FEAR OF MEDICAL POT ABUSE DESERVES FULL PUBLIC VETTING

Defenders of Hawaii's medical marijuana law were startled this week
by a late effort to sharply limit uses of marijuana to reduce severe
pain. The proposal carries an assumption that either doctors or
patients are being less than candid about whether the pain actually
exists. This may be. But the onus should be on Sen. Josh Green, who
proposed the last-minute change, to provide evidence of such
shenanigans before such changes become law.

Green, a Big Island emergency room physician and chairman of the
Senate Health Committee, injected the proposal in a House-Senate
conference this week in a bill to launch a medical marijuana
dispensary as a pilot program.

The senator's concerns about the program - "pretty hard to wrap my
mind around" - are not surprising. Opponents of medical marijuana
point out that the number of Hawaii residents issued blue cards by
the state Department of Public Safety as legal users has soared from
255 in 2001, the program's first year, to more than 8,000.

Hawaii's law, similar to laws in 10 other states, allows cannabis to
be used by patients diagnosed as having a debilitating medical
condition. That condition includes a variety of ailments, including
severe pain, severe nausea and Crohn's disease, an intestinal condition.

Keith Kamita, deputy director of public safety for law enforcement,
says the bulk of residents certified to use medical marijuana are in
their 20s and 30s, and most of them cite severe pain as their medical
condition. Green proposed that marijuana be accessible only to
patients suffering from multiple sclerosis, cancer, HIV/AIDS or glaucoma.

A cautious approach makes sense for a pilot project. As Hawaii
gingerly tests the waters of marijuana dispensaries, it should
proceed carefully, with clear guidelines for physicans and patients
alike. The four diseases enumerated by Green are objectively and
physically diagnosable. Not so with cases of pain, which depend on a
doctor's trust of his or her patients.

Dr. Jim Berg, a Big Island physician who the Narcotic Enforcement
Division records showed had authorized 2,957 marijuana certificates
as of last June, defends the medical use.

In an open letter to Green yesterday, Berg maintained that he has
"witnessed the truth of these patients and know it helps them, and
that it can be used safely." He suggested that his patients include
those who have chronic neck, shoulder, wrist, ankle, knee or back
pain from injuries in manual labor jobs.

Matt Rifkin, co-chairman of the Big Island Americans for Safe Access,
an advocate of medical marijuana rights, says the limitation proposed
by Green could disqualify most the patients who now have blue cards.

Berg says it would effectively disqualify more than 90 percent of
currently registered patients.

Green's concern may be worthy of an investigation into the integrity
of the medical marijuana program. But there are no shortcuts. Any
proposals to lay the ground rules for such a controversial program
deserve a full public vetting before being implemented.