MEDICAL MARIJUANA CARDS ABOUND

The Number of Oregon Patients Allowed to Use the Drug Soars to Nearly
10,000, Which Some See As a Success and Others a Problem

Nearly 10,000 Oregonians carry medical marijuana cards, about 20 times
more than officials predicted when the program started six years ago.

The fee-based program, which gets no money from the state general
fund, has grown so fast that it built up a cash surplus of nearly $1
million last year.

To reduce the surplus, officials slashed the annual fee for a medical
marijuana card from $150 to $55 this month. For Oregon Health Plan
patients, the fee dropped to $20.

The number of cardholders has doubled in less than two years. Between
80 and 100 new or renewal applications arrive on a typical day, said
Pam Salsbury, who manages the state's medical marijuana office in the
Department of Human Services.

"I don't think anybody in their wildest dreams thought there would be
this many people in the program," Salsbury said. "We're hearing from
other states that have a program and wonder how we do it."

Critics say the unforeseen growth shows that medical marijuana cards
can serve as a cover for recreational drug use. Defenders say it
reflects growing acceptance, by doctors and patients, of marijuana as
an alternative to mainstream medicine.

Oregon is one of 10 states where medical marijuana use is legal. The
others are Alaska, California, Colorado, Hawaii, Maine, Montana,
Nevada, Vermont and Washington. The laws vary widely.

Oregon's Medical Marijuana Act, approved by voters in 1998, allows
residents to use a small amount of marijuana for medical purposes.
They must grow their own or designate a caregiver to do so for them.

A doctor must verify that the patient has a "debilitating medical
condition" such as cancer, glaucoma or AIDS, or a symptom such as
nausea or severe pain. The doctor's signature does not count as a
prescription.

More than 1,500 Oregon doctors have signed at least one patient
application, according to state figures through 2004. But 10 doctors
account for two-thirds of the current and pending marijuana card requests.

Each of those 10 physicians has signed more than 100 applications, and
the top two have signed 2,796 and 1,783 apiece. The state does not
divulge the names of participating doctors.

"Loopholes for Abuse"

"Unquestionably, people are taking advantage of a system that was
created for individuals with medical problems," said Ken Magee, the
Drug Enforcement Administration's agent in charge of operations for
Oregon and Idaho.

The federal agency, he noted, considers marijuana a dangerous drug
with no medicinal value.

Oregon's medical marijuana program has a "very lax system of review
and oversight," Magee said. "The law is riddled with loopholes for
abuse."

Qualifying conditions such as "severe pain" or "persistent muscle
spasms" are so vague that they allow little rigorous control over
misuse, he said.

More than 80 percent of the current cardholders cited severe pain on
their applications. About 30 percent cited persistent muscle spasms,
and 22 percent cited nausea. Applicants often give more than one
medical reason.

Colorado's 4-year-old medical marijuana program is modeled on
Oregon's. Despite a larger population, Colorado has only 504
cardholders, about one-twentieth as many as Oregon.

After an Oregon patient's application for a medical marijuana card is
complete, Salsbury said, the state sends the signing doctor a letter.
The doctor must sign a second form verifying that he or she did see
the patient and did approve the card request.

Once the application is complete and verified, she said, the state
issues a card. Under the law, officials don't evaluate motives.

"That's not for us to question," she said.

State Disciplines Two Doctors

Two doctors -- Dr. Phillip Leveque of Molalla and Dr. Larry Bogart of
Roseburg -- have been disciplined by the Oregon Board of Medical
Examiners for inappropriate recommendation of medical marijuana. The
board regulates medical practice.

Leveque, an 81-year-old osteopath, had his license suspended in March
and revoked in October. He said he had signed several thousand medical
marijuana requests.

The board in October also stripped Bogart, a 66-year-old psychiatrist
who said he has signed more than 1,000 medical marijuana applications
during the past five years, of his ability to treat children,
prescribe controlled drugs or sign marijuana card applications. He
retains his license.

The Oregon Medical Association, the largest physicians group in the
state, stayed neutral on the original medical marijuana law in 1998.
The association opposed a ballot measure last November that would have
broadened the law, easing restrictions on allowable limits and
creating state-regulated dispensaries to sell marijuana to
cardholders.

A federal appeals court in California ruled in 2003 against the Bush
administration's bid to punish doctors who recommend medical marijuana
to their patients. Since that court opinion, fewer doctors in Oregon
are afraid to sign medical marijuana card requests, said Jim
Kronenberg, the medical association's chief operating officer.

"We continue to encourage our members to be very circumspect about how
they participate," he said. Doctors are urged to keep careful records
and avoid even the appearance of prescribing an illegal drug.

Advocate Sees More Acceptance

John Sajo, who heads Voter Power, an advocacy group for medical
marijuana users, attributed the rapid growth in the Oregon program to
increasing acceptance by doctors. He said marijuana helps some
patients avoid more potent and expensive prescription drugs.

"It's not just the patients saying they feel better," he said. "It's
also the patients saying: 'And don't write me the morphine
prescription anymore.' "

Others say marijuana is a "gateway drug" that can lead to using more
addictive drugs.

"We're making a big mistake in making marijuana available," said Walt
Myers, Salem police chief and head of Gov. Ted Kulongoski's task force
on methamphetamine. "There are enough drugs on the market that will
relieve the pain of any disease known to mankind, without resorting to
marijuana."