorney. "Yeah, maybe. So what? Is it more harmful to public health if people occasionally use a small amount for personal use? Or is it better for the public health for patients to get their medicine?"

As the Pink Floyd classic "Us and Them" wafts from a stereo system, a heavyset man with a white goatee and a jaunty fisherman's hat demonstrates horticultural techniques on a sheet of notebook paper to his conversation partner, who nods politely between bong hits. At the next table, a gravel-voiced woman in a tie-dyed shirt rattles off a list of ailments, interspersed with unflattering observations about sheriff's deputies in Yamhill County, while a leather-necked Vietnam veteran trundles his wheelchair around the room at breakneck speed.

Welcome to the Patient Resource Center. Run by Voter Power, the center is part social club, part walk-in clinic and part chill space. Located in an airy fourth-floor room across from O'Bryant Square, it provides a refuge where cardholders can mingle, medicate and score. (There's also a garden in the building.)

Presiding over the subdued chaos is Voter Power director Sajo. With his calm gray eyes and chirpy expression, Sajo, 51, has the well-scrubbed look of a dentist. A longtime advocate of legalization (and, incidentally, one of Oregon's strongest go players), he started Voter Power in 1998 to press for marijuana reform and has become a sort of village elder for the medical-marijuana community.

It's not an easy job. "There's never enough supply," Sajo frets. "And there are a lot of gray areas in the law."

Relationships between patients and caregivers often fray. Patients suspect caregivers of diverting their supply, or they fear being cut off. Caregivers accuse patients of selling their medicine on the black market. Both worry the other might terminate the relationship and then snitch them out to the cops.

To ease cardholders through the constant supply hiccups, the Center offers "excess" marijuana from legal gardens that happen to be reaping a bountiful harvest. The excess is free--after all, it's illegal for patients to buy or sell pot--but cardholders do pay a daily "entrance fee" of $20.

"We're trying to walk a fine line between adhering to all the laws and at the same time helping the patients," Sajo says.

These are the sorts of legal contortions OMMA was supposed to render superfluous. But in fact, as one traces the contours of medical marijuana in Oregon, one is struck how closely it has come to parallel the underground subculture it was meant to replace. The terminology is new--instead of potheads scoring weed from dealers, patients now obtain medicine from caregivers--but the dynamics remain largely unchanged.

Despite the program's warts, Oregonians seem to feel pretty good about the medical-marijuana law. According to a poll conducted in February by the Marijuana Policy Project, 62 percent of registered voters strongly support the law, while 12 percent strongly oppose it.

It's not hard to understand why. OMMA failed to set off an epidemic of teenage bong hits. In fact, government surveys show that fewer high school students smoke pot on a regular basis since the law was passed (see chart, page 27).

There have been isolated reports of forgeries, thefts and other abuses, but in general, the dire jeremiads from the war-on-drugs crowd were never borne out. Even law-and-order types like Multnomah County Sheriff Dan Noelle and District Attorney Mike Schrunk seem hard pressed to come up with concrete examples of the law's adverse effects.

The immediate challenge for the initiative, dubbed "OMMA II," is getting on the ballot. So far, it has failed to line up major financial backers. Conventional wisdom holds that shoestring petitions should start circulating by January if they are to have a chance of making the June 5 deadline for the November election.

"It's going to require an awful lot of money to get this on the ballot in such a short time," says Dr. Richard Bayer, who campaigned for the original law. "Without six figures in the bank, it's going to be a challenge."

If the initiative succeeds in becoming a fully grown ballot measure, the campaign is likely to resemble a family squabble over curfew, with advocates arguing that the current law is unreasonably restrictive, while opponents predict that loosening the screws will only trigger more outrageous demands.

Critics of medical marijuana frequently charge that "dopers" are sneaking in under the guise of the sick. But this complaint ignores reality. Pot smokers are already breaking the rules. Is it really any worse if they bend the rules instead?

"Yeah, it's hypocritical," shrugs Floyd Ferris Landrath, a marijuana activist who has encouraged pot smokers to apply for cards even if they have no legitimate medical reason. "But the laws on prohibition are hypocritical."

LICENSE TO CHILL

This week, medical-marijuana advocates fired the latest salvo in Oregon's ongoing cultural war over cannabis. Known as OMMA II, the initiative would make radical changes to the state's medical-pot law.

Under current rules outlined by the Oregon Medical Marijuana Act, patients may qualify for the medical-marijuana program only if they suffer from Alzheimer's, cancer, glaucoma, HIV, seizures, spasms, nausea, severe pain or cachexia (a withering of the body.) They must obtain a physician's approval. They may not possess more than one ounce of marijuana at any time, nor cultivate more than three mature plants and four immature plants. They may designate a caregiver to grow the pot for them, but they cannot pay the caregiver any money. And they can't give or sell their pot to another cardholder.

If OMMA II becomes law, patients would not be restricted to any particular diagnosis so long as a doctor, nurse practitioner or naturopath says they could benefit from marijuana. Patients would be allowed to possess up to one pound of marijuana--or, under certain conditions, up to six pounds (that's 96 ounces, or 2,722 grams, kids). They could grow up to 10 plants at a time. They could also obtain marijuana from licensed dispensaries. Caregivers could be paid for their pot.

Finally, if patients successfully register after they have been busted, any punishment is automatically reduced to a $500 fine.

Advocates say the changes are necessary to guarantee cardholders access to a lifesaving drug. "We approach this not as a political issue but as a medical issue," says John Sajo, the executive director of Voter Power, a group of medical-marijuana patients and advocates. "Marijuana is medicine--safe, effective medicine--and patients should get however much they need. It might be politically risky, but it's the right thing to do."

Law-and-order types, however, pooh-pooh the proposal. "Six pounds?!" splutters Clatsop County District Attorney Josh Marquis. "Jesus Christ! That's a lot. These guys aren't really trying to expand medical marijuana. They're looking to legalize recreational use."

Activists say the current law suffers three major flaws: supply, access and stigma. OMMA originally assumed most patients would simply grow their own marijuana, but the reality is that few patients have the space, the equipment or the expertise. The caregiver system, in which registered caregivers grow pot for patients, has proven tricky to maintain, in part because of the niggardly restrictions of the law. An ounce of weed is not enough for many patients. "Most of the patients who qualify don't have medicine most of the time," Sajo says. "That's intolerable."

In addition, many patients can't find a doctor willing to sign the form. Those who do discover that, although the law requires the state Department of Human Services to process applications within 30 days, cards often are not issued for a year or more. The paperwork hassles and the cost ($150 a year) conspire to keep many deserving patients out of the program. "For a lot of people, getting the card just isn't worth the bother," Sajo says.

Finally, the program has been bedeviled by perceptions that patients are just looking for an excuse to get high. It remains unclear whether OMMA II--or any other law--can do much about that "Cheech and Chong" image. --CL


The federal Controlled Substances Act lists marijuana as a Schedule I substance, meaning the drug has "no currently accepted medical use in treatment in the United States."




In 1999, the Institute of Medicine, part of the National Academy of Sciences, released a groundbreaking study concluding that--oops!--marijuana has medical uses after all. Read the report at www.nap.edu/readingroom/books/marimed .




Since Oregon's law went into effect, the state Department of Human Services has received 4,003 applications and issued 3,580 cards. There are currently 1,700 cardholders, who rely on an estimated 800 caregivers for their marijuana. For information about the program, see www.ohd.hr.state.or.us/oaps/mm/ welcome.htm .




Dr. Phillip Leveque, a 78 -year -old Molalla osteopath, has single-handedly approved 49% of Oregon's medical- marijuana cardholders. He is currently under investigation by the state Board of Medical Examiners.




Ken Brown grew up in St. Johns in the '50s and '60s, attending James John Elementary and Roosevelt High School. He'd like to renew contact with old friends and acquaintances. To get in touch, contact WW at (503) 243-2122 or email buzz@wweek.com or call 243-2122, ext. 380. We accept insider trading!
 
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