Wednesday, February 16, 2011

Delaware considers legalizing medical marijuana

From Delaware Online:

John (pictured) sits cross-legged on an old recliner in his living room and strikes the flint of his lighter.

He takes a few puffs of marijuana from his glass water bong. He says it is the only thing that will relieve the pain he endures from muscle spasticity caused by multiple sclerosis, a debilitating neurological disorder that prevents him from standing.

"I know I could go on marinol, but this is better," said John, stopping mid-sentence to take another hit. "More effective," he added as he exhaled. Marinol is a legal and prescribed form of synthetic marijuana.

There is growing scientific evidence suggesting valid medical uses of marijuana, leading to its legalization for medical use in 15 states and District of Columbia.

Delaware lawmakers are currently considering following that lead. But the experiences of other states show that decriminalizing marijuana usage and possession for the ill -- but not for the rest of the population -- can be messy.

Critics say the law would make it harder for cops to tell whether someone is smoking pot illegally. Some say legalizing marijuana for medical use is the first step toward legalizing the drug for everyone.

Montana's state House last week voted to repeal its six-year-old medical marijuana law, with legislative leaders claiming they were duped into creating a pathway for full legalization.

Others fear that head shops will spring up on every street corner.

In states such as California, Colorado and Michigan, municipalities have implemented a host of zoning regulations to try to limit the number of marijuana dispensaries -- known by some as "pot stores" -- popping up on street corners.

Across the Delaware River, New Jersey's Democratic-controlled Legislature appears headed toward a showdown with Republican Gov. Chris Christie over how to regulate the growing and distribution of medical marijuana more than a year after its law went on the books.

Like New Jersey's law, legislation being considered by Delaware lawmakers would prohibit home cultivation and initially limit access to three dispensaries, one in each county. Christie's administration is trying to limit access to medical marijuana in New Jersey to six locations across the 8,721-square-mile state.

This is the third consecutive year Senate Majority Whip Margaret Rose Henry has introduced medical marijuana legislation in the Delaware Senate. After lining up more support for the bill, Henry is optimistic she can muster the votes to pass the legislation.

Rep. Helene Keeley, the House co-sponsor of the bill, said it's been crafted so that Delaware does not end up "like California." Unlike California and 13 other states, Delaware's legislation would not permit people to grow their own marijuana, Keeley said.

"If you're really using this for the proper reasons, then it should be done in a professional way," said Keeley, D-Wilmington West. "I'd rather see the law very restrictive in who can and cannot do this."

Senate Minority Leader Gary Simpson, R-Milford, remains on the fence, concerned that marijuana is a gateway drug, saying, "It's going to be a very mixed vote and I've not made a final decision."

Certified by physician
Senate Bill 17, introduced in January, would make Delaware the 16th state to decriminalize sections of the state's marijuana prohibition laws for residents who get certified by their physician.

Under current Delaware law, simple possession of an ounce of marijuana is a class B misdemeanor, punishable by up to six months in prison and a fine of up to $1,150.

But first-time offenders rarely see prison time unless the person is charged with dealing or possessing the drugs near a school or park, said Brian Robertson, head of the drug-crimes unit in the attorney general's New Castle County office.

Class B felony charges punishable by a minimum of two years in prison are leveled when a person is found to be in possession of more than five pounds of marijuana. The law does not spell out different penalties for possessing amounts of marijuana between 1 ounce and five pounds.

Under the proposal, patients would be allowed to possess up to six ounces of medical marijuana, less than the amount the National Institute on Drug Abuse has said is a month's supply for medical use. Qualifying conditions include cancer, HIV/AIDS, hepatitis C, PTSD, glaucoma, Crohn's disease, Lou Gehrig's disease or other chronic wasting diseases.

The Delaware Department of Health and Social Services would issue medical marijuana user identification cards to residents whose physicians certify that the patient would receive a therapeutic or palliative benefit from marijuana. The state also would issue cards to designated caregivers, who could obtain marijuana for certain patients.

Initially, the state would issue licenses to three so-called "compassion centers," or dispensaries, which would be permitted to grow, package and sell marijuana to residents with state-issued ID cards. The dispensaries would have to be not-for-profit organizations and submit to random inspections by DHSS.

No position taken
Opponents of legalizing marijuana remain worried that the controlled substance will end up in the hands of healthy people, which is common in states like California.

The Delaware State Police and the Medical Society of Delaware have not taken a position on the legislation, according to spokesmen.

Attorney General Beau Biden's office hasn't taken a position on the medical marijuana legislation, either, spokesman Jason Miller said.

The experience of other states, however, reveals the pitfalls of having two different marijuana drug laws and that "a well-intentioned law will be exploited for criminal means," Robertson said.

Telling police that "it's legal in this situation and illegal in this situation" creates confusion, Robertson said.

Henry said provisions prohibiting home cultivation of marijuana were added to the legislation this year to placate law enforcement.

"There was great concern that if we allowed people to grow at home, that it could get out of hand," Henry said.

In New Jersey, the Christie administration wants to prevent the type of doctor shopping for medical marijuana certifications that has become common in some parts of California, said Donna Leusner, spokeswoman for the New Jersey Department of Health and Senior Services.

The administration is trying to require physicians to register with the state to be able to recommend medical marijuana and supervise a patient using it.

"We wanted to implement the program in a safe and responsible way ... so that we don't run into some of the problems that they've had in other states where you can go into a doctor's office and in a couple of minutes say you have back pain and come out with a way to get medicinal marijuana," Leusner said.

But just 70 of New Jersey's 30,000 physicians had signed up as of last week, according to the New Jersey DHSS.

Chris Goldstein of the Coalition for Medical Marijuana New Jersey said Christie's administration has been hostile to implementing the law that his predecessor, Jon Corzine, signed during his last day in office in January 2010.

"Passing a law that's like New Jersey's may not give the access that people really intend," Goldstein said. "Compassion is not given in half measures."

Limited research
Since marijuana was outlawed across the country in 1937, there has been limited research inside the United States on medical benefits and harms because the drug remains a Schedule I controlled substance. Most research has been done in European countries.

In California, where voters approved medical marijuana in a 1997 referendum, the state Legislature has funded marijuana research at the University of California as the debate rages on whether to fully legalize pot.

In a clinical study released last February, researchers found that smoking marijuana cigarettes provided better pain relief to HIV patients when compared with available drugs and therapies.

"Cannabis provided some relief above and beyond the regimen they were on," said Dr. J.H. Atkinson of the Center for Medicinal Cannabis Research at UC San Diego.

Doses of marijuana can be administered without smoking, which can cause lung damage, Atkinson said.

Marinol is a legal prescription drug that contains synthetic THC, the main psychoactive substance found in marijuana, which is illegal. But marinol has limited uses because the pill gets diluted in the bloodstream and can take hours to take effect, said Dr. Joseph McSherry, a Burlington, Vt., neurologist and medical marijuana advocate.

For AIDS or cancer patients suffering from nausea caused by their medication, swallowing a marinol pill to quell the nausea and trigger an appetite can prove difficult, McSherry said.

"It's hard to swallow a pill and you need the relief to swallow your pill," McSherry said. "If they inhale a little cannabis, they can actually swallow the 20 pills they have to take."

Joe Scarborough is an HIV-positive Wilmington man who has smoked marijuana in the past to counteract the side effects of HIV and cancer medications.

He said HIV medications in the mid-1990s "would make you sick to your stomach," and that marijuana was the only drug that helped him avoid nausea and vomiting.

Scarborough said marijuana gave him an appetite, a common side effect known among recreational pot smokers as "the munchies."

"You can't throw up those meds or they're not going to work," Scarborough said. "So what's going to help with my appetite? Well, a good case of the munchies will help."

Scarborough said he returned to marijuana use briefly in 2006 while he was battling cancer, but has since quit using the drug. "I'm willing to risk it to save my life and stay healthy, but not to go to a Grateful Dead show," Scarborough said.

Dr. Gabriel Somori, a pain management specialist at Coastal Pain Care Physicians in Lewes, said additional research is needed to determine whether components of THC can be isolated for pain management, without the euphoric buzz of marijuana.

"It's going to be interesting to see, because it probably could have a role in pain management," Somori said.

Relief from pain
John, a Delaware man in his late 40s who is currently smoking marijuana illegally for his neurological disease, didn't want to be identified for fear of being prosecuted.

John said he smokes up to two ounces of marijuana monthly to relieve a pain behind his right eye and to stop his limbs from shaking because of multiple sclerosis. He also is battling bladder cancer.

John admits he smoked marijuana and took other illegal drugs in his youth for recreational purposes. But since he was diagnosed with multiple sclerosis in 1994, he says, marijuana has become a medicine that helps him deal with a painful life confined to his recliner.

"I do it more for the relief than the buzz," said the former computer technician. "You got to do what you go to do. And this is what I've got to do."

Advocates of legalizing marijuana for physician-supervised medical purposes say people like John should have access to limited amounts of cannabis to relieve what ails them.

"We risk going to jail for trying to take the medications that are keeping us alive," Scarborough said during a January event touting Delaware's legislation that featured medical marijuana advocate and former talk-show host Montel Williams.

Given the cultural and political clashes marijuana has created over the past half century, Don Brill may seem an unlikely person to help lead the medical marijuana legalization movement in Delaware.

Brill, a 60-year-old Brandywine Hundred resident and a researcher at the DuPont Experimental Station, recently launched an advocacy website, http://www.delawareansformedicalmarijuana.org/.

In 2009, as he was preparing to undergo chemotherapy for gastric lymphoma, Brill said, a nurse recommended to his wife that he may want to consider smoking marijuana to ease the pain he was about to experience.

"I'm one of those people who, in my group of friends and acquaintances, no one uses marijuana," Brill said. "We don't even think about it."

Brill and his wife reached out to younger people who had connections to obtain the illegal drug.

"That's very problematic because now I'm asking someone to almost be a dealer, and that's not good," Brill said, "especially for those of us that speeding is the only way we break the law."

Brill's radiation wasn't as discomforting as predicted, so he ended up not attempting to purchase the street drug.

But the experience motivated Brill to work for legalization of medical marijuana so that people facing life-changing diseases aren't forced to break laws.

For John, his marijuana use remains out of sight, even though he knows there are inherent risks involved.

"People say, 'Well, it can cause lung cancer,' " John said. "I say, 'I understand that, but I already have MS.' "