DOCTORS EXPRESS CONCERN OVER MARIJUANA USE

The number of people in Hawai'i who have registered to use marijuana
for medical purposes continues to grow, reaching almost 2,000 since
the state Legislature created the program four years ago.

And the number of patients signed up has increased steadily every
year, according to Keith Kamita, administrator with the state
Narcotics Enforcement Division, which oversees the program.

Yet patients and doctors have some concerns with the state's system,
and the U.S. Supreme Court is weighing whether laws such as Hawai'i's
are valid.

Last month, the high court heard arguments in a case in which two
California women have filed a complaint to prevent the federal
government from confiscating their medical marijuana and prosecuting
them for its use.

Dr. Inam Rahman, head of the Hawaii Medical Association, said many
members of the physicians association are wary of recommending
marijuana to their patients precisely because of that conflict between
the federal laws that criminalize marijuana use and the state laws
that allow its use for certain medical conditions.

Rahman said physicians worry that "the federal government can always
come after the doctors." Hawai'i is one of 10 states that have passed
medical marijuana laws since 1996.

The system isn't working for every patient.

Kailua resident Ruth Hendrix, 46, said she was disappointed to find
that getting access to medical marijuana is more difficult here than
it was in California.

"We had stores where you just went to buy it," Hendrix said.

Hendrix said she has used medical marijuana for two conditions:
chronic pain and hepatitis C, "which comes with extreme nausea."

She said she went to a local doctor who ran some tests after she
arrived in October but the doctor did not want to go through the
procedure of registering with the state law enforcement office.

In California, she said she went to the doctor who diagnosed her and
wrote a one-page recommendation. Then she went to the store to
register, they confirmed the information with the doctor and she could
get her marijuana.

She expected a similar setup here. "I was surprised they were so far
behind," she said."I have not been successful."

Hendrix said she will wait until after the holidays and then pursue
finding a doctor who is willing to register patients.

"I probably made a hundred phone calls," she said.

From his perspective, Kamita said the Hawai'i program works pretty
well with only a few complaints each year, usually from patients who
criticize doctors who are reluctant to register patients for marijuana.

Kamita said his office does get some complaints from people who report
that their neighbors are growing marijuana or calls from police who
get those reports. Being part of law enforcement means that his agency
will check around the clock.

"If they are registered, we'll verify that with law
enforcement."

Another complaint is that Kamita's office won't provide a list of
doctors who issue medical marijuana certificates because no state
agency should be recommending a specific business or doctor over another.

Here's how the system works in Hawai'i, according to Kamita: A patient
visits a physician who indicates that the person has a debilitating
medical condition, fills out the application which is reviewed by his
agency, and then a medical marijuana certificate is issued.

Kamita said the doctor's role works as a recommendation.

"You can't write a prescription for marijuana," he said.

The patient or a caregiver can grow up to three mature or flowering
plants and four immature plants up to one ounce per plant.

Rahman, who practices internal medicine, said many doctors are
reluctant to recommend marijuana over other available pain treatments.
He said marijuana that's smoked is harder to monitor than pills and
"there's always a potential for abuse."

Most of the registered patients are on Neighbor Islands, despite the
fact that many more people live on O'ahu.

Kamita said that's because there are "a few pockets of physicians who
are the major utilizers of this program."

For example, one Big Island physician has 436 patients in the program.
Two other doctors have more than 200, one who lives on the Big island,
the other on Kaua'i, Kamita said.

And those few shape the island-by-island breakdown. "Most of the
physicians participating in this program have about five to six
patients," he said. "Some have one or two."