Monday, June 6, 2016

Dr Uma Uplifting Health and Wellness

Tuesday, June 2, 2015

Cannabis should be removed from the regulatory jurisdiction of the CSA

Here's Why We Should Rethink Rescheduling Marijuana By Jon Gettman · 
Fri May 29, 2015

Editor's Note: These remarks are a summary of a presentation by the author, Jon Gettman, to the Ninth National Clinical Conference on Cannabis Therapeutics.

After observing the final stages of NORML’s original effort to reschedule marijuana in the late 1980s and early 1990s and leading  two successive efforts to use the rescheduling process to make marijuana available as medicine under the federal Controlled Substances Act during the last 20 years, I know as much about this regulatory framework as anyone.

Rescheduling cannabis under the Controlled Substances Act—based on the history of these three failed efforts—is clearly not a feasible option for changing federal law with respect to medical marijuana. Furthermore, it is no longer an acceptable policy option. Marijuana must be removed from the Controlled Substances Act (CSA).

This is not a matter of “descheduling,” as many have begun to describe it—as this term actually invokes the procedures of the CSA to remove a drug from its regulatory provisions. Instead, cannabis should be removed from the regulatory jurisdiction of the CSA and regulated by new laws modeled on federal regulations for alcohol and tobacco.

There are a lot of reasons for this. First, cannabis is not a drug. Opponents of medical marijuana deride the plant as a crude drug because of the number of cannabinoid chemical compounds it contains... As if this is a bad thing. Actually, this is one of the good things about cannabis; it is an elegant botanical compound.

The history of rescheduling demonstrates why marijuana does not belong in the schedules of the CSA. The NORML rescheduling effort took over two decades because of government opposition. The legal battle produced several court decisions that, in effect, forced the government to complete the statutory process for considering marijuana’s legal status under the CSA. This meant that the government had to formally assess whether marijuana has a high potential for abuse and whether or not it has an accepted medical use in the United States.

One key obstacle to rescheduling is that the federal courts provide the government with a great deal of discretion in making such determinations. As long as the explanation is reasonable and the process is neither arbitrary nor capricious, the government can do what it wants—as long as they can explain why they decided what they have decided.

In 1988, the original NORML petition went before an administrative law judge, Francis Young, who decided that the government’s decision to keep marijuana in Schedule I was indeed unreasonable, arbitrary and capricious. However, the DEA appealed his decision, and the courts eventually ruled in the agency's favor.

After the discovery of the endocannabinoid receptor system and subsequent research detailing why marijuana has a lower potential for abuse than other drugs (with the crucial support of HIGH TIMES), I filed a new rescheduling petition in 1995. This one was also rejected by the DEA, and the federal courts would not hear our appeal because I was not a medical marijuana patient—and thus was not personally affected by their decision.

In 2002, I organized the Coalition for Rescheduling Cannabis, consisting of several patients and medical marijuana advocacy organizations, and once again, with legal support from HIGH TIMES, filed the third rescheduling petition. This one was also rejected by the DEA, but the U.S. Court of Appeals agreed to hear our case. However, once again, the court ruled in  the DEA’s favor for the same reason as before—the government has discretion to determine what constitutes accepted medical use in the United States.

It would have been nice to win one of these battles. But I had other objectives in mind as well.

The 1995 petition was filed before medical marijuana was legalized in California. At that time, one objective for the petition was to get a ruling that marijuana did not have a high abuse potential and did have medical value. While the petition failed, Proposition 215 achieved that in an influential and profound way. The other objective I had in mind was what in science we call falsification—to either make rescheduling work or to eliminate it as a viable policy option. I think the failure of the government to recognize modern science and adapt law to contemporary research eliminates rescheduling as a way to address the need for legal, regulated medical marijuana.

But let’s back up in time and look at two visionary prophets.

First, consider the sage advice of Lester Grinspoon, a pioneer in publicizing medical marijuana’s therapeutic value. Grinspoon’s long held opinion was, and is, that marijuana should be like aspirin, inexpensive and widely available. This should be the goal of public policy, and advocacy, today.

What is the purpose of the Controlled Substances Act? The purpose of the CSA is to produce a closed regulatory system. So, let’s consider an observation from the 1970s by a widely respected scholar about drug control systems. John Kaplan published a chapter in a book about drug control with a prescient observation. (The citation is contained in a recent article by this author and Michael Kennedy on modern cannabis regulation.) Kaplan observed that closed systems don’t work if you cannot effectively control the technology of production.

Prohibition has failed, and the country is moving toward marijuana’s legalization. This failure is due in large part to the government’s difficulty in controlling the technology of growing cannabis. The CSA is not a viable regulatory framework for medical cannabis because it is impossible to set up a closed system. It is just too easy to grow cannabis, anywhere in the United States.

Another problem is that the controls required by the CSA are more stringent than what currently exist in many states. America has already moved past the CSA paradigm, and it is time that the government, politicians and advocates recognize this.

The CSA and, for that matter, the regulatory process of the Food and Drug Administration is a sound piece of public policy. Both regulatory frameworks provide necessary protection for consumers with respect to safety and proving the effectiveness of pharmaceutical products. These frameworks also protect capital investment in research and development to produce pharmaceutical products. But they are inadequate and unnecessary with respect to the elegant botanical compound we call cannabis.

Regulatory law should not be used to inflate consumer costs—nor should the primary goal be to protect corporate profits or to guarantee tax revenue streams for the government. Indeed, inflated prices for marijuana serve to subsidize the current black market and exacerbate the very problems legalization seeks to resolve.

Rescheduling, at this point in time, is a cop-out.

It is an inadequate response to a pressing conflict between state and federal law. Marijuana should be removed from the schedules and regulated like alcohol and tobacco. The nation needs to heed the lessons of the past. As Kaplan observed, closed systems do not work when production cannot be controlled. More important, Lester Grinspoon was right. Marijuana should be like aspirin, inexpensive and widely available for therapeutic use.


Monday, June 23, 2014

Worldwide Campaign: Cannabis for Therapeutic Purposes is a Human Right

Patients Out of Time – An international consortium of medical cannabis organisations are demanding that humans, regardless of state or allegiance and without qualification, be able to use cannabis therapeutically. In a joint declaration, the organisations from Europe and North America refer to Article 3 of the Declaration of Human Rights adopted by the United Nations in 1948. The declaration is the beginning of a worldwide campaign on the use of cannabis for therapeutic purposes.
The declaration was published in six languages on a dedicated Web site (www.medical-cannabis-declaration.org), and it states: “Every medical doctor has the right to treat his or her patients with cannabinoids and cannabis products according to the rules of good medical care” and “every patient has the right to access cannabis and cannabinoids for medical treatment supervised by a medical doctor, regardless of social status, standard of living or financial means.”
“The declaration is based on overwhelming scientific evidence. It takes a strong stance against the prejudices and untruthfulness of lawmakers, other political players and ‘experts’ with limited medical knowledge on the issue,” says Franjo Grotenhermen, MD, Executive Director of the International Association for Cannabinoid Medicines (Germany).
It is the aim of the declaration to generate worldwide support and allow organizations around the globe to adopt a more definitive position. “The joint declaration and related Web site form the nucleus of a worldwide movement regarding the human right to use cannabis for therapeutic purposes,” adds Al Byrne of Patients Out of Time (USA). The declaration is the product of knowledgeable experts from multiple countries who are working to challenge anti-cannabis forces.
Cannabis has established medical use throughout the world’s history and, coupled with the recent discovery of the role of the endogenous cannabinoid system in the human body, must be made available to all citizens of all countries. The creators of the declaration designed it to encourage and allow both organizations and individuals to join them by signing the document in support of the common goal to create a worldwide campaign to end the wrongful prohibition of therapeutic cannabis. Many scientists, doctors and other experts in the field have already offered their support by adding their signatures.

To sign the Medical Cannabis Declaration click here
The initial signatories of the declaration are listed below. Please join us in demanding an end to medical cannabis prohibition and the inclusion of therapeutic cannabis in the national Pharmacopoeia of every country on earth:


  • American Cannabis Nurses Association (ACNA), USA
  • Americans for Safe Access (ASA), USA
  • Arbeitsgemeinschaft Cannabis als Medizin (ACM), Germany
  • Associazione per la Cannabis Terapeutica (ACT), Italy
  • International Association for Cannabinoid Medicines (IACM), International
  •  Norsk Forening for Cannabinoidmedisin (NFCM), Norway
  •  Patients Out of Time (POT), USA
  •  Schweizer Arbeitsgruppe für Cannabinoide in der Medizin (SACM), Switzerland
  •  Selbsthilfenetzwerk Cannabis Medizin (SCM), Germany
  •  Society of Cannabis Clinicians (SCC), USA
  •  Union Francophone pour les Cannabinoïdes en Médecine (UFCM), France and Luxembourg

Wednesday, January 8, 2014

Lester Grinspoon responds to David Brooks

The Harvard professor emeritus and author of Marihuana Reconsidered responds to the New York Times columnist’s anti-pot polemic.

Lester Grinspoon
Lester Grinspoon

Last week the New York Times columnist David Brooks wrote a piece, “Weed Been There, Done That,” which slammed the legalization of marijuana in Colorado and other states and labeled users stupid at worst and indolent at best. Among other criticisms, he wrote that cannabis is “not a particularly uplifting form of pleasure and should be discouraged more than encouraged.”

In making his case, Brooks cited long-debunked research and relied on old stereotypes that serious scholars discredited decades ago. One of the leading thinkers on the topic is Dr. Lester Grinspoon, Harvard psychiatrist and author of the 1971 classic, Marihuana Reconsidered, an exhaustive study of the scientific, medical, cultural and legal arguments against the plant. That book stripped away the myths, lies and distortions surrounding cannabis and sparked an enormous debate in this country and around the world. Joe Dolce spoke to the doctor, who at 85, from his home in Newton, Massachusetts.

Lester, how did you react to Brooks’ takedown of cannabis?
My overall impression is that David Brooks, who seems like a very smart man, is very much mistaken about what he thinks he knows about marijuana and out of date. I think he has just touched the tip of the iceberg in his experience with marijuana. His ignorance about this subject is vast. I hope he’s on more solid ground with the other things he writes about in the New York Times.

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I was a psychiatrist at Harvard Medical School in the 1960s, and I saw all these people using this “dangerous drug.” I could see no problem that these people were having.

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Let’s start at the top. He says that all of his friends gave it up after college, as if it’s indicative of some sort of emotional or psychological immaturity.
I think it’s true that most people who use it as young people do give it up in the course of their lives. I don’t think they give it up because it’s harmful. They give it up because they turn to other things, like getting married or having children, or having jobs with drug testing.

On the other hand, young people who use it and give it up don’t ever discover some of its other uses. It’s certainly a good recreational drug—better than alcohol or any other drug that might be considered recreational. It’s so…free. You don’t have a hangover, it’s less expensive in the long run, it doesn’t compromise functioning in a way that alcohol can.

But now it’s becoming increasingly understood that it is a very interesting and versatile medicine with much less toxicity than some of the pharmaceutical products it replaces. And more people at older ages are using it.

There’s a third category of use—and mind you these categories are conflated—which is the least appreciated: it’s what I call enhancement. Everyone knows that if you smoke, things that aren’t ordinarily culinary treats taste wonderful or that it can enhance a sexual experience. But I’m talking about experiences that aren’t so obvious. Like going to a museum. Take Allen Ginsberg’s experience with Cezanne….

He wrote about this in The Paris Review in 1965…
Ginsberg, who was a regular smoker of marijuana, was concerned that his friends were getting a great deal out of Cezanne but that he couldn’t really “see” his artistry. So he decided to smoke before going to the Museum of Modern Art to see Cezanne and he found an understanding that he had not been able to achieve sober. Furthermore, he pointed out that the perceptions stuck. It wasn’t something he saw only when high.

For many people that’s the case, and not just with art. My closest friend, Carl Sagan, used it as an adjunct or a catalyst for his creative processes. He wrote an essay for Marihuana Reconsidered under the pseudonym Mr. X, in which he described how he was in the shower one night with his wife, high on marijuana, and got the idea for 11 essays on the origins of racism along the lines of something called Gaussian distribution curves. He used these essays as the bases for university commencement addresses, lectures and in his books.


Carl Sagan and Lester Grinspoon, 1981

Brooks seems to say that smoking is a youthful folly, yet you didn’t start smoking until you were 43, correct?
I had a strange experience. I was a psychiatrist at Harvard Medical School in the 1960s, and I saw all these people using this “dangerous drug.” People would be smoking and I, as a physician, who knew everything about drugs—I was so arrogant I could have been the country’s drug czar—I would give them my little lecture on the dangers of marijuana and urge them to give it up.

Well, this went on for a while, even though I could see no problem that these people were having and they seemed to enjoy it a lot. And then I started to question what I knew about the scientific and medical basis of marijuana prohibition, and I went to the Conway Library to examine why we in this country were arresting about 300,000 people a year, 89% for possession, and most of them very young. [There are currently over 800,000 citizens in US jails for marijuana arrests. 24 million have been arrested for marijuana related offenses since the publication of Marihuana Reconsidered.]

And I had a very uncomfortable discovery—I had been brainwashed like just about every other citizen in this country. Marijuana was not a toxic drug. In fact it was remarkably nontoxic. The problem was not any inherent psychopharmalogical property with the drug itself, but rather the way we were treating it by arresting so many people, imprisoning some of them, and compromising their possibility for successful careers.

I published that paper in the International Journal of Psychiatry, and nobody read it. Well, almost nobody. One day I got a call from the editor of Scientific American who had seen the piece and asked me to condense it so he could publish it in his journal. It ran as the lead piece in November 1969. That created a big stir, and eventually Harvard University Press published Marihuana Reconsidered in 1971.

It wasn’t only that the data impressed me. I was becoming increasingly fascinated by what the drug had to offer. I resolved then that I must try some myself, but decided to postpone that adventure until after the book’s publication. If the book were successful, I thought I would undoubtedly be called before many legislative bodies and courts, which did occur. They might ask me if I had used it, and I didn’t want to compromise my objectivity. I finally decided in 1973 that I would start using it, and I’ve been using it ever since.

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Marijuana is a thought generator. The mind shoots out many bad ideas and many good ideas. You’ve got to look at them straight to see if they hold up.

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Brooks claims it’s addictive in 1 in 6 teenagers.
I don’t believe it is addictive, and there’s no evidence of it being so. You get addicted to things like alcohol, cigarettes or heroin and many opiate derivatives, but people do not become addicted to marijuana. There are people who use it all day long and that seems to me silly—you get the high in the morning but the rest of the day, there isn’t much. Nevertheless, it’s not an addiction because those people can give it up if they want to and will not suffer any withdrawal effects. Some may get a little irritable or depressed. That has nothing to do with withdrawal symptoms.

But addiction data is so deceptive. When some of these kids go through the criminal justice system, they often have to go into therapy. And the therapist, in order to get reimbursed, has to specify a reimbursable diagnosis and so he puts down cannabis addiction or dependence.

He claims that “smoking and driving is a good way to get killed.” Agree or disagree?
I am opposed to smoking and driving. Using any psychoactive drug, even one with a minor effect on reflexes is dangerous. However, unlike the stereotypical drunk driver who is speeding recklessly with one hand on the wheel and who isn’t in control of his car, the person who is high is usually in the right lane with both hands on the wheel and he’s going so slow he’s a pain in the neck. That doesn’t mean he hasn’t increased his risk—he might get distracted by a pretty scene on the road. However, I have to tell you there is far less danger to both the driver and other people from the stoned driver than the drunk driver.

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People are seeing a relative or a friend using it medically and seeing results and asking, “Hey, what’s all the fuss about over this?”

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He insists that young people who smoke “suffer IQ loss and perform worse on cognitive tests.”
Both of those statements are absolute nonsense. I’d like to see the data he finds convincing. I’ve been reading it for a long time now, and I find no data for either contention. A lot of those cognitive studies were compromised.

Let me give you a little anecdote. Years ago I got a call from the editor of a journal called Depression who asked me to give my feedback on an article on cannabis being useful in treating depression. I explored it and it seemed to be true. By the time the article was published, I noticed a new paragraph at the end that said we want the readers to know that while the studies say that marijuana is useful in treating depression, we in no way support its use for depression or any other purpose. And I said, “Why in the world did you add this last paragraph?” The editor almost started crying. She said, “Dr. Grinspoon, our lab is supported by NIDA [National Institute on Drug Abuse] and if we don’t include that we jeopardize our funding.” You’ve got to be careful with a lot of that literature. They won’t publish anything positive about marijuana.

He says there was one member of his clique who “may have been the smartest, but that there was something sad about him as he sunk deeper into pothead life…”
[Laughing] I would be careful about that type of comment. Carl Sagan and many smart people I know used pot and they weren’t sad people.

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I like it both ways. I like it straight, and I like it stoned. I like to move from one state of consciousness to another.

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He said it was “fun, but repetitive…Most of us figured out that weed doesn’t make you funny or more creative.”
I don’t know about making you funnier, but judging from my experience, it is a lubricant of creativity.

To Brooks’ mind, “Smoking weed was not something you were proud of or that people admire.”
That’s the cultural bias against marijuana. He’s supporting the enormous mistake that this country made in 1937 when it initiated the draconian prohibition on marijuana. Its use as a medicine is one of the reasons that the Gallup poll last year showed that 58% of Americans are now interested in getting rid of prohibition. That’s up 10% from a year ago! Support for rolling back prohibition is going up exponentially. [Ed. note: A CNN poll released on Jan. 6 showed that 55% of Americans support legalizing marijuana.] And the reason is that people are seeing a relative or a friend using it medically and seeing results and asking, “Hey, what’s all the fuss about over this?”

He writes, “I think we had a sense that the actions you take change you inside, making you a little less coherent….”
I disagree. Marijuana is a thought generator. The mind is always shooting out thoughts but with marijuana they shoot out in greater frequency. It shoots out many bad ideas and many good ideas. You’ve got to look at them straight to see if they hold up. But it generates ideas.

What do you say to this one: “Government should encourage higher pleasures like being in nature and should discourage lesser pleasures like being high.”
That may true for David Brooks, but it’s certainly not true for people like me. I like it both ways. I like it straight, and I like it stoned. I like to move from one state of consciousness to another. It’s a mild state of enhancement but it can help you to see around some corners that you haven’t been able to navigate before.

Tina Brown, former editor of The New Yorker and Vanity Fair tweeted this after Brooks’ column appeared: “Legal weed contributes to us being a fatter, dumber, sleepier nation, even less able to compete with the Chinese.” Will pot be our nation’s downfall?
I’ll tell you, I was delighted when Tina Brown was no longer editor of The New Yorker. I think this is emblematic of her point of view and that helps me understand why I never fond of her magazine. Pot has been around for at least 10,000 years, and the Chinese used it as a medicine as long ago as 5,000 years, so it’s likely that it grew somewhere near there and that wasn’t a lazy society. Fortunately it now grows all over the world.


Thursday, November 21, 2013

Washington State Medical Cannabis Program Alternatives: A Whole Plant Botanical Cannabis Therapy Treatment Clinic Model

My name is Rick Rosio and I am a Washington State Citizen and an HIV Patient. I am also the program director of Washington’s Veterans for Compassionate Care, a program driven health care delivery clinic model that seeks approval to provide Whole Plant Botanical Cannabis therapy to the Warfighter communities.

The state has issued a new mandate in response to the passage of I-502 calling for all Washington Citizens who are medical patients using Cannabis as a therapy, to follow an entirely new framework for accessing Whole Plant Botanical Cannabis.

After careful review of the proposed amendments to the medical cannabis program of Washington State, we have concluded the proposed changes by the advisory group to the LCBD to merge the medical cannabis program into I-502 regulations is harmful and unacceptable to Washington Citizen/Patients.

We feel this move has the potential to deeply disadvantage the entire spectrum of the vulnerable disabilities communities.

This would effectively end the ability of Washington Citizen/Patients to have whole plant botanical cannabis substance access and make all other vulnerable patient loads exposed to new and unexpected regimes in finding the same type of palpable relief to many of the maladies that these patients have been unable to meet with traditional pharmaceuticals.

The cannabis benefit

The medical literature is full of historical evidence proving that Cannabis is indeed a very significant adjunct to wellness care, having been a “Traditional” substance offered in the medical pharmacopeia for many, many years before the unscientific ugly stain of Prohibition took it out.

It is this ideal of Wellness delivered through a whole plant botanical substance that is the Human Right of every Citizen within the Public Commons! The Cannabis Hemp Plant is a long standing member of the Public Commons, with ancient ties to human engagement for a myriad of uses. As such, it would be Anti-Human to keep the body politic itself out of the Public Commons, so why are we trying to keep a plant that has been a member of that same Public Commons longer than even we humans, when its benefits to humanity are so well enshrined throughout history.

We are Washington Citizens, therefore harken to our own cultural underpinnings of being “Pioneers”… hearty self-directed individuals hell-bent on bringing about a life worth living.

And that is the core of the message we want to bring today, that we are still “Pioneers” attempting to carry on our unique states’ mandate to craft lives worth living for each and every one of our Washington Citizens … for at some point, we will all be patients and deserving of the quality of experience that this spirit of what it means to be a Washington Citizen is all about.

Good compassionate care brought about in the most nurturing and hospitable form it can be delivered in – that is where and why Cannabis Therapy shines so bright, it has all those characteristics that make life worth living.

Affordable medicine

The Washington Medical Cannabis Program has produced a great number of benefits to our citizen/patients.

We have seen many of these vulnerable citizen/patient groups find relief in their increasing economic burdens brought about by an economic climate that has pushed many into situations where they can no longer afford any other option to being able to grow their own Whole Plant Botanical Cannabis and find uses for it that traditional medical treatments are simply not able to deliver.

Therefore, we cannot allow the complete eradication of the Medical Cannabis Program because of the unique abilities of the Cannabis Hemp Plant to meet the needs of our states most vulnerable. The sick and dying need special attention, those with life threatening conditions need specialized treatments, the economically depressed have special needs that only direct personal access to the plant can deliver.

There is a clear mandate for the state to regulate this segment and indeed bringing the benefits of the plant to the larger medical community is a valid long term strategy. The state feels a need to craft a regulatory environment to allow for the roll-out of the I-502 program, making a recreational component of this plant available by taking away the entirety of the existing Medical Cannabis Program.

One does NOT have to mean extinguishing the other.

The people voted for it … in 1998

The state can certainly produce a regulatory system to support a flourishing recreational model, while also crafting a similar regulatory scheme allowing for smart rational parameters that continue to allow for Washington Citizen/Patients who voted for the right to have Whole Plant Botanical Cannabis to continue on a redrawn blueprint for promoting wellness for our own states Citizen/Patients.

The citizens of this state have rights and now, one of them is to Whole Plant Botanical Cannabis and we urge our elected officials to recognize that we the Citizen/Patients have spoken clearly about this issue. The many benefits those that grow are able to achieve should not be totally taken away. The collective garden model is a necessary adjunct for those sick and injured who are not able to garden for themselves.

Now, with the state’s input at this crucial time, a new set of operating protocols can be established allowing for a more specified system that patients can use to guide them in pursuit of a self-directed healthcare regime.

What advances such a model is a regulatory system that affirms the Washington citizens’ rights to behavior consistent with the law of the state. This logically continues to provide for each citizen to care for themselves, with remade limits, either through a personal grow or a reworked collective garden model.

We’ll vote again …

The ideal of providing access point protection and regulation under Washington law is simply a smart and sensible control factor, one that could aid and assist during a transitional period to a full service commercial market place.

We vote, our friends and family members vote …

We will support the right of Washington State Citizen/Patients in keeping to the spirit of the existing medical cannabis program protocols while formulating new operating guidelines that enshrine these originating principles. We will campaign insuring that Washington will not return to a time of prohibitionist attitudes where the sick and suffering live in fear without personal access.

Friday, September 27, 2013

Motivations - Julia Glick

Day 14, September 27

Motivations

There are some, in the medical cannabis activist community who express to me that violating the law publicly in front of my previous employer is a mistake- that I am motivated by revenge, or that, since the laws governing cannabis are gradually relaxing, there is no need to push this issue into a more direct and confrontational place. I disagree completely with both assertions. This is my response.

The assertion that I am motivated by a desire for payback after my treatment as a nurse is nonsense on its face. Anyone who really knows me understands that revenge is an idea completely reprehensible to me on many levels. Revenge is based upon an unfulfilled feeling that a wrong has not been balanced through some application of justice- that the wronged party has a right to inflict pain on another person because that person inflicted pain on them. It is the law of the jungle, of the Old Testament, of many religions. I am not feeling that and I never have.

Let me be crystal clear: I am motivated for this action because of a much deeper level of appreciation- that even as the political framework creeps slowly towards some measure of justice for medical cannabis patients- the medical establishment of Oregon is stuck in a place which violates its ethics and responsibilities to treat ALL patients with acceptance and dignity and respect.

Let me get to the heart of the matter:

“Benzodiazepines and Marijuana

For different reasons, I advise against concurrent chronic opioids and either benzodiazepines or marijuana. Benzodiazepines and alcohol markedly increase the risk of overdose. The proliferation of state laws permitting medical and recreational use of marijuana make some physicians uncomfortable saying “No” to marijuana. Patients who request marijuana generally do so for “mood modulation.” It doesn’t make sense to me to add a drug to a pain regimen that has the analgesic properties of 50 mg of codeine when it already includes much more potent opioids. Patients should choose between marijuana and opioids, and I’m always surprised how many opt for the former.

 (Oregon Board of medical Examiners Newsletter, January 2013)

The BME newsletter from January 2013 articulates a position towards medical cannabis patients which is untenable on every level. It violates the ethics of medicine which REQUIRE clinicians to form trust relationships based on mutual consideration. It also violates the responsibility of medical systems to continually improve the delivery of health care based upon science and critical thinking.

It indicates a profoundly disturbing delusional process at the top level of Oregon medical practice that blames the victim of opiate addiction, even though it was the physician who made them addicted through over-prescribing of dangerous opiates.

If medical cannabis patients are going to be officially marginalized by the leadership of Oregon medical practice then I am going to speak about it. My lack of a license actually benefits me in that I can express myself without fear of Board of Nursing investigations. I believe I am more a nurse today than I have ever been.

If even one physician or nurse publicly supports this action I will be surprised. The medical board, with the support of the DEA, is an executioner standing forever above the head of any practicing physician who dares to question the utter insanity of this policy. I am not motivated by revenge towards Samaritan Health, but a belief that there are many good people in their system (including many physicians) who really believe that “patients come first”. And that the system is capable of improvement. Medical systems don’t get to pick and choose whom they respect. Treating 98% of patients with acceptance and dignity, while treating 2% with intolerance and rejection undermines the moral authority of the system.

The other criticisim I am hearing is that since the process of change is moving in the direction of increasing sanity why should I rock the boat? It might be perceived as crazy and outrageous by the population of the community.

To this I can only say that if standing up publicly to reject laws which are themselves baseless in actually protecting society is foolish, then I am foolish. If defending cannabis patients who are marginalized, drug tested, humiliated in office visits, subjected to pain contracts, forced to choose opiates or cannabis, rejected by their clinicians, or subjected to ignorant tirades by clinicians is foolish then I gratefully accept that title.

The medical establishment of Oregon is broken. The treatment of cannabis patients is unacceptable. I am giving an opportunity for the community of patients, or anyone rejected by the medical establishment- to voice their concern.

The process of change may be gradually occurring in the state of Oregon but it is not occurring in the offices of the Oregon BME. It is not happening in the Administration of Samaritan Health Services. I suspect that there will soon be new guidelines issued which require OMMP patients to choose either cannabis or opiates. Though reprehensible, perhaps it will be a good thing because tens-of- thousands of patients will stop using dangerous opiates. However forcing them with threats and pain contracts will further undermine trust, and subjecting patients to increasing pain for those who cannot rely on cannabis solely, is incomprehensible.

One additional comment: The much heralded process of change in these insane laws does not extend to the federal government or federal administrative level. Cannabis patients are utterly victimized by federal laws, and the change of administration and some funding increases will renew the war on patients. Also, the Dispensary Bill (HB 3460) passed into law this year, will likely be a mess of intruding agencies, fees, regulatory schemes, rules, taxes, surcharges, license fees, security systems, compliance systems, as every agency with some interest is lobbying to create some revenue stream for themselves. Even the OMMP itself is an over priced protection racket, extorting hundreds of dollars from patients in order to maybe keep the Oregon Sheriff from arresting them on some other charge. The price of cannabis in the dispensaries will sky rocket, and the black market will proliferate. That is my prediction.

Perhaps we are moving gradually in the right direction, but we have a long way to go. I intend to speed it up. I am doing my best to make change happen, and to act in a way which honors my life commitment to nursing. I am throwing this out to the community, and if what I am articulating is in fact real, the community of patients will respond. If it is fabricated then I will make a tiny impact, but I hardly doubt that this action will negatively reflect on the cannabis community unless I completely mess it up.

I take refuge in a belief that things can be a lot better, and that time for me to act is limited. I also take enormous strength from the people who I have tried to assist for these many years. I will assist them in every way I can, and frankly, I am mystified by the historical timidity of Oregon’s cannabis activist community. What I am planning is really pretty tame. We should be closing down the BME, we should be bringing business as usual to a halt, like my gay brothers and sisters did so well in response to the AIDS crisis many years ago.

Julia Glick