Patients Get the Shaft in the Aloha State

Hawaii’s approach to medical marijuana is unique. Because of the way that the state’s Narcotics Enforcement Division (NED) administers its program, the sick are profiled and treated like criminals, research is disregarded, myths are glorified, and physicians are intimidated.

One noteworthy example is NED teaming up with the police departments on the islands of Hawaii, Maui and Kauai to distribute a colorful brochure, stamped with their logos, that informs readers that “MARIJUANA IS NOT MEDICINE. MARIJUANA IS ADDICTIVE.” The

brochure is handed out in public places like shopping malls and at gatherings such as Rotary Club meetings.

Teri Heede, a patient and an advocate, found out that she was a target at one of these anti-marijuana police presen- tations.

“The police chief put my picture up on the screen for everyone to see and said that I am the kind of person that testifies to the legislature,” she said.

Depending on how her day is going, Heede, who has mul- tiple sclerosis, gets around town with a cane, a walker or   a motorized wheel chair. She uses smoked or vaporized cannabis to help with vision and mobility.

Studies show that neurodegenerative conditions like mul- tiple sclerosis respond well to cannabis therapy for painful cramping and muscle spasms. Perhaps the best document describing the medicinal value of cannabis is the United States Patent # 6,630,507 B1, owned by the U.S. Department of Health and Human Services, and entitled Cannabinoids as Antioxidants  and  Neuroprotectants. This federal rhapsody on the medicinal benefit of cannabis delves into the usefulness of cannabinoids in treating myr- iad oxidation-associated diseases, including inflammatory and autoimmune diseases. Inflammation is a  problem with neurodegenerative diseases such as multiple sclerosis. As an anti-inflammatory, cannabis has been shown  to slow the progress of multiple sclerosis.

A few years back, Hawaii’s Department of Public Safety,

which oversees NED, released its entire medical marijua- na registry database, cram-packed with supposedly confi- dential information, to a newspaper reporter. Heede’s records were among the 5,000 patient records that were released.

“With Hawaii’s program, we grow  cannabis,”  she  said. “We do not have dispensaries. So handing out my address put me at risk for theft. What they did is against all regu- lations, but I guess that doesn’t apply to law enforcement.”

You might ask, with good reason, why a law enforcement agency is tasked with overseeing a medical program. Apparently, Hawaii’s legislature is well aware of how screwed up the situation is, but, worried about the cost of transferring the program to another agency during poor economic times, they have done nothing…for 12 years.

“The Department of Health won’t touch it,  because  they do not feel that they have the funding,”  said  Clif  Otto,  MD. “That does not make any sense at all. With a $25 annual registration fee to at least 8,000 patients, you’d think that a couple hundred thousand dollars a  year would allow them to print up the registry cards. So instead we have an agency that is in clear violation of its duty to faithfully execute the program.” There are approximately 11,000 patients in Hawaii’s medical marijuana program, according to information released by NED in January.

Most of the 17 medical cannabis programs in the United States came about by way of public referendum. Not in Hawaii, where, thinking it was the right thing to do, leg- islators designed and enacted the program in 2000. And then, to the bewilderment of many, these same legislators decided that the right thing to do was to give oversight of a medical program to its law enforcement arm. The story goes that the intent of the law was to give oversight to the Department of Health, but squabbles over administration and budgets pushed it into the realm of the Department of Public Safety where NED gleefully grabbed control.

Since that time, advocates have tried, without much suc- cess, to convince the Department of Health to add new conditions such as post-traumatic stress disorder (PTSD) to a short list of qualifying conditions.

PTSD is considered the fourth most common psychiatric disorder, affecting 10 percent of all men and 18 percent of all women, with rates much higher in high-trauma locales such as war zones or extreme-poverty areas. PTSD is something that many suffer from after experiencing or witnessing trauma. The National Center for PTSD, oper- ating within the U.S. Department of Veterans Affairs, esti- mates that up to 8 percent of the country’s population will have PTSD at some point in their lives, and that approxi- mately 5.2 million adults will have PTSD during any given year.

While trying to get the condition added, these advocates were initially told that the department does not have the authority to add new conditions. When it was pointed out that the statute governing the law clearly states that the Department of Health does have the authority to add new conditions, a spokesperson from that agency said that inadequate evidence exists about cannabis and PTSD.

“So without even public hearings, they invoked their rule- making authority and said that there is inadequate evi- dence,” said Otto. “They don’t even have a medical advi- sory board or administrative rules to address adding new conditions.”

Otto, an ophthalmologist and retina specialist, is a veteran. “I’ve treated patients over in Japan who were getting deployed all of the time and were definitely suffering from

PTSD,” he said. “I’ve seen PTSD myself in practice. From talking with patients, and from what I’ve read about the neurochemistry behind the effects of cannabis, it appears that cannabis could be very useful in treating PTSD.”

As a physician, Otto does not recommend patients for the program. He views the reporting requirements as being too stringent, and the time required to receive the approval, up to six months, as being ridiculous. Legislation proposed, HB1963, would have mandated that physicians register all locations used to recommend patients, and would move the incidence of any false state- ment on a medical marijuana application from petty mis- demeanor to Class C felony. To the relief of patients, advo- cates, and supporting legislators, the NED-inspired bill is dead. The Chairman of the House Judiciary Committee refused to hear it, which effectively killed it. As a result of well-documented intimidation of physicians by NED since the inception of the program, however, few physicians are willing to make patient recommendations.

The logic of NED, in turn, holds that since just a few doc- tors are recommending cannabis to patients, these few are obviously abusing the system. Keith Kamita, the head of NED, has been known to reveal the identities of doctors and portray them as criminals.

“He has been overseeing this program since its inception, and he’s actually been caught giving presentations out in the community, slandering recommending doctors,” said Otto. “He has given Power Point presentations with actu- al names of recommending doctors, and told people in the community that these are criminal doctors.”

When the sick, on the other hand, call the same agency to ask for the names of doctors that might be able to give them a recommendation, they are told that this confiden- tial information cannot be released. It goes to reason that anyone desperate enough to call an agency called the Narcotics Enforcement Division to ask where to find a marijuana recommendation is in need of help, most likely diagnosed with a serious medical condition, and without connections in the trade. No criminal looking for marijua- na would call the police, and not offering to help the sick    is inhumane. While Otto might not want to risk his license by recommending cannabis, he has noticed that more and more of his patients, particularly the older ones, are curious about the plant’s medical benefit. Many, for instance, want to know about how cannabis can relieve symptoms in eye conditions such as glaucoma.

“Cannabis lowers pressure by about 25 percent in about  60 percent of the population, but you have to use it about every three hours,” he said, adding,  “You  will not develop  a tolerance to the pressure-lowering effects either.”

In Search of Compassionate Care for the Traumatized Hawaii’s environment nurtures more than gorgeous tropi- cal plants; the state is home to many veterans.

Studies show that neurodegenerative  conditions  like multiple  sclerosis respond well to cannabis therapy for painful cramping and muscle spasms. Perhaps the best document describing the medicinal value of cannabis is the United States Patent # 6,630,507 B1, owned by the U.S. Department of Health and Human Services, and entitled Cannabinoids as Antioxidants and Neuroprotectants.

Combat injuries inflicted on military veterans make them much more likely than the general population to experi- ence PTSD. Many rely on cannabis for therapeutic benefit. With PTSD, there is no shortage of information that cannabis does double duty; it alleviates the high anxiety, panic attacks and recurring nightmares; and helps wean people off of the opiates that doctors prescribe like jelly beans to treat PTSD.

Alfred Wylie is a 100-percent disabled Vietnam-era veter- an. As a naval nuclear weapons specialist working on a combat aircraft carrier, he was sent on missions to Russia,

Lebanon and Cuba between 1958 and 1961. He was left with painful scars and PTSD.

“I had nightmares every night from 1960 until 1998,” he said. “Nightmares of killing people. Every single night.”

Wylie began smoking cannabis to treat the PTSD in 1965. Only with in-depth therapy in the 1990s did he feel that  he was making significant progress in overcoming his mental anguish. Cannabis has always helped him to cope.

Wylie has a master’s degree in psychiatry. “What you have to understand about PTSD is that when you are in a situ- ation where people are being killed all around you, you just literally numb out,” he said. “Cannabis is a somatic drug. That means that it brings in body consciousness. That is why it is popular to those suffering from trauma. They can feel their bodies again. When their feel their bod- ies again, it is not in a painful, hurtful manner.” According to statistics assembled by the Pew Research Center, one out of every 10 veterans alive today was seri- ously injured at some point while serving in the military; three-quarters of those injuries occurred in combat, and those with significant service-related injuries are more than three times as likely as other veterans to experience PTSD. Estimates put troops returning from Iraq and

Afghanistan with PTSD, depression and traumatic brain injury at well over 300,000.

While cannabis has been shown to help PTSD patients, legislators have been reluctant to admit PTSD as a quali- fying indicator. To get around the omission, many qualify for a recommendation with indicators such as pain. In yet another blatant display of its anti-medical, anti-compas- sion agenda, the NED-inspired, now defeated HB1963, would have eliminated pain as a qualifying condition. Eighty percent of those qualifying for a medical cannabis card in Hawaii used pain as their qualifying condition.

Wylie grows his own, and finds gardening to be therapeutic.

Hawaii’s medical marijuana law does not mention dispen- saries. Each patient is allowed to grow seven plants. Patients who are too sick or otherwise unable to grow cannabis are permitted to have a caregiver. A caregiver can only grow for one patient.

For the state’s law to be truly compassionate, according to Wylie, PTSD should be added as a qualifying  condition and dispensaries should be established. Standing in the way, he feels, are pharmaceutical companies, which do more than any entity to keep cannabis away from those who need it most.

“There is a lot of pressure from the alcohol, tobacco and sugar industries, but it’s really the pharmaceutical industry that is doing everything it can to control it,” he said. “If it were up to them they would keep it illegal, and shoot people trying to sell it. They have billions of dollars and they pay off legislators to make sure that these laws are in place.”

The influence of the law enforcement community hinders reform, according to Jeanne Ohta, executive director  of  the Drug Policy Forum of Hawaii. While  a growing  body of research shows the benefit of the natural alternative of cannabis therapy, NED has gone to great lengths, even fly- ing in colleagues from other states, to push the anti- cannabis agenda that keeps its officers employed.

“It is hard to make headway because law enforcement has so much say in policy,” she said. “Legislators believe them.”

Teri Heede views using cannabis for medicine as a civil

right. In light of the way that she and others are target- ed, she feels that cannabis should be completely deregu- lated.

“Before I started using cannabis as medicine and advocating for the sick and dying, I saw no reason for legalization,” she said. “Now that I’ve started this, I  see  every reason for legalization. We need research. We need to get the criminals out of the equation. We need  to protect sick people. If it were decriminalized, the really sick who do not have the lead time to grow could buy small quantities easily without fear of prosecution.”

Heede is a Vietnam-era veteran and a longtime advocate for many causes. Other patients have told her that they are intimidated by police harassment. Her physician, who was threatened by the police after making a house call to Heede when she was bedridden with an especially bad relapse, is intimidated. She is not.

“As long as I can roll in on my scooter, walk in on my crutches, or hobble in on my cane, I will be coming in to testify at the state legislature,” she said. “I’ll also write letters, speak to the media and advise patients. Having the Narcotics Enforcement Division overseeing our medical marijuana program is like having the fox guarding the hen house.”