Medical marijuana raises complex issues

Medical marijuana raises complex issues

Sept. 28, 2000

By Katharhynn Heidelberg
Journal Staff Writer

From a compassionate means of alleviating pain and suffering, to a "foot in the door" for other drugs and complicated legal challenges, Colorado’s Amendment 20 evokes a full range of responses.

The measure proposes the legalization of marijuana for persons with debilitating medical conditions.

The amendment also stipulates who may recommend marijuana, what parts of the plant may be used, and has special stipulations for patients under the age of 18.

A "state health agency" must verify the condition for which usage is being sought, and will then issue a registry identification card, if all conditions are met. The card protects the patient from prosecution when he or she obtains marijuana, and is valid for one year. Once the patient is free of the condition for which the card was given, it must be surrendered within 24 hours.

The amendment also calls for strict control of access to the registry, and to guard against fraudulent cards. It further stipulates that employers do not have to accommodate usage in the workplace, and that medical-insurance providers are not liable for coverage for medical marijuana.

But, despite its seemingly innocuous intent, the ballot measure has prompted serious concerns among local law-enforcement officials.

"It would be a big nightmare," Montezuma County Sheriff Joey Chavez said. "If legalized, it will open the door for other drug issues. I’m totally against it."

Cortez Police Chief Roy Lane said he is worried that the measure will begin a push for the legalization of other drugs. "It also kinds of concerns me that we’re opening a door. Will they find a way of legalizing other drugs? It scares me."

Eleanor Scott of Coloradans Against the Legalization of Marijuana echoed the concerns.

"This is not the end," she said by phone from Denver, citing new initiatives under way in states that have previously passed medical-marijuana legislation.

"If this passes, there are next steps that open it up a little wider," she said.

But Martin Chilcutt, Amendment 20’s main proponent, said these fears are unfounded. "It is not a gateway drug," he said, citing a recent study by the Federal Institute of Medicine that listed alcohol and cigarettes as being more likely to lead to other drug use. And, he added, marijuana is "absolutely not addictive. Medical research shows that."

Concerns are not limited to law-enforcement problems, however. Pharmacists fear potential legal liability. Although the ballot language stipulates that usage must be legitimate, and those who are seeking marijuana for medical purposes must hold a registration card issued by a governor-appointed state health agency, pharmacists worry that the burden for determining the legitimacy of marijuana cards will fall to them.

Chilcutt insisted that pharmacists would have nothing to do with providing the herb. "In no way will the pharmacist be held responsible," he said. Pharmacies "have nothing to fear; they won’t be supplying the drug. A physician will recommend it to their patient, and it’s up to the patient to obtain their therapeutic cannabis." The entire process, he said, would be regulated.

Where patients would get the cannabis is the problem.

Chilcutt said the proposed measure simply makes it legal for patients with a debilitating illness to obtain the plant. It would allow patients to grow up to six plants, so they would not have to get it illegally, or worry about quality-control issues. "Wegot a pretty simple, tightly controlled procedure here," he said.

Quality control remains a concern. Scott said patients or their caregivers will not necessarily know the correct dosage of marijuana to use, and that there is nothing in the initiative that says they have to be seen by a doctor more than once a year, when registry cards come up for renewal.

"It’s (choosing) your medicine by popular vote instead of scientific process," Scott said. She added that no medical organization endorses Amendment 20.

Research provided by Scott’s organization also contends that marijuana is not as harmless as proponents would have the public believe. They cite research which claims that marijuana smoke contains 50 to 70 percent more cancer-causing elements than tobacco.

This is meaningless to those who support the measure. Without the legislation, Chilcutt said, "Most will continue to obtain it the way they’ve been obtaining it."

Smoking marijuana can relax users, creating a mild euphoric feeling, research says. Marijuana is also an appetite stimulant and reportedly can quell the nausea of chemotherapy. It also can relieve eyeball pressure in persons with glaucoma.

Chilcutt, himself a cancer survivor, said the advantages of medical marijuana vary. A key one is that marijuana, as relative to pharmaceutical pain medication, is inexpensive.

Patients, particularly cancer patients, are often unable to keep traditional pain medication down. "They find it more convenient to smoke a little marijuana to relieve pain and nausea, and it also helps with weight gain," he said. "That’s one of the main reasons patients like it."

Scott said there are other drugs available for pain and nausea. Both Chilcutt and Scott mentioned Marinol, a prescription drug containing the psychoactive ingredient in marijuana, THC. But medical-marijuana proponents say smoking marijuana provides a more gradual and manageable dose than pills.

Amendment 20, according to its proponents, allows those approved for registry cards to obtain marijuana. However, whether the measure then protects the person from whom the patient obtains the marijuana is less clear.

"That’s the big loophole," Scott said. "The person selling it is still selling it illegally."

The proposed legislation also provides that the governor designate an agency to make application forms available for patients who feel they might meet the stipulations. According to Cindy Parmenter of the Colorado Department of Public Health and Environment, that precise agency has yet to be determined.

Susan Liddle, a researcher at the Colorado Legislative Council for the General Assembly, explained that concerns over the wording of the amendment would have to be hashed out in legal battles.

Chilcutt said the measure does not affect other drug-use laws. "All the other laws out there about marijuana on the books will not be changed. (Patients) can’t use it in the workplace or in public places."

But Scott said, "All of this is still against federal laws."