O.C. CLINIC SEES POT AS A VALID TREATMENT

Two doctors open an office focused on recommending marijuana. Being a
target of law enforcement is a fear.

Andy Kinnon recently walked into an Orange County doctor's office looking
for relief. When he walked out an hour later, Kinnon said, he had just the
thing he'd been seeking: a recommendation, on embossed white paper signed
and dated by a physician, for all the marijuana he could smoke.

"I suffer from migraine headaches," Kinnon, 41, explained. "They're wicked
- -- you have to shut out light and sound."

For years he'd tried various remedies, none of which had worked. Finally,
in 1996, Kinnon said, he discovered the one thing that helped ease the pain
- -- cannabis, which he's been smoking ever since.

"I've tried everything else," Kinnon said. "Now I have the legal right to
use it as medicine. These guys are folk heroes."

The guys he's talking about are Drs. Phillip A. Denney and Robert E.
Sullivan, who last week opened in a Lake Forest strip mall a medical
practice devoted to recommending medical marijuana to patients.

In focusing their entire practice on that narrow specialty, the pair joined
a handful of doctors statewide -- mostly in Northern California -- openly
promoting the treatment of a variety of ailments with cannabis, which
California voters legalized with the approval of Proposition 215 in 1996.
But both acknowledge they have also opened themselves to what they contend
is police harassment and an array of challenges that they say have plagued
many colleagues.

"I'm scared to death," Denney, 55, said Feb. 9, the day the office opened
in a retail center just off Interstate 5 and Kinnon showed up to become
their first patient. "I'm scared that the medical board will take away my
license. I'm scared that the federal government will kick down my door and
take me off to prison in handcuffs."

His fear is not entirely unfounded.

The National Organization for the Reform of Marijuana Laws, generally
considered the most authoritative source on such matters, lists on its
website a dozen California physicians who routinely recommend cannabis as a
treatment.

Despite a 2003 U.S. Supreme Court decision upholding the right of doctors
to discuss marijuana with their patients, the website says at least eight
of these doctors have come under investigation by the California Medical
Board, following law enforcement complaints that their medical examinations
of patients were a sham.

Dr. William Eidelman, an alternative-medicine specialist who until recently
practiced in Santa Monica, had his license suspended last year after
undercover sheriff's deputies posing as patients said he had recommended
cannabis without sufficient medical cause. Eidelman, who estimates he has
issued more than 4,000 recommendations for medical marijuana since 1998,
denies the charge and is fighting the suspension in a series of hearings
before an administrative law judge this week in Los Angeles.

And Dr. Tod Mikuriya, a Berkeley psychiatrist, is being investigated over
allegations that he recommended cannabis on several occasions without
performing adequate medical evaluations. "One of the things I've been
trying to get is practice guidelines," he said. "What exactly do they
expect, in other words, with regards to an examination?"

Denney and Sullivan say each of their patients is given a thorough physical
examination. Vital signs such as pulse, blood pressure, height, weight,
vision and temperature are recorded, and a complete medical history is
taken. They say documentation from other treating physicians is sought.

"We're going to be held to a higher standard" than most other doctors,
Denney said.

The recommendations signed by doctors provide a degree of legal protection
to patients who are caught by police with marijuana in their possession.
Because Proposition 215 legalized the consumption of marijuana for
medicinal purposes, few prosecutors would waste their time and resources
pressing charges against anyone who could demonstrate approved medical need.

About half of his patients, Denney said, come in complaining of chronic
pain caused by old surgeries, injuries, lost limbs, arthritis or
neuropathic ailments. "Cannabis can be nothing short of miraculous for
these people," he said. Other conditions often helped by the herb, he said,
include chronic digestive disease, nausea, vomiting, diarrhea, facial tics,
seizures, glaucoma, insomnia and muscle spasms.

"We're just trying to provide a service that nobody else is providing,"
Denney said. "We'd be very happy if nobody came to see us because they
could get this from their family physician."

Denney himself began his medical career with a family practice. After
graduating from USC's School of Medicine in 1976 and serving a short stint
at L.A.'s County-USC Medical Center, Denney moved to the town of Greenwood
in Northern California and established a family practice there.

Later he became an emergency room physician in Sacramento. That's where he
met Sullivan, a Saint Louis University Medical School graduate who had also
been in family practice. The two hit it off. Four and a half years ago,
after his hours at a Placerville hospital were cut back, Denney became
interested in the medical benefits of marijuana, which he had smoked
recreationally in the 1960s.

"I became fascinated by the potential of offering this to people for
medicinal purposes," he recalled. Although Proposition 215 had legalized
medical marijuana in 1996, Denney said, he was struck by "the lack of
interest by practicing physicians."

A fledgling cannabis practice he established slowly grew, with Denney being
invited to make "house calls" to clinics all over Northern California. But
what impressed him even more, Denney said, were the distances some patients
were willing to travel for appointments. "I had patients from every county
in California," he said.

Encouraged by new legislation and court rulings that he believes have
improved the climate for medicinal cannabis practitioners, Denney recently
decided to relocate his practice. "I looked at a map of California," he
said, "and asked, Where is the largest population with the least amount of
access to these services? The answer was clear: the Los Angeles Basin."

Dr. Felicia Cohn, director of medical ethics for the UC Irvine College of
Medicine, likens the doctors' marketing of themselves as medicinal
marijuana specialists to ophthalmologists who advertise Lasik eye surgery
- -- focusing on the cure, instead of the disease. "I don't see anything
unethical about it," she said.

"In fact, I'd say it requires a certain amount of moral fortitude to take a
politically active position for a controversial, though legal, medication.
I teach my medical students all the time that we get the healthcare system
we build. And if we want there to be input into that system, who better
than physicians to advocate for the healthcare they consider appropriate?"

Law enforcement officials have a decidedly different view.

Thom Mrozek, a spokesman for the U.S. attorney's office in Los Angeles,
declined to comment on the new medical practice within his jurisdiction.
The use of marijuana for medical reasons in general, he said, "is the
subject of some appellate cases ... litigated by the Department of Justice
in Washington, D.C. I haven't dealt with this issue at all."

John Anderson, head of the narcotics enforcement team at the Orange County
district attorney's office, said the use of medicinal cannabis in the
county is handled on a case-by-case basis. "The guidelines are spelled out
quite vaguely," he said. "It's very complex; the biggest problem in
California from top to bottom is that our law is inconsistent with federal
law. In all honesty, in the last several years we've seen only a handful of
these cases. Orange County doesn't appear to be a bastion of medical
marijuana use."

And a spokesman for the federal Drug Enforcement Administration in San
Francisco, while acknowledging a doctor's legal right to recommend cannabis
to patients, said his agency doesn't condone it. "We do not recognize the
term 'medical marijuana,' " Richard Meyer said. "Marijuana is not a
medicine at all."

Though the DEA doesn't go after doctors just for making recommendations,
Meyer said, "the way federal law now stands, it is illegal to possess,
cultivate or distribute marijuana, regardless of the amount, and regardless
of the intended purposes. This is the first time in our history that a
substance has become a medicine by popular vote. We believe that the
marijuana lobby has deceived the public in California, big time. Our
mission is not to go after users, but ... distributors."

That's why Denney and Sullivan carefully avoid telling patients anything
about where to get their marijuana. Most, Denney said, get it in one of
three ways: They buy it on the street, grow it themselves or obtain it from
one of several medical "cannabis clubs" whose legality is in dispute.

Opening day of the doctors' new Orange County practice resembled something
of a reunion of activists involved in the issue.

"I came to congratulate them and tell them how wonderful it is that they
are taking this on," said Anna T. Boyce, a retired nurse from Mission Viejo
who said she had helped write Proposition 215. "This is the only clinic of
its kind in Southern California, and I don't feel the hostile atmosphere
that we had even two years ago. People are finally beginning to realize
that it's not a harmful drug."

Edward Feldkamp, 63, of Lake Forest said he'd also come to lend his
support. The survivor of a 1982 surgery for cancer of the saliva gland, he
smokes cannabis several times daily to fight off the pain. "I tried yoga
and meditation," he said, "and then I discovered how effective marijuana
was -- it's the only thing that works."

Like other patients, Feldkamp has had to travel long distances to renew the
official physician's recommendation that expires after one year. From now
on, he'll just have to drive a few miles. "I think it's wonderful," he said
of the new practice in town. "It takes a brave doctor in this day and age
to put his patients first."

Five patients showed up on the first day, none flinching at the $200 fee
for an initial consultation. The doctors believe they will be the first
among many. "I don't mind sticking my neck out," Denney said, adding that
"politics is the 400-pound gorilla. I'm flying by the seat of my pants."

Why, then, is he willing to do it?

"It's the right thing to do," the doctor said.