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Physicians’ Perspective: The Oregon Medical Marijuana Act - 10 Years After
by Dr. Rick Bayer, MD

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The Oregon Medical Marijuana Act - 10 Years After by Dr. Rick Bayer

Cannabis or marijuana has been an important herbal medicine used by many cultures for thousands of years. Though federal law prohibits use of this herb, 14 states have now passed medical marijuana (mmj) laws over the last decade. These laws protect more than 20% of all Americans.

The first state to modify criminal penalties was California in 1996. Oregon voters were close behind, passing the Oregon Medical Marijuana Act (OMMA) in 1998. Since state laws do not change federal laws, marijuana remains illegal until Congress changes federal laws or a new President issues administrative orders.

The Oregon Medical Marijuana Program (OMMP), part of the Department of Human Services (DHS), administers the OMMA. If an Oregonian has a debilitating condition as defined in the OMMA, s/he applies by having her/his physician certify the qualifying condition and that mmj “might help”. To learn about the OMMP and the law (ORS 475.300-475.346) go online to the website http://oregon.gov/DHS/ph/ommp/.

Debilitating conditions include cancer, glaucoma, wasting (cachexia) caused by HIV infection or other conditions, severe pain, severe nausea, seizures, or persistent muscle spasms like those caused by multiple sclerosis. The only condition added by DHS since 1998 is agitation from Alzheimer’s disease.

The most commonly reported debilitating condition is severe pain. Note: our legislature feels doctors are not proficient in controlling pain. Therefore, the Oregon Medical Board requires as of January 2, 2009 that licensed doctors receive special continuing education on treating pain and end-of-life care.

OMMP issues a one-year permit to qualified applicants whose identifying information is entered into a confidential data base at DHS. The permit allows limited exceptions to state law for growing and possessing cannabis. Although legal for a patient to pay expenses related to his/her grower’s supplies and utilities, selling cannabis remains a crime. Since there is no allowance for patients to sell to each other when growing a garden is not practical, some patients have limited access to medicine.

The OMMA is not a substitute for reform. Rather, it is a bridge to the time when the feds reschedule marijuana to allow patients to purchase it by prescription.

By October 2008, over 20,000 patients had registered with the OMMP. Adding legitimacy are the 3000 Oregon physicians who participate in the OMMP. These physicians likely represent the majority of Oregon doctors who routinely manage patients with terminal and chronic illness. Perhaps this degree of participation indicates the Oregon medical community is committed to improving pain and symptom control.

Patient fees pay for administration of OMMP so it never costs taxpayers a dime. In fact, the OMMP contributed nearly $1 million to the state General Fund in 2005.

In spite of a poll showing 76% of Oregonians support “seriously ill patients to use and grow their own medical marijuana with the approval of their physician”, the OMMA still faces opposition from law enforcement and some politicians. A ballot initiative amending the OMMA to allow dispensaries to sell mmj failed in 2004. Perhaps this means Oregonians like the OMMA as is, but do not want commercial sales to further provoke federal authorities. The federal Drug Enforcement Agency (DEA) is very nasty about dispensaries in California, even threatening landlords with property forfeiture if renting to dispensaries.

Some in Oregon wish to retry a dispensary initiative. My opinion about amending the OMMA is we need federal changes first. Otherwise, we will have the DEA repeating the California raids in Oregon. Rescheduling marijuana so patients can obtain it by prescription would be ideal. Calling the DEA off their pursuit of medical marijuana patients—particularly in states where mmj laws passed—would be a good start.

This 2009 legislative session also challenges the OMMA. In 2007 and 2005, Republicans and Associated Oregon Industries attempted to codify discrimination against OMMA registrants who work. Some businesses pursue federal contracts—good business—but then ignore actual employee impairment, and fire Oregonians simply for being OMMA registrants—bad business. Oregon law says medical marijuana must be treated like other medicines. Our legislature, citizens, and courts have to decide what is fair. Decent people do not discriminate against the sick and disabled. But, it takes vigilance because some seek to transform greed into a virtue.

The OMMA is challenged by citizen initiatives too. During Oregon’s 2008 election cycle, Kevin Mannix filed an initiative to repeal the OMMA, but he never collected signatures. With endless money flowing from Loren Parks to Kevin Mannix, there is potential for a blizzard of negative ads against the OMMA. There are many businesses including law enforcement, pharmaceuticals, and drug testing industries that directly profit from mmj prohibition.

Fourteen states including Oregon, Washington, California, Alaska, Arizona, Colorado, Hawaii, Maine, Nevada, Maryland, Montana, Rhode Island, New Mexico, and most recently, Michigan have mmj legislation. That is over a quarter of all states and covers, as noted at the beginning of this article, over 20% of US population. The conflict between state and federal laws has resulted in a series of court battles concerning states’ rights, medical necessity, and drug policy enforcement.

Ten years after the OMMA passed, many patients have benefited. All Oregonians save money by less marijuana prosecutions and a patient-funded OMMP that contributed to the General Fund. Most importantly, the OMMA puts Oregon closer to a more humane world where the sick can access pain and symptom control without the heartless bludgeon of reefer-madness prohibition.

Rick Bayer, MD is board-certified in internal medicine, a fellow in the American College of Physicians, and practiced in Oregon for many years. Co-author of Is Marijuana the Right Medicine For You? A Factual Guide to Medical Uses of Marijuana, he was the filing chief petitioner for the Oregon Medical Marijuana Act in 1998, and manages www.omma1998.org that includes a medical cannabis/marijuana bibliography.


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