WAITING FOR MEDICAL MARIJUANA

The Antidrug Mafia Makes Sure Washington State Keeps Off The Grass.

BACK IN 1996, an odd couple of state senators, Seattle liberal
Democrat Jeanne Kohl-Welles and Spokane conservative Republican Bob
McCaslin, introduced a bill allowing physicians to prescribe marijuana
for patients suffering from conditions no other drug could treat. The
bill didn't make it through both houses, but funding to explore the
feasibility of such a program did.

Kohl-Welles, who has seen up close how marijuana can alleviate the
agonies of cancer patients, was disappointed that her bill did not
pass but satisfied that at least a start toward addressing the problem
had been made. Four and a half years later, she is far from satisfied.
Furious might be a better word to describe her feelings about the
combination of bureaucratic inertia, academic fecklessness, and
deliberate administrative obstructiveness that have rendered impotent
the clearly expressed will of both the Legislature and the people of
this state.

The $130,000 the Legislature allotted was to be split between two
projects. $70,000 of the appropriation was spent on an
experimental-protocol design from Mahmoud Abdel-Monem, then the dean
of Washington State University's pharmacy program. "That turned out to
be a total waste of money," Kohl-Welles says today. "All the experts
we had look at the plan said it was so flawed that it would be
scientifically useless."

The rest of the money was supposed to be devoted to determining
guidelines and soliciting permission from federal authorities for a
pilot medical-marijuana program. This facet was made the
responsibility of the executive director of the state Board of
Pharmacy, Donald H. Williams. "I kept checking with Don over the
ensuing months," says Kohl-Welles, "and he kept telling me that his
office was in the process of getting a proposal to the feds together.

"After a year of this, I was getting very upset that nothing
apparently was being done. It turned out that the Board of Pharmacy
members had not even been informed of the project. I wrote a letter
expressing my feelings to Don's boss, [then-Secretary of the
Department of Health] Bruce Miyohara, who directed Don to get to work
on a study." Thus goaded, Williams engaged University of Washington
pharmacy professor Allan Ellsworth to put together the long-delayed
application.

As spring 1997 turned to summer, Williams repeatedly assured the
senator that Dr. Ellsworth's application to the FDA was taking shape,
that the attitude at the National Institutes of Health was
encouraging, and that he was "optimistic that we can get approval for
our study." Still, nothing happened and continued not to happen.
Kohl-Welles learned that Williams had been seen and heard in the
audience at one of Ken Schram's televised Town Meetings on KOMO TV
inveighing against any relaxation in marijuana laws. Finally a tip
from one of Ellsworth's UW colleagues led Kohl-Welles to e-mail the
pharmacy professor directly to inquire about the status of the
application for conducting the clinical trials. "As it's now been one
and a half years (as I recall) that you've been working on the
application," Kohl-Welles wrote, "I'm beginning to wonder what's going
on."

Once again, "nothing" was the answer. "Sorry I haven't prioritized
this project as high as you would like me to," Ellsworth replied, but,
"I run hot and cold. The reality of the balance of work it takes to
prepare an NIH proposal vs. the high likelihood of rejection for
bureaucratic hoops certainly dampens the enthusiasm."

Not to worry, though, Ellsworth continued, "The application is 75
percent prepared. Needs some updating, support letters, etc. and it
could be ready to go. . . ." Ah, but go where? Despite assurances from
Williams that $60,000 the Legislature had appropriated for the
marijuana study would be rolled over into the health department's
budget for the following year, Kohl-Welles learned that the money had
been returned unspent to the general fund.

At this point the people of the state of Washington intervened. In
November 1998, voters passed Initiative 692 authorizing physicians to
prescribe marijuana when medically appropriate. Surely such a clear
citizen mandate would make the bureaucracy sit up and take notice. All
that was needed was for the State Department of Health to present to
the federal government the terms and guidelines of how a scientific,
therapeutic research program on medical marijuana would be carried out
in the Evergreen state. Still, nothing happened.

After another year-plus listening to the sounds of silence from the
Department of Health, a group of more than two dozen state legislators
returned to the attack. In an April 27 letter to new Health Secretary
Mary Selecky, they demanded to know why, now that the voters had
approved I-692 and the federal government had issued clear, concrete
guidelines for studies of the efficacy of medical marijuana, her
department continued to balk at instituting such a study.

Selecky's May 26 reply barely condescends to respond to the
legislators' demand for an answer. Instead it reviews, in highly
selective and defensive fashion, the impediments that contributed to
its failure to act in the past, the difficulties inherent in gaining
federal approval for such studies, and niggling imprecisions in I-692
(How must a physician document the decision to prescribe marijuana?
What is "a 60-day supply"?). "After review of current federal
guidelines for medical-marijuana research," Selecky writes (without
supporting her assertion) "we are convinced that the obstacles to a
therapeutic research program as you propose are formidable."

In bolstering her position, Selecky also refers to "a report entitled
Implementation of Initiative 692: The Washington Medical Use of
Marijuana Act." This "report" is certainly worthy of study, not so
much for the support it offers the Secretary's arguments as for the
evidence it provides of how legislative and popular will can be
obstructed under the guise of nonpartisan community consultation, with
the taxpayers footing the bill for their own disempowerment.

The report in question was the work of a group called "The Governor's
Council on Substance Abuse," which operates bizarrely under the
auspices of the Department of Community, Trade, and Economic
Development. As its title suggests, the group's membership of 24 is
dominated by police officers, social service professionals, and
antidrug program representatives, and includes not one person active
in the therapeutic field.

Although the 23-page document issued by the group in January 2000 is
described on its cover as "a report to the Legislature," legislators
did not receive copies of it, nor did Governor Locke, despite his name
above the title, request any such report be made to him. "The Council
decides what subjects it wants to advise the governor on," says the
group's staff coordinator Dr. (of Education) Carol Owens, whose
salary, along with the rest of the Council's expenses, is covered by
federal block-grant monies. "They felt this subject was one [on which]
they had something important to contribute."

The contribution, apart from some commonsense advice for clarifying
I-692's vague reference to "60-day supplies," is restricted to four
recommendations: to further emphasize (and fund) programs publicizing
the dangers of marijuana, to provide more programs to break young
"abusers" of their vice, to clarify the status of a hypothetical
patient affected differently by state and federal law, and, finally,
"to track the consequences of the initiative"--assuming there ever are
any to track.

"What leaves me so outraged and offended looking at this report and at
everything that's been going on all these years is the total silence
about the people [I-692] is supposed to help," says Kohl-Welles, "the
total lack of any consideration for the painfully ill and terminally
ill. There's no mention of them, no consideration for them." And no
Governor's Council on Patient Needs and Rights to speak for them,
either. No one to make the case that, in Kohl-Welles' words, "pain and
suffering are nonpartisan."