FEWER REGISTER TO USE MEDICAL MARIJUANA

After five years of rapid growth in the number of patients certified
to use marijuana for medical purposes, enrollment in the state
registry dropped sharply last year for the first time since medical
marijuana was legalized in 2000.

The number of people registered with the state and certified by a
doctor to have debilitating conditions that qualify them to legally
use marijuana dropped by almost 22 percent during the past 10 months,
according to statistics supplied by the state Department of Public
Safety.

Keith Kamita, who oversees the program as administrator of the
department's Narcotics Enforcement Division, said people continue to
sign up, so he doesn't see the decline as any indication that
patients are having trouble getting certified.

"I think there's a lot of people who try it and then don't go back to
it," Kamita said.

Pamela Lichty, president of the Drug Policy Forum of Hawai'i, said
it's unclear why the number of registered medical marijuana patients
is dropping, but the causes may include a lack of publicity for the
program in recent years or fewer doctors who are willing to certify
patients.

The forum, an organization that promotes a public health approach to
drug- and substance-abuse issues, has been urging state lawmakers for
years to move the medical marijuana program out of the Department of
Public Safety and into the state Department of Health.

Lichty said she will resume that effort in the state Legislature this
year because her group believes Public Safety, which enforces laws
prohibiting illegal drugs, is the wrong agency to oversee the legal
use of marijuana by people who are ill.

Moving the program will encourage more people to use the program and
also ease the anxiety of physicians who are asked to certify
patients, Lichty said.

The Public Safety Department and Kamita are responsible for
overseeing physicians' authority to write prescriptions to ensure
there is no abuse, she said.

"He is kind of an overseer of physicians' behavior, and so they're
not crazy about the idea of dealing with him," she said.

Most On Big Isle

More than half the people certified and registered with the state to
use medical marijuana are on the Big Island. That, Lichty said,
suggests O'ahu doctors aren't aware of the potential benefits of
marijuana and aren't familiar with the legal protections under the
program.

Under the program, a doctor must certify that the patient has a
qualifying medical condition such as cancer, AIDS or glaucoma, and
that the doctor believes the potential benefits of medical marijuana
use would likely outweigh the patient's health risks.

Kamita said doctors face no risk of enforcement action from his
office for certifying patients under the law as long as the doctors
do not actually prescribe marijuana or give marijuana to their patients.

With more than 2,000 patients certified and registered by doctors
statewide, Kamita said he doubts doctors have a problem dealing with
his agency and said the program should stay where it is.

Kamita said he believes specialists in Honolulu rarely certify
patients for marijuana use because those specialists are prescribing
other, more effective drugs.

Few Takers

One organization that established a clinic on Queen Street
specifically to certify patients who are eligible for medical
marijuana use has found relatively few takers.

The Hemp and Cannabis Foundation, which also operates clinics in
Oregon, Washington state and Colorado, saw only about 200 patients in
Hawai'i in its first year of operation, said foundation executive
director and founder Paul Stanford.

"Things have gone a bit more slowly than we would have liked," but
the organization began radio advertisements in recent weeks to let
more people know about the clinic, Stanford said. He said the clinic
also began seeing patients in Hilo because there was demand there.

Seen As Business

Stanford said he believes relatively few people sign up from O'ahu
because it is impractical for many people to grow their own marijuana
for medical use. He said that is less of a problem on the Big Island,
where more people live in rural settings.

Kamita said some doctors on the Big Island are involved in certifying
patients for medical marijuana use "strictly as a business." He cited
one Big Island physician who is responsible for certifying 897
patients, or more than half the people certified on the Big Island.

Kamita declined to identify the doctor but said he believes there
should be a cap on the number of patients any single physician can
certify. That will help ensure the patients get appropriate follow-up
care, he said.

"If you have 897 patients, I'm wondering how much interaction you are
having with the patient," Kamita said.

HAWAI'I MEDICAL MARIJUANA LAW

Under the law, a person must be certified by a physician to use
marijuana for a "debilitating" medical condition. The certificate
allows the patient to have up to three mature, flowering marijuana
plants, four immature plants and an ounce of usable marijuana for
each mature plant. The certificate must be renewed each year.