Some proponents of using marijuana to alleviate persistent symptoms of common illnesses say it is time to make the substance easier to come by and to regulate the system by which it is cultivated and distributed.
But critics of Question 5 say the proposed changes could increase illicit trafficking and recreational use of marijuana under the guise of expanded medical access and an ineffective network of state-registered growers and distribution centers.
And at least one medical marijuana patient worries that by creating more government involvement, the law could complicate his ability to use and grow the substance he needs daily.
On Nov. 3, Maine voters will be asked to decide.
Question 5 asks, “Do you want to change the medical marijuana laws to allow treatment of more medical conditions and to create a regulated system of distribution?”
Existing Maine law approved in 1999 through public referendum allows an individual suffering from one of four specific conditions to grow, possess and use small amounts of marijuana if a physician determines the effect of the drug may be beneficial.
The list of allowable conditions includes persistent nausea, vomiting, wasting syndrome or loss of appetite related to AIDS or cancer; elevated pressure in the eye due to glaucoma; seizures associated with conditions such as epilepsy; and persistent muscle spasms related to chronic conditions such as multiple sclerosis.
The current law also allows qualified patients with physician documentation to possess up to 2½ ounces of marijuana, and to grow up to six plants at a time for their own use. They also may designate a “caregiver” to grow the plants for them.
The proposal before voters next month would expand the list of qualifying diagnoses to include hepatitis C, Lou Gehrig’s disease, Alzheimer’s disease, Crohn’s disease and others. It would establish a system of nonprofit, board-governed dispensaries — storefront operations where qualified patients or their designated caregivers could purchase marijuana in Maine. The dispensaries also would be licensed to grow marijuana for qualified patients.
The 14-page bill contains many other provisions as well, including the issuance of registry cards for patients, caregivers and dispensary board members. The oversight of the dispensary and registry systems would rest with the Maine Department of Health and Human Services.
Organizer Jonathan Leavitt heads the political action committee Maine Citizens for Patient Rights, which is spearheading the low-profile referendum. He says the provisions of Question 5 are needed to expand access and improve the quality of medical marijuana in Maine.
“Ten years ago, voters overwhelmingly voted to support medical marijuana,” he said in a recent interview. “But so far, it has only been used by a handful of patients.” The reason for that, he said, is that existing law does little to help patients find safe, legal sources of high-quality marijuana and fails to protect them adequately from having their supplies confiscated.
“There’s not a lot to talk about,” he said. “The public has already signed off on this. We’re just making some corrections and improvements.”
But Question 5 is vigorously opposed by state health and public safety officials, including Roy McKinney, director of the Maine Drug Enforcement Agency.
In his testimony last spring before the Legislature’s Health and Human Services committee, McKinney said the marijuana dispensary system in California — the model for the one being proposed for Maine — has led to many problems. Among them, he said, are significant increases in street dealing, illegal diversion to recreational users, complaints of other drugs being sold illicitly at the dispensaries and neighborhood disruption.
“This legislation raises concerns for the public health, safety and welfare of Maine citizens,” McKinney told the committee.
On Friday, McKinney reiterated his opposition to Question 5. The proposed law would not allow DHHS to share registry information with law enforcement officials, and does not clarify the murky federal-state disconnect, he said.
“They’re trying to give some legitimacy to the distribution of marijuana,” he said. “This proposal has the guise of regulation, but there are no teeth in it.”
The measure also is opposed by the Maine Office of Substance Abuse within DHHS. Director Guy Cousins says that any measure that encourages more people to grow, possess or use marijuana will increase the availability of the drug for recreational users, including teens.
From a public health perspective, Cousins said recently, the variable potency of marijuana plants means patients can’t predict how much they need to use to get a therapeutic dose, and the smoke from a marijuana cigarette contains high levels of carcinogens and other substances that can damage health.
The existing medical marijuana laws are founded in compassion for the sick and dying, Cousins said. “But at the same time,” he said, “we need to ensure the safety of the people of Maine.”
Dr. David McDermott, president of the Maine Medical Association, said Maine physicians are divided on the medical marijuana issue.
“There are some who are big proponents,” he said. “But there are probably more who see most of this ruckus as an opportunity for recreational users to validate their use and avoid prosecution.”
The MMA, which opposed the 1999 referendum question, is not taking a position this time around.
“If we have physicians interested in prescribing marijuana,” McDermott said, “we’ll help them understand the existing guidelines.”
Over the past decade, physician John Woytowicz of Augusta has counseled about 50 patients about the potential for marijuana to ease their symptoms. More than half have gone on to use the substance under his supervision, he said.
“There has been a broad range of experiences,” Woytowicz said recently, but many patients have found relief.
He described one woman in her 50s with the crippling degenerative disease multiple sclerosis. She has had decreased muscle spasms and pain — and has been able to reduce her use of narcotic painkillers and intravenous steroids — since she started using marijuana six months ago, the doctor said.
For patients like this, Woytowicz said, the changes proposed in Question 5 would be beneficial, both in expanding the list of allowable disorders for which patients can use marijuana and in offering a simple way to obtain the substance.
Many patients do not know anyone who can provide them with marijuana, he said. And, he pointed out, while some choose to grow their own, as the current law allows, that’s not a solution for everyone.
“If you’re diagnosed with cancer and getting chemotherapy next week, you may not have the luxury of time,” he said. “A dispensary is a great idea.”
In the Somerset County town of Madison, medical marijuana user Don LaRouche says Question 5 jeopardizes a system that is working fine for Mainers like him.
LaRouche, 47, has been growing and using marijuana under the provisions of the current law for about two years. It has eased the muscle cramping and other symptoms of his multiple sclerosis, he said, as well as reduced the pressure in his eyes due to glaucoma. He smokes a marijuana cigarette, on average, every two hours during the day.
“I’ve tried other medications; they don’t work and they have too many side effects,” he said Monday.
LaRouche said DHHS has an inherent conflict of interest in providing oversight of marijuana dispensaries and the registry, due to its connection with the Office of Substance Abuse.
“Why do we want [DHHS] to know where we live and what our business is?” he asked.
LaRouche also objects to a provision in the proposed law that would charge dispensaries an annual fee of $5,000 and could also make individual patients pay to participate in the registry.
“This law we have right now is not the greatest,” he said, “but it’s a lot better than what they’re trying to get in.”
Read the full text of the Question 5 proposal on the Web: ballotpedia.org/wiki/index.php/Maine_Medical_Marijuana_Initiative_(2009)