LET'S CLEAR UP THE VERY FLAWED MEDICAL MARIJUANA ACT

The Medical Marijuana Act is found in title 50, chapter 46 of the
Montana Code. I would encourage all citizens to read this poorly
written law. It legalizes, for virtually any medical reason, the use
of marijuana, a heretofore illegal recreational drug.

A person who wishes to use medical marijuana must be designated as a
"qualifying patient" by obtaining "written certification" from a
physician who has diagnosed a "debilitating medical condition." The
patient then applies for a "registry identification card." Once the
card is obtained, the qualifying patient may then use medical
marijuana at will, virtually without restriction -- either growing it
and preparing it himself or designating a "caregiver" to provide these
services.

To be designated as a qualifying patient, a person must be diagnosed
with a debilitating medical condition. Here is a partial list of
approved debilitating medical conditions: cancer, glaucoma, AIDS and
any chronic or debilitating medical condition that produces wasting,
severe pain, chronic pain, severe nausea, seizures or severe muscle
spasms.

By these criteria anyone could be a qualifying patient, as it is
impossible to disprove severe pain, chronic pain or severe nausea.

By this law, it would be perfectly legal to use marijuana to treat
arthritis, fibromyalgia, headaches, heartburn, irritable bowel
syndrome, menstrual cramps, nocturnal leg cramps, recurring hiccups or
any other condition causing chronic pain, ad infinitum.

The most recent statistics from the Montana Department of Public
Health and Human Services show that there are 19,635 registered
qualifying patients. Of these, 18,099 (92.1 percent) were qualified,
in part or totally, due to chronic pain or chronic nausea.

On the other hand, a mere 4 percent were qualified due to a proven
disease such as cancer or AIDS. The remaining patients were qualified
on the basis of "wasting syndrome" or muscle spasms, which are
ill-defined.

Next, the term "caregiver" is defined as a person "18 years of age or
older who has agreed to undertake responsibility for managing the well
being of a person with respect to the medical use of marijuana."

Aside from age, there is no other qualification. By this law, it is
perfectly legal for a teenager who has no medical knowledge or
training to grow and distribute marijuana. Furthermore, this
18-year-old caregiver may charge whatever he wishes for his services.

Marijuana is classified by the Drug Enforcement Agency as a Schedule I
drug and cannot be prescribed even by a highly trained physician since
it is against federal law.

However, the MMA allows an untrained teenager to grow and distribute
this very same schedule I drug, and to profit from it. Other examples
of schedule I drugs are heroin, LSD, mescaline, methaqualone
(Quaaludes) and psilocybin. Schedule I drugs are considered by the DEA
to have no legitimate medical use, and a physician who tried to
prescribe them could face criminal charges and professional censure.
Nevertheless, by the provisions in this state law, a medically
ignorant teenager may legally produce and distribute this popular
street drug.

But it gets worse. Under the provisions of the MMA, a child may be
declared a qualifying patient and, with parental consent, may use
medical marijuana. For example, by this law, a 5-year-old child with
juvenile rheumatoid arthritis could use medical marijuana.

Furthermore, the MMA provides many legal protections for qualifying
patients and caregivers, but there is no provision for enforcement of
the few restrictions placed on them.

For example, the identity of those who possess a registry
identification card is confidential, and anyone who illegally divulges
this information is subject to fine and imprisonment.

On the other hand, although the law provides limits on the amount of
marijuana a caregiver or patient may possess, there is no mechanism to
enforce these limitations. Indeed, section 201, paragraph 7 of the MMA
specifically prohibits inspection of marijuana production sites by any
governmental agency or law enforcement.

The MMA provides no quality control on the production of medical
marijuana. The MMA provides very little in the way of public
protection. There is nothing in the MMA to prohibit someone from
smoking marijuana on a city sidewalk, in a place of business or across
the street from an elementary school. There is no provision to protect
small children from harmful effects of second hand smoke or from an
incapacitated parent.

Regarding the qualification process -- the only requirement is that
the qualification be rendered during a bona fide doctor-patient
encounter. The vast majority of qualifications are not done by trusted
family physicians, but are handed out by a small group of sympathetic
physicians who roam the state conducting medical marijuana clinics
where everyone qualifies. The most recent statistics show that, to
date, 322 physicians have certified at least one qualifying patient.
Of these physicians, 179 have qualified no more than four patients
each, and 79 physicians have qualified from five to 19 patients. This
means that a mere 46 doctors qualified at least 17,346 patients, a
full 90 percent of the total. That's an average of 377 qualifying
patients per physician!

The MDPHHS is required to annually report the number of registry
identification cards revoked for abuse or fraud. To date, not a single
revocation is reported on the website.

Also, in the first 48 months since this law went into effect, a total
of 1,301 qualifying patients were registered. In the last 18 months, a
total of 18,334 qualifying patients were registered. This massive
increase in the number of qualifying patients is due to marijuana
advocates organizing medical marijuana clinics and signing up patients
at lightning speed.

If the MMA must exist at all, it should exist to provide for -- and
properly regulate -- a medical service to the few people who actually
need it, not to afford legal protection for illicit drug use. It
should protect the public from associated dangers, fraud and abuses.
The MMA must be revised.

Here are some provisions that a new and improved MMA should
contain:

1. A statement such as this: "Inasmuch as the DEA has classified
marijuana a Schedule I drug, that there are hundreds of other
legitimate pharmaceutical products to treat virtually every known
human ailment, and that marijuana has a long history of being a
recreational drug with a negative impact on civil society, the purpose
of this law is to provide access to medical marijuana for the few
patients who really need it and to provide for the general public welfare."

2. Certification of qualifying patients must be approved by unanimous
vote of a panel of at least five reviewing physicians. Recertification
should be done every six months. Certification fees should be
significant -- on the order of $500 to $1,000 per certification period.

3. Smoking of medical marijuana must be restricted to private
dwellings. Use of medical marijuana in public must be restricted to
oral forms. Smoking of medical marijuana must not occur in the
presence of children under age 18. Children under age 18 must not be
eligible to use medical marijuana.

4. Caregivers must be at least age 30 and must have basic medical
training and a high school diploma and must pass a background check.
They must carry malpractice insurance just like all other medical
providers licensed in Montana.

5. Marijuana production facilities must meet basic standards and must
be subject to random inspection by all appropriate governmental
agencies. Penalties for fraud and abuse must be specified, significant
and enforced.

6. Certification must be allowed only for specific medical diagnoses.
A list of specific qualifying diagnoses must be developed and adhered
to.

The MMA is bad law. The MMA as it currently exists is a threat to
civil society. It must be repealed and replaced with a real law that
serves the public well.

Dr. Ronald P. Skipper is a surgeon at the Central Montana Medical
Center in Lewistown.