In 1998, Oregon voters passed a law to protect seriously ill patients
from prosecution for using marijuana as medicine.

The Oregon Medical Marijuana Act is 3 years old, but strong feelings
and confusion about it still exist. As a public health officer in the
state Department of Human Services, I oversee the medical marijuana
program and want to clarify some facts.

The act grants legal protection to qualified patients. Those who are
registered for the Oregon Medical Marijuana Program are issued a card
to show they have met requirements for the legal use of medical

To qualify for a card, an applicant must be an Oregon resident and
suffer from one of nine listed debilitating medical conditions. An
attending physician must document the patient's medical condition and
confirm that the patient may benefit from medical marijuana.

The law allows patients to designate a primary caregiver to legally
assist in growing and administering medical marijuana. The law
includes a petition process for adding new medical conditions to the
list when there is supporting scientific and clinical evidence.

The act gave responsibility for creating the registry system to the
Department of Human Services. From the beginning, our goal has been
to operate a program that is accountable to patients and the public.
Here is how we interpret the law:

Marijuana is a legitimate medication for some patients, and both they
and their physicians are legally protected from prosecution for its
use and for discussing its use.

Medical marijuana use is restricted to patients who have one or more
of the medical conditions named in the law.

The decision of whether to use marijuana as medicine is made by the
patient with his or her attending physician.

Restrictions reduce the potential for abuse of the law and ensure
that medical marijuana is not diverted to illegal purposes.

For two years, the program worked as intended. Almost 600 patients
registered in the first year, and more than 300 physicians
participated. We added one medical condition to the list.

In 2001, we discovered that an attending physician's signature had
been forged on seven applications. We immediately contacted law
enforcement and conducted a stringent internal review. This resulted
in changes to our management of the program.

We also found that there had been a sharp increase in the number of
patients and that one physician had signed documentation for 1,642
people, about 40 percent of the applicants. The act states that the
attending physician must have "primary responsibility for the care
and treatment of the applicant." We questioned whether one individual
could fulfill this role for so many patients.

Subsequently, we filed new rules to better define attending physician

The doctor must review the patient's medical history, conduct a
physical exam, provide for follow-up care and document this in the
patient's medical record. The rules give the state authority to
review medical records when we question whether a legitimate
physician-patient relationship exists. Under these rules, about 300
applications were denied because of insufficient documentation.

Patients, advocates and policy-makers have expressed a range of
perspectives on these recent changes. Some think that we are becoming
too intrusive and erecting barriers to qualified patients. Others
think that we should be more restrictive. Our goal is to achieve a
balance of providing quality service for patients the act was meant
to serve while ensuring that only legitimate patients receive
registration cards.

Grant Higginson is state public health officer at the Oregon
Department of Human Services.

Newshawk: "Phil Smith" <>
Pubdate: Fri, 22 Mar 2002
Source: Portland Tribune (OR)
Authors: Grant Higginson