HAWAII MEDICAL POT USERS UP 87 PERCENT

But, Despite Protections Under State Law, Access to Drug Remains an Issue

The number of medical marijuana patients in Hawai'i has grown 87
percent in the past two years, with the biggest gains on Maui and the
Big Island.

According to the state Department of Public Safety, 4,200 patients
were registered state-wide as of June 30, with 444 more signing up since then.

One reason for the increase is that more doctors have been certifying
patients for the program, according to Keith Kamita, head of the
department's Narcotics Enforcement Division. Still, a relatively few
physicians account for most of the state's medical marijuana
patients, he said. One Big Island doctor, for example, accounts for
about half of the total certified patients statewide.

"The ones that utilize the program, they have a lot of patients ...
this is their primary means of making money," he said. "Most are
general practitioners. (Oncologists and other specialists) don't
utilize the program because there are better drugs available and
marijuana has other problems."

In fiscal year 2008, patients statewide visited 85 on-island
physicians to obtain a qualifying diagnosis for medical marijuana
use, compared with 62 physicians in fiscal 2006, according to DPS.

Even though doctors only diagnose qualifying illnesses and do not
prescribe or supply marijuana to patients, many doctors remain
hesitant to participate in the program, according to Dr. Yvonne
Conner of Hilo, who has 400 medical marijuana patients.

"Many physicians are still afraid that their medical license might be
at risk or they don't want the notoriety," she said.

Access Is a Problem

Despite the growing use of medical marijuana in Hawai'i, access to
the drug remains an issue for many patients whose marijuana use is
protected by a state law that conflicts with federal and state laws
prohibiting any use or distribution of marijuana.

Conner said some patients are physically and mentally unable to grow
their own, and others just don't have a green thumb.

"They have a license to grow it, but they don't have an honest way to
get supplies," she said.

The head of a Maui group that was openly providing marijuana to
patients was arrested Nov. 11 along with six other men for allegedly
running a drug-trafficking ring.

Brian Murphy, of Patients Without Time, admits providing startup
plants and marijuana to medical marijuana patients, sometimes for a
price but in many cases for free. He said the group, which has 1,250
members, has been operating as a de-facto cooperative out of an
office in Pa'ia in an act of civil disobedience.

"We've been doing this with transparency for four years, and not one
cop has come into the office and told me, 'We don't want you doing
this,' " he said.

"I'm not hiding anything. My feeling was that, as in California
(where medical marijuana dispensaries have been operating), I assumed
the state would be compassionate. To say we're drug dealers is
ridiculous. I am not a profiteer. We're just trying to help people."

Murphy, 53, a disabled Navy veteran, obtained a medical marijuana
permit in 2002 for an inherited neurological disorder, arthritis and
back problems. He said it's inhumane to expect sick people to obtain
medical marijuana "on the streets."

"We have a law that says we are allowed to use it. All I'm doing is
making the law work, and I don't think that's criminal to do it."

All Sales Are Illegal

Maui Police Capt. Gerald Matsunaga said selling marijuana -- even for
approved medical use -- is illegal under any circumstances. An
information sheet provided by the state Narcotics Enforcement
Division warns patients as much.

Matsunaga said police are not interested in going after people "with
legitimate medical marijuana permits if they are operating within the
law." He said Murphy and his group exploited Hawai'i's medical
marijuana program to run a drug-trafficking ring that extended beyond
the medical marijuana community.

Murphy denies doing anything except helping seriously ill patients.

Hawai'i is one of 13 states that has approved medical marijuana use.
Under Hawai'i's law, passed in 2000, patients must be diagnosed by a
medical doctor as having a "debilitating" medical condition such as
cancer, glaucoma, HIV/AIDS, severe pain or seizures. Qualifying
patients must register with the state Narcotics Enforcement Division
and renew their participation annually.

The law allows registered patients to keep an "adequate supply" of
marijuana on hand, which is defined as three mature plants, four
young plants and an ounce of marijuana for each mature plant.

The law also defines "medical use" as the acquisition, possession,
cultivation, use, distribution or transportation of marijuana or
paraphernalia in connection with its use to alleviate the symptoms or
effects of a qualifying patient's debilitating medical condition.

The law is silent on how patients are to acquire marijuana in the
first place or continue to supply themselves.

'A Cruel Joke'

State Rep. Joe Bertram III, D-11th (Makena, Wailea, Kihei), calls the
medical marijuana law "a cruel joke" because it legalizes medical use
of marijuana but fails to provide patients safe, easy access to it.
Bertram has held a medical marijuana permit since 2005.

During the 2008 legislative session, Bertram proposed creation of a
secure growing facility on Maui and expanding the amount of marijuana
patients can legally possess, but settled for a bill that would have
created a task force to study cultivation and other issues
surrounding the medical marijuana law.

The bill was opposed by law enforcement officials, who object to any
expansion of the state's medical marijuana program. Gov. Linda Lingle
vetoed the measure, calling it "objectionable because it is an
exercise aimed at finding ways to circumvent federal law."

George "Greywolf" Klare, 70, of Pahoa, said he uses marijuana to help
him tolerate pain from a broken pelvis and the effects of skin
cancer. He first obtained a medical marijuana permit in California in
1997 and registered as a patient in Hawai'i last year.

The retired teacher and marijuana advocate said he has been robbed at
home by drug-seeking criminals and harassed by police. Klare said the
medical marijuana program should be moved from the auspices of the
Department of Public Safety to the Department of Health.

"The attitude of law enforcement is that they only see marijuana as a
dangerous drug," he said.

Legal Ambiguities

A 2004 report by the Legislative Reference Bureau that examined the
possibility of a legal distribution system for Hawai'i's medical
marijuana program highlighted the legal ambiguities in the state law
and said that "severely restricted sources of supply and limitations
on its transport" make it likely that many patients and their
caregivers break the law to obtain marijuana.

The report and Kamita both said it is unlikely the state will seek to
clarify those portions of the medical marijuana law unless federal
drug laws change.

However, Kamita favors tinkering with the criteria for "debilitating"
medical conditions, which he said are "a little too loose,"
particularly when it comes to cases of severe pain and similar
conditions that are difficult to support with medical evidence.

He noted that "severe pain" is cited as the debilitating condition
for two-thirds of registered medical marijuana patients. As of last
month, only 50 were using marijuana for cancer, 64 for HIV/AIDS, and
12 for wasting syndrome, he said.

"We have concerns that (the Legislature) may need to look at this law
better in terms of debilitating conditions and what they really want
to allow. It's a little too broad. The intent when they first passed
it was as a last-resort type of thing, and that's not what's happening."

Kamita said there have been no complaints filed against patients or
doctors for abusing the program.

Murphy discounted the threat of abuse, saying it's a bigger problem
for prescription narcotics.

He said he has attended at least 17 funerals for patients who used
marijuana for relief in their final days.

"This is not a joke," he said.

Conner said marijuana taken by various methods can ease a range of
symptoms and conditions and boost a patient's sense of well-being.

"It really helps people to deal with their illness," she said. "It
relaxes muscles and helps reduce pain. Nausea is a major thing for
people with HIV/AIDS, and if they use cannabis, especially if they
eat it, it controls the nausea completely.

"It improves the quality of life for everyone who uses it and, in
general, makes them feel better and have a positive outlook on life
that makes them more readily able to deal with whatever their disease is."