PROFITABLE POT

Isle Medical Cannabis Users Are Rising, and Some Doctors Are Charging
High Fees to Certify Patients

Medical marijuana has become a lucrative business in Hawaii.

Legal users soared to more than 8,000 over the past decade from 255
in 2001, the program's first year.

$38 million a year, with patients consuming an average of 1 ounce per
month at a street price of $400.

It's a burgeoning business for doctors, who charge as much as $300 to
certify medical marijuana patients. The consultation typically lasts
an hour and often is not covered by medical insurance.

There were 175 physicians licensed to certify medical marijuana
patients as of June, up from 35 in 2001, according to the Narcotics
Enforcement Division of the state Department of Public Safety.

The state charges a $25 processing fee for a medical marijuana
certificate. Patients are required to be certified annually.

Hawaii's medical marijuana law allows patients with a debilitating
condition; such as cancer, AIDS, glaucoma, severe pain or nausea; to
use the drug if they are certified by a physician registered with the
state. It is still illegal to buy marijuana, but patients can grow it legally.

Matthew Brittain, a licensed clinical social worker and substance
abuse counselor on the Big Island, has built a niche for himself
referring potential medical cannabis users to doctors. Brittain has
about 600 active patients and charges as much as $100 for referrals
and handling the paperwork.

"We're in this to make money; I wouldn't spend the time if I weren't
making money because I have to pay my bills," said Brittain, who also
is a certified medical cannabis user for a degenerative back condition.

The Big Island, which has 13.6 percent of the state's population,
accounts for 57.8 percent of the medical marijuana certificates.

Out-of-state doctors are also benefiting from the increase in Hawaii
patients. Doctors from the Hemp & Cannabis Foundation, based in
Portland, Ore., make frequent trips to the islands. The company
charges $250 for a marijuana certificate, including the $25 state fee.

"There's a big market," said Keith Kamita, deputy director for law
enforcement at the Department of Public Safety, which administers the
medical marijuana program.

What concerns law enforcement officers is that certain doctors are
willing to issue medical marijuana certificates to patients who are
not suffering from major illnesses.

"Is there a true doctor-patient relationship, or are they just paying
a fee to smoke marijuana?" Kamita asked. "There are some questionable
practices."

Kamita said the bulk of marijuana permits are for residents in their
20s and 30s, most of whom cite severe pain as their medical condition.

"We know that the ages are younger and we're getting more and more
minors ... which concerns us," Kamita said. "Because the term is so
broad, doctors are interpreting it in their own manner. We don't see
what their diagnosis is. It's not what the original (law) was
intended for. It was touted as this would be a last-resort type of
drug, but that's not the case."

Dr. Jim Berg, a Big Island physician, has issued the most marijuana
certificates since the law was passed, according to state records.
The Narcotics Enforcement Division records showed Berg had authorized
2,957 certificates as of June 2010.

Berg disputed that number, but said he doesn't keep count. He said he
typically charges between $125 and $150 per office visit.

Once the marijuana certificate is issued, patients in Hawaii have to
break the law to acquire the drug. Buying marijuana or the seeds to
grow the plant is illegal even with a certificate. Certified patients
or caregivers can jointly grow seven plants; three mature and four
immature, or nonflowering; and have up to 1 ounce of usable marijuana
per mature plant.

"What they've done is created a law that makes somebody break it in
order for the law to be fulfilled. It's a Catch-22," Berg said. "An
unbelievably high percentage of my patients are extremely law-abiding
patients. People who are coming for medical marijuana usually want to
be legal; they're trying to do what the state wants them to do."

Patients or their caregivers often end up buying pot, paying as much
as $400 an ounce.

"When I can't grow it ... I spend (money) or I don't walk," said Teri
Heede, a 55-year-old Makakilo resident and retired computer engineer
suffering from multiple sclerosis, which causes her frequent
blindness and immobility. "There is no other way to purchase it,
except illegally, so there is no legal mechanism for us to comply
with the law."

Heede said she used to take 25 to 30 pills a day to alleviate her
condition. Now she uses at least one-eighth of an ounce daily and
virtually no pills.

"Marijuana holds it at bay and in some cases totally alleviates it,"
said Heede, who has lobbied lawmakers for the past two years to
establish marijuana dispensaries in Hawaii. "Pills weren't working."

Medical marijuana advocates are pushing to make it easier for
patients to buy the drug. A bill to allow the distribution of medical
marijuana through a single Maui dispensary, or "compassion center,"
for five years as a pilot program passed out of two committees in the
state Legislature last week. It would also establish a 30 percent tax
on medical marijuana products.

Fifteen states and the District of Columbia have medical marijuana
programs. In many states, the industry is growing rapidly with new
fields emerging for cutters, growers, rippers, testers and so-called
bud tenders, who help patients choose the right strain of weed for
their illness.

Illegal cannabis sales nationwide are estimated at $35 billion to $40
billion, according to the National Organization for the Reform of
Marijuana Laws in Washington, D.C.

The United Food & Commercial Workers Union, Local 5, in California
has organized 200 medical cannabis members and has another 400
workers whose collective bargaining contracts still must be
negotiated, said Dan Rush, Local 5 cannabis division director.

In California, the nonprofit medical cannabis companies "generate a
tremendous amount of revenue, which makes them willing to want to pay
their workers well," Rush said.

The union has recognition agreements with cannabis companies that
will be employing another 2,100 people in California within the next
year, Rush said. "What we're trying to do is take that from the black
market and bring it to the open market."

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VARYING LAWS

Fifteen states and Washington, D.C., have medical marijuana programs,
but laws vary from state to state:

California has legalized medical marijuana sales with retail
dispensaries and home delivery services available in certain
counties. About a dozen counties or cities in California tax medical
marijuana products. Most recently, Los Angeles passed a tax measure.

Marijuana sales are illegal in Hawaii, Alaska, Washington, Oregon,
Nevada, Michigan, Vermont and Montana. People can possess or grow a
small amount in those states, but not purchase it.

State-sanctioned marijuana sales are legal in Colorado, New Mexico,
Rhode Island, New Jersey, Maine, Arizona and the District of Columbia.

In Maryland, if people are arrested for possession of the drug, they
can use medical necessity as a defense.

Source: National Organization for the Reform of Marijuana Laws

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LEGISLATIVE EFFORTS

Bills related to medical marijuana that are still alive in the Legislature:

HB 1085: Makes Hawaii statutes on controlled substances consistent
with federal laws and increases fee for registration.

SB 1458: Creates a five-year pilot program with one medical marijuana
dispensary on Maui.

SB 1460: Decriminalizes an ounce or less of marijuana.

SB 175: Moves medical marijuana program from Department of Public
Safety to Department of Health.