A RISKY PRACTICE FOR POT DOCTORS

Conflicting Calif., Federal Laws Confuse Physicians Who Prescribe Marijuana

COOL, Calif. -- Dr. Mollie Fry never thought that telling her
patients where to get the medicine she recommended for pain,
depression and nausea would be a problem.

Federal drug agents who raided her home and office thought otherwise,
and she was indicted last year on felony charges of conspiring to
distribute marijuana.

"I assumed the fact that I had 'M.D.' at the end of my name gave me
the right to make judgments about people's health," said Fry, who
estimates that she has issued thousands of cannabis recommendations
since setting up her thriving practice northeast of Sacramento in 1999.

Since California passed the nation's first medical marijuana law a
decade ago, a provision requiring written doctor approval to grow and
buy pot has created conflict between state and federal drug laws, and
strained the doctor-patient relationship.

Until the stalemate is resolved, doctors recommending marijuana do it
with trepidation and a good deal of risk.

Medical marijuana advocates estimate that 1,500 doctors, mostly
oncologists and AIDS specialists, have authorized pot for at least
one patient. But most recommendations have come from about 15
self-appointed specialists, the so-called pot docs, who charge $150
and more to walk what the California Medical Association calls "a
gray area between the clearly permissible and clearly impermissible
categories of action."

After complaints by local law enforcement, nearly all have been
investigated by the state board that licenses and disciplines
physicians. Four had devoted their practices to acting as medical
marijuana consultants and ultimately were sanctioned, ranging from
the public rebuke that Fry got to suspension of their licenses.

California's medical marijuana law, also known as Proposition 215,
named a host of ailments for which marijuana might prove helpful in
easing symptoms: cancer, anorexia, AIDS, glaucoma, arthritis, migraine.

Unlike medical marijuana laws in 10 other states, California's gave
doctors discretion to certify patients with "any other illness for
which marijuana provides relief," leaving open the possibility that
recommendations could be made to people who did not need them.

David Thornton, executive director of the California Medical Board,
said that until the board issued guidelines two years ago outlining
what constituted "accepted medical standards," physicians pretty much
had to figure it out on their own. Most concluded that it was not
worth the risk.

Although a federal appeals court ruled four years ago that the U.S.
Drug Enforcement Administration cannot go after doctors merely
because they recommend marijuana to patients, the state medical
board's guidelines make it clear that the ruling did not amount to
immunity from prosecution or disciplinary proceedings.

The board advises doctors that relying on a patient's word instead of
prior medical records to determine whether a marijuana recommendation
is appropriate could constitute medical negligence. Failing to
conduct an independent exam or to consider whether another drug would
be as effective could lead to charges of unprofessional conduct.

The California Medical Association is more explicit, warning doctors
never to tell patients where to get pot and urging them to remind
patients of possible side effects. Discussing dosages, opining on
whether they should smoke or eat marijuana, and signing a form that
enables patients to obtain a state-issued medical marijuana ID card
also are steps the medical association cautions could lead to their
being sanctioned.

Frank Lucido, a Berkeley physician who devotes about 30 percent of
his practice to working with medical marijuana patients, said he
abides by those recommendations but thinks pot docs are being held to
higher standards than doctors who prescribe lots of Viagra,
prescription painkillers and other abused medications.

Fry, 50, who is awaiting trial, continues signing recommendation
forms for patients. She no longer sells her patients starter plants
but freely tells them about what she sees as the benefits of growing
their own pot.

"What did I take an oath to do? To do no harm and to alleviate pain
and suffering," Fry said. "I'm going to be true to my oath, and I'm
even willing to go to prison for it."