MARIJUANA UNDER MICROSCOPE

State, Municipal Officials Evaluate Rules Under Amendment 20

The last 11 years for a Durango man haven't been heaven, but they
could have been hell without marijuana to suppress the painful muscle
spasms associated with his multiple sclerosis.

The 62-year-old disabled veteran who asked to be identified only by
his initials, A.R., said he grows marijuana to extract cannabis oil
to treat his disability, which was diagnosed in 1998.

A Veterans Administration doctor vouched in 2000 that A.R. possibly
could benefit from marijuana, allowing him to get on the state health
department's registry of medical marijuana users.

"Cannabis keeps me upright and mobile," A.R. said. "It also keeps my
mind sound and my head clear."

A.R., who also receives a weekly injection of Interferon beta-1a, is
soured on the negative view society in general holds for marijuana.

"I was evicted from federally subsidized housing in March when they
found I was using marijuana," A.R. said. "I don't complain about
people who abuse prescription drugs like Oxycontin or illegal drugs."

Multiple sclerosis-type spasms was one of several medical conditions
approved for marijuana therapy when 54 percent of Colorado voters
added Amendment 20 to the constitution in November 2000.

The number of marijuana users and their suppliers - called caregivers
- - erupted in July this year when the state Board of Health said
caregivers no longer would be limited to five patients.

Concern About Abuse

While Amendment 20 brought medical marijuana into the open and
allowed users to relax, it heightened anxiety among law-enforcement,
health and municipal officials who fear the system is being abused.
While the state decides who can use pot for health reasons, it
doesn't regulate or keep track of who is providing the medicine.

Doctors don't prescribe or recommend marijuana but can find that an
applicant's condition could benefit from marijuana therapy. People
who hold a medical marijuana card may possess no more than 2 ounces
of usable marijuana. If they grow their own, they may have no more
than six marijuana plants, three or fewer of which are producing
usable marijuana. Caregivers can have six plants for each client.

The state Medical Marijuana Registry can issue an identification card
if the applicant is at least 18 years old and lives in Colorado. He
or she must submit an application supplied by the department that
must be notarized and lists name, address, date of birth and Social
Security number. The application must be accompanied by a statement
from a physician noting a debilitating condition and that the patient
could benefit from marijuana.

Durango, which found itself with four marijuana dispensaries in
seemingly little more time than it takes to toke up, imposed a 60-day
moratorium on the issuance of business licenses for dispensaries
Sept. 1. In the interim, a committee has proposed amendments to the
business license code addressing location, hours of operation and
security measures for dispensaries.

City councilors are scheduled to consider the revisions Tuesday at
their regular meeting. The 20-member committee included a
representative each from the police department, City Council and
Durango Fire & Rescue Authority, two lawyers, representatives of
three dispensaries (the fourth is in unincorporated La Plata County)
and community members.

Questions About Regulation

Health, law-enforcement and municipal officials across the state are
scrambling to regulate the distribution of medical marijuana which,
while legal, has taken them by surprise by its rapid spread. Even
Mancos has ceased issuing business licenses for marijuana outlets
until officials can decide what to do.

The Colorado Department of Public Health and Environment worries
about the swelling rolls of its Medical Marijuana Registry. Ned
Calonge, the state's chief medical officer, in July cited the
disproportionate number of men ages 18 to 30 who claimed chronic
debilitating pain to obtain a registry identification card. Jim
Martin, executive director of the state health department, echoed
Calonge's concern.

"The number of young people who received an identification card
because of severe pain is not what would be expected in that
demographic," Martin said. "It's remarkable."

Martin said the health department and the office of the state
attorney general are "reviewing a number of issues," which he didn't specify.

"We're trying to get a sense of how to work through a complex legal
environment while staying within what the voters approved," he said.

Mike Saccone, director of communications for the attorney general's
office, said his boss would like the state Board of Medical Examiners
to review how physicians sign off on applications for medical marijuana.

Marijuana dispensaries are another gray area, Saccone said, because
they aren't defined in Amendment 20.

The Boulder Daily Camera reported Tuesday that D.A. Stan Garnett told
Boulder County commissioners that uncertain guidelines governing
dispensaries, marijuana cultivation and the use of medicinal pot by
people on probation should be clarified.

Durango police Capt. Micki Browning agreed there are unsettled issues
surrounding medical marijuana.

"Law-enforcement agencies around the state each have their own
requirements," Browning said. "But the closer we can define issues,
the more specific we can be, the better we can strike a balance
between ensuring safety and serving dispensary clients."

The sale of marijuana, even in dispensaries, is illegal under federal law.

Allen St. Pierre, executive director of the National Organization for
the Reform of Marijuana Laws (NORML), a Washington-based
organization, said if the range of ailments covered by
medical-marijuana laws or the number of people given access to
cannabis raises a red flag, it's logical for authorities to consider
their options.

Although he's a gung-ho advocate of marijuana-law reform, St. Pierre
said, "No responsible person in the drug-reform movement would stand
in the way of such review."

An edition of Westword, a weekly paper in Denver, carried 10 display
ads by medical-marijuana dispensaries under the banner of alternative healing.

Mark Busnardo, a partner in the Durango Health Center, one of the
four dispensaries in Durango, said being designated a primary
caregiver helps dispensaries justify the amount of marijuana they
control in case of an investigation.

He said the distribution of medical marijuana is in its infancy.

"If done right, dispensaries can work for everyone," Busnardo said.
"Marijuana has been demonized unfairly."

Dispensaries can sell smaller quantities than street dealers,
Busnardo said. It's often take-it-or-leave-it with dealers who have
prepackaged amounts, 1/4th of an ounce, typically, he said.
Dispensaries also can offer marijuana tinctures, sprays, vaporizers
or edibles for patients who don't want to smoke pot.

American Medical Association Policy

The official policy of the American Medical Association regarding
medical marijuana recommends further study of its efficacy, keeping
cannabis a Schedule 1 (restricted) drug pending outcome of study,
development of a nonsmoking delivery method and encourages the free
exchange between physicians and patients about marijuana without fear
of criminal sanctions.

The AMA policy doesn't reflect unanimity.

The pro side cites the safe and effective use of medical marijuana
and says thousands of deaths from prescription drugs could be prevented.

The con side says prescription drugs can handle the chore and
marijuana is addictive, leading to hard-drug use. Opponents also say
marijuana impairs the brain and immune system and interferes with fertility.

Busnardo and his partner are going to sponsor presentations by health
practitioners on the value of nutrition, exercise and sleep. Also,
they plan to start a fund to help people who can't afford upfront or
ongoing costs of marijuana treatment by hiring a band and charging
nominal admission, such as $5, Busnardo said.

Cannabis was cultivated in China as early as 5000 B.C. There are
three varieties - sativa, indica and ruderalis. Now, hybrid strains
carry names such as Mexican true blue, trainwreck, white widow,
werewolf, sour diesel and cherry bomb.

While people with chronic and life-threatening health problems swear
by cannabis, the catchy names don't make the treatment option
acceptable to health-insurance companies.

Kayla Arnesan, a spokeswoman for Rocky Mountain Health Plans, which
covers 160,000 people exclusively in the state, said: "Medical
marijuana is not covered under the Rocky Mountain health benefit plan."

Casey Hanneman with Denman Consulting Services, an Aurora-based
adviser to health benefit providers (including The Durango Herald),
said in an e-mail because medical doctors can't prescribe marijuana,
his firm recommends against including marijuana therapy in health plans.

He added: "Other considerations would include that there is no Food
and Drug Administration approval for marijuana for medical treatment,
and it is an illegal substance/drug under most state and federal
laws. Also the IRS publication 502 specifically disallows deductions
for controlled substances."

Court verdicts, too, in which medical marijuana use is detected by an
employer's drug testing usually go against the user, St. Pierre said.
He cited the case of Ross vs. RagingWire that went to the California
Supreme Court last year in which the employer prevailed.

A.R., the disabled veteran, knows where he stands.

"I've bounced around in my years," A.R. said. "Marijuana works for me."