Day 14, September 27
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.