June 23, 2018
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Bill would let physicians decide who gets marijuana

By Tom Groening, BDN Staff

AUGUSTA, Maine — A bill expected to be submitted in the coming legislative session would eliminate the categories for which medical marijuana can be prescribed. It also would allow any physician to write a prescription for the plant, which advocates say has broad medicinal applications, rather than limiting it to a select few who are licensed.

Rep . Mark Dion, D-Portland, a former Cumberland County sheriff, will submit the bill in January.

“I’m trying to restore physician autonomy,” he said Friday. “Nowhere else does the state intrude into the physician-patient relationship.” Dion said doctors are able to prescribe a host of other medicines without having to ensure that they correspond with a specific ailment.

The Maine Medical Association is prepared to oppose the bill, according to Gordon Smith, the organization’s executive vice president. If the categories are removed, Smith argued, then the medical marijuana program would become no more than a “front” for legalized pot.

Paul McCarrier, director of the Medical Marijuana Caregivers of Maine, said the restrictions prevent effective use of the substance. The categories for which the drug is permitted are narrow, including chronic pain and symptoms associated with AIDS. As a result, he said, “People have to lie to their doctors.”

For Ryan Begin, 32, of Montville the proposed law has personal consequences.

A veteran of two tours of duty in Iraq, where an improvised explosive device “blew off my elbow,” as he describes it, he suffers from chronic pain, PTSD and other health issues. Through the Veterans Administration, he had been prescribed painkillers such as morphine and sleep aids, which led to addiction, he said.

He overdosed on Valium that had been prescribed to him by a doctor.

“I went on suboxone to get off the opioids,” Begin said. The drugs led to him developing diverticulitis, and when he returned to the Togus VA Center, physicians wanted to put him back on pills.

“This is wrong,” Begin said. “We’re forcing people to take synthetics.”

Instead, he turned to marijuana.

“It just relaxes me,” he said. When a panic attack begins, which he attributes to PTSD, he rolls a joint. “It just gives you time to breathe,” he said.

Begin believes many veterans who are returning to society from combat zones have or will experience the rollercoaster of drugs that he experienced. Marijuana is, in his view, an inexpensive, safe, mild, nonaddictive alternative that would help his fellow veterans.

“Veterans have been using marijuana for treatment since Vietnam,” he said.

Last year, Dion spoke in favor of a similar bill offered by Rep. Deborah Sanderson, R-Chelsea.

“It’s a real conservative idea,” Dion said. “I want to remove the government from the examining room.”

He believes doctors should have the full discretion to prescribe marijuana just as they would antibiotics or any other medication.

“It’s not about marijuana,” Dion said, but rather about the state not looking over a physician’s shoulder.

Alysia Melnick of the ACLU of Maine said her organization is supporting Dion’s proposal to protect patient access to the best appropriate treatment.

“It’s also an issue of individual autonomy,” she said, part of the private relationship between doctor and patient, so “doctors have the same discretion that they would have for any other drugs.”

“It makes no sense to us that the state should have any say in what a doctor does in their office,” she said.

Melnick finds it ironic that current laws favor physicians prescribing painkillers for a host of complaints even as the high public cost of addiction to those drugs, and the evidence that they leak out into the black market, is clear.

“We know more and more about the benefits of marijuana as medicine,” she said. “I hope the public perception catches up with the facts.”

But Smith of the Maine Medical Association, which opposed Sanderson’s bill, disagrees with that assertion. Marijuana is not an FDA-approved drug, he notes.

“It’s an alternative track” for treatment, he said, and its use should be carefully controlled.

“Let’s see how the current law goes before we greatly expand it,” Smith said.

And he rejects the argument that physicians have broad discretion to choose medicine for their patients without linking those decisions to a checklist of ailments.

“Some might get into serious difficulty if their patients started pressuring them [for medical marijuana] for anxiety and depression,” conditions which are hard to diagnose, he said.

“Marijuana has its place, particularly for nausea and vomiting,” Smith said. But removing categories for which the substance is approved “is a huge change.”

The proposal is in concept form only, Dion said. Its text would be drafted sometime after the Legislature begins work next month.

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