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Rhode Island Patient Advocacy Coalition

Legal marijuana use grows in R.I.

Providence Business News
6/8/09
http://pbn.com/detail.html?sub_id=a963ad2f7d41&page=1

Ellen Lenox Smith smoked marijuana once in college. It didn’t go well. She didn’t get high like her friends, but felt sick instead. She spent a whole day in bed.

She only tried it again at her doctor’s behest. Now 59, Smith, of Scituate, is very sick with a rare genetic condition called Ehlers-Danlos syndrome, a connective-tissue disorder that weakens the joints and makes it easy for bones and even internal organs to fall out of place.

Once an athlete, Smith now needs a wheelchair to get around. She’s undergone 17 surgeries, and she had to quit the job she loved, as a middle school teacher. Extreme pain is a constant in her life, and the only thing that makes it bearable is spoonfuls of marijuana-infused olive oil.

“My husband would tell you, if it weren’t for medical marijuana, I wouldn’t be alive anymore,” she said in an interview. The drug eases the pain enough for her to sleep, she explained. Without sleep, she couldn’t function at all.

Smith is among the hundreds of severely ill Rhode Islanders who are using marijuana to ease pain, nausea, loss of appetite and other symptoms that the drug has been shown to help with.

As of last year, 618 patients were registered with Rhode Island’s medical-marijuana program, up from 209 in 2006, the year it was created by state law. Some have cancer, complications from HIV/AIDS, or hepatitis C; a handful have glaucoma. The vast majority, like Smith, have a serious, chronic or debilitating disease or condition.

Under the Rhode Island Medical Marijuana Act, doctors cannot “prescribe” marijuana, but they can recommend it, and they can certify patients to register with the state program, allowing them and up to two designated caregivers to legally possess up to 2.5 oz. of usable marijuana and/or 12 plants each.

Thirteen states allow medical-marijuana use, and more are considering it. But most, including Rhode Island, don’t provide a legal way to obtain the drug. The exceptions are New Mexico, which in March licensed its first dispensary, and California, which allows dispensaries but doesn’t directly oversee them.

Rhode Island is in line to be next. In the last several weeks, both the R.I. House and the R.I. Senate approved, by large margins, bills to allow up to three nonprofit, state-licensed “compassion centers” to dispense medical marijuana to registered patients.

Gov. Donald L. Carcieri opposes the measure and is expected to veto it if a bill reaches his desk, though he hasn’t officially said he will. The General Assembly, however, would likely have the votes to override a veto. The federal government, for its part, was already refraining from prosecuting medical-marijuana dispensaries, and the Obama administration has specifically said it won’t.

“Without the threat of federal raids, there’s no practical reason [against developing] a safe way for patients to access this drug,” said Rep. Thomas C. Slater, D-Providence, one of the bills’ sponsors. In the meantime, legislators and advocates say, patients are having to deal with criminals, or else struggle with the difficulties of indoor cultivation.

Smith has dealt with both challenges. At first she bought the drug illicitly, and then last year, when she was growing it, local youths stole her plants. This year, she and her husband are trying again, this time in a more hidden place.

But Smith, whose body won’t tolerate morphine, Oxycontin or other painkillers, said she’s “thrilled” by the prospect of soon being able to obtain marijuana without any hardship.

“I think it’s the right thing to do,” she said. “If we’re going to make it legal, let’s make it safe.”

There are other ways in which dispensaries would help, noted Dr. Todd E. Handel, whose Pawtucket practice, the Handel Center for Spine, Sports and Rehabilitation, specializes in spine treatments, neuromuscular medicine and pain management.

Handel said he’s certified 15 to 20 patients for the state program, most to treat severe, chronic, debilitating pain. Many were taking narcotic pain medications already, Handel said, but those drugs have much-worse side effects than marijuana, affecting their cognition and alertness.

“They find that marijuana helps in decreasing their pain, and it allows them to use much less of their pain medication,” he said. “There are some patients who’ve been able to stop their opioid pain medications completely. Others have been able to cut their dose, sometimes in half, and find that the medication is more effective in a lower dose.”

Yet the law doesn’t allow him to counsel the patients on how to use the drug, Handel said, or on how to obtain it. Legal dispensaries, he said, would help address those problems.

But even if the bill becomes law this year, change won’t come for awhile. Jesse Stout, executive director of the Rhode Island Patient Advocacy Coalition, the lead advocate for medical marijuana in the state, noted that the licensing process outlined in the bill would give the R.I. Department of Health three months to issue regulations, then two months to accept applications and hold hearings, then two months to choose the licensees.

“So it’s seven months after the bill passes, so perhaps January or February, and then I would imagine it would take at least a few weeks to open up a compassion center once it’s licensed,” he said. “So we’re looking at spring of 2010.”