Editorial: Growing pains for medical pot system

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    In this Friday, April 22, 2016 photo, a jar containing a strain of marijuana nicknamed "Killer D" is seen at a medical marijuana facility in Unity, Maine. A growing number of health experts and law enforcement officials are making the case that marijuana could help reduce the numbers of overdoses and redirect money into fighting heroin and other opiates. (AP Photo/Robert F. Bukaty)

Published: 8/12/2016 6:41:59 PM

At the Olympic Games, the top three names in any sport step up to glory on a podium. In the medical marijuana certification games, this state’s top-three prescribing physicians are missing in action.

Nearly eight years after Massachusetts approved use of medical cannabis, the system created to supply that therapy is hobbled by opposition in Washington, D.C., and misunderstanding and missteps here.

The breakdown isn’t fair to prospective patients with a legitimate need for this medication. The resulting bottleneck in access must be fixed. Experts say 2 percent of a state’s residents typically seek marijuana as medicine – or 135,000 people in Massachusetts. As of now, 31,000 patients have been certified by the state.

Health officials should expand physician training options and public education efforts. They must not knuckle under to backward attitudes inside the Beltway.

This month, the state’s top medical pot certifier, Dr. Jill Griffin of Northampton, announced she will no longer see any patients seeking this option; earlier this summer she stopped taking new ones. Her existing patients have the option of having their files transferred to a different practice on King Street.

Griffin departs with sharp words for a system that hasn’t accepted what voters made legal in 2008. In a recorded message to patients on her office phone, Griffin claims she faced “hostility toward those who practice the type of medicine that I practice.” She feared a career setback and said the risk of losing her license was “a peril I can no longer endure.” Though voters said yes, the medical hierarchy hardly budged, with fears of its own.

In the eyes of the federal government, marijuana remains a Schedule 1 drug, sharing that category with heroin and LSD. The Drug Enforcement Agency recently rejected a petition to reschedule marijuana. For now, the federal government holds that marijuana has no legitimate medical use. While 25 states and the District of Columbia see it differently, and sanction cannabis as a medical therapy, federal opposition is interfering with sane management of state programs. This shadow may not lift any time soon. Massachusetts health officials should fight back and uphold the decision voters made.

Doctors need that cover if this law is to have any real meaning. As it is, most established health care institutions, including the area’s largest, Baystate Health Systems, steer clear of certifying patients for medical marijuana use. One worry has been complications with the banking system.

That left a small group of doctors to handle too large a demand, opening the door to access and accountability problems. Out of roughly 36,000 doctors in the state, 161 have taken the required course qualifying them to provide medical pot certifications.   The state’s law says a patient must face a “debilitating condition.” As it should, the measure trusted doctors to judge whether a prospective patient’s condition was legitimate and could be eased with medical marijuana.

Griffin says she has done nothing wrong. Her file with the Board of Registration in Medicine shows no disciplinary action.

But she didn’t like what she was seeing.

Questions about the certification process led regulators this summer to suspend the medical licenses of the two physicians who, along with Griffin,  topped the list of doctors qualifying patients: Dr. John C. Nadolny and Tyrone S. Cushing. Those doctors faced disciplinary action because the Board of Registration in Medicine alleged they improperly handled medical marijuana cases – Nadolny for delegating work to nurse practitioners and Cushing for certifying a patient without having the bonafide doctor-patient relationship the law requires. This sort of regulatory oversight remains key to preserving the law’s terms.

Meantime, while regulators fret about the application of standards, another referendum on the ballot is poised to change the playing field. If recreational use of marijuana is approved at the polls this November for people 21 and older, efforts to fix the oversight of the drug’s medical uses may be left in the dust. Doctors who understand the efficacy of medical pot have an important role to play, but it’s less likely patients will pay an average of $200 for a consultation.

That still leaves the apparatus of an existing law in need of healing.




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