How the U.S. attorney general’s memo affects New Mexico’s groundbreaking program
Dr. K. Paul Stoller has long examined the role of cannabis in clinical medicine. In 1976, before he was a medical student, he published an article on the effects of THC on hand-eye coordination.
But Stoller never prescribed marijuana to a patient, even after New Mexico started its Medical Cannabis Program in 2007. On Tuesday, Oct. 19, when Attorney General Eric Holder told federal prosecutors to lay off those who are within the limits of their state laws, Stoller changed his policy.
Though 14 states had developed some form of cannabis program, marijuana remained illegal under federal law, meaning the feds could still crack down on patients and distributors. And they still can, though the U.S. attorney general has directed them not to.
Still, for Stoller, the news was heartening. "Once that memo came out, the onus was on us," he says. "A lot of physicians were scared and are still scared of stepping up and recommending this and prescribing this. They're afraid the federal government is going to come in and take their DEA license away. And I think that's basically ancient history now.”
A Drug Enforcement Administration license allows physicians to prescribe medication. Without that permit, "You're basically shut down," says Stoller. If the political breeze happened to blow the wrong way, he says, the DEA would have been knocking on your door.
"A lot of physicians were scared and are still scared of stepping up and recommending this and prescribing this. They're afraid the federal government is going to come in and take their DEA license away. And I think that's basically ancient history now.”
Dr. K. Paul Stoller
Stoller is board certified in pediatrics and also hyperbaric medicine—the use of decompression chambers and pure oxygen to treat a variety of conditions, including brain injury and Post Traumatic Stress Disorder. There's an overlap, he says, between the kinds of patients he treats with hyperbaric methods and those who might benefit from medical cannabis. "Marijuana changes the way the body perceives pain," he says. "A lot of the people that are drawn to it are not getting any benefit from standard pain medications."
Stoller began advertising in the Alibi's Billboard ads last week. He’s offering evaluations for patients who think they may qualify for the cannabis program. And the e-mails just started rolling in. He's begun seeing patients and recommending a cannabis course of treatment when merited.
Unlike in California, New Mexico’s physicians are not the last word in obtaining a prescription. The patient submits an application, filled out by a doctor, along with medical records and a recommendation. But the state's Department of Health is the final arbiter. That's fine by Stoller. "It's another layer of bureaucracy, and for something that's so new, I don't mind having the Department of Health between me and anyone criticizing me."
Other physicians should offer marijuana to patients who need it, he says. "There's years and years of prejudice and fear to overcome, so it's not going to happen overnight."
"Most people I deal with never thought about smoking marijuana until a tragic accident."
Robert Davis, Peace Medical Marijuana Consultants
When Robert Davis began Peace Medical Marijuana Consultants, part of his mission was to educate doctors. But as things have progressed, he's found that doctors are getting more comfortable with the state’s program. Instead, Davis is looking to help those who are bedridden or wheelchair-bound set up their own growing facilities at home.
As of press time, there are 746 patients active in the program, according to the state's Department of Health. Of those patients, 201 have a license to produce their own medication. Approved patients are allowed four mature plants and 12 seedlings. There are 15 qualifying conditions, including: severe chronic pain, PTSD, hepatitis C infection, Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease), cancer, glaucoma, epilepsy and HIV/AIDS.
But plenty of folks don't know anything about growing, says Davis. "Most people I deal with never thought about smoking marijuana until a tragic accident," he says. "A lot are Vietnam vets and don't leave their houses much." Davis offers basic advice, the kind you could get from any book, and he helps install lighting systems and ventilation.
He's also familiar with the security requirements the state demands of homegrowers and makes sure patients know how to meet those. He's not yet technically a caregiver—someone registered to help manage patient care and medication—but he says he’ll be one soon. Without that card, Davis can't touch the patients' medical cannabis.
Part of what sets New Mexico apart is that the Lynn and Erin Compassionate Use Act—the 2007 law allowing medical cannabis in New Mexico—required the state to come up with a distribution system.
Before he started his consulting firm, he helped a close family member with a life-threatening illness who was in serious pain navigate the application process and find a doctor who would recommend the program. Davis familiarized himself with the rules, paperwork and procedures required to obtain a prescription. Word spread, and phone calls starting coming in.
Still, he says, "people were afraid" even to seek out patient cards when they saw raids on dispensaries in other states. After the U.S. attorney general's memo came out last month, he says there was an avalanche of people who wanted to get into the program.
The business costs Davis more money than it makes at this point, he says. "But I do it because I love it. We're an example state, and we're on the right track."
Part of what sets New Mexico apart is that the Lynn and Erin Compassionate Use Act—the 2007 law allowing medical cannabis in New Mexico—required the state to come up with a distribution system. Back when the act first passed, there was speculation the state might set up its own grow operation. Instead, a system has been established where citizens set up nonprofit companies and then the state issues a permit.
It's not an easy license to get. Chris Minnick, spokesperson for the state's Department of Health, says 25 nonprofits have applied. Until a few days ago, only one had ever been approved. The Santa Fe Institute of Natural Medicine began growing and dispensing marijuana to patients just a few months ago, but in September it acknowledged it couldn't meet demand. Four more nonprofits were given the go-ahead by the DOH on Monday, Nov. 9. Secretary Alfredo Vigil determines how many additional producers will be approved to meet patient demand.
And the state's likely to stay pretty tight with that number. "There's no precedent for this anywhere else in the nation. We're the only state that's got this kind of system where we're regulating the production end of it," Minnick says. "So we've got to proceed very deliberately in the approval of the nonprofits. The ultimate goal is to create a sustainable program that's going to last."
Frank Smith asked us not to use his real name in this story. The 25-year-old Albuquerque college student is seeking his culinary degree. He says business-savvy runs in his family. Nine months ago, he began the lengthy application to become a licensed producer. "It's a time-consuming process," he says. First he looked on the DOH website for the requirements. Then he found out what a nonprofit is, what it does and how it could grow medical marijuana. He hired a certified public accountant to get the paperwork moving to become a nonprofit.
He's got an indoor growing location, about 2,500 square feet, in Albuquerque. That's good, he adds, because some patients aren't able to make the trek to Santa Fe for their cannabis. The space, though a bit small, is ready to operate, he says, and full of equipment—but no cannabis plants yet. Nonprofits can maintain up to 95 plants and unlimited ounces of harvested medication, he says. The next step for Smith is the site visit, and the DOH will come down and make sure everything's up to par.
His application is appealing to the department, he says, because he's included salary caps. Any extra income earned at the end of the year would be donated to charity. There would also be an account set up to provide cannabis for lower prices or completely free to patients who can't afford it. He says his prices per gram will compare to those of other nonprofits: $5 for C-grade, $10 for B-grade and $20 for A-grade. He won't personally grow the crop, but he has hired a gardener with 15 years experience and five years focused on organic gardening. The company plans to cultivate six to 10 varieties that produce different effects to treat different symptoms.
Smith is acutely aware that his real name is in the DOH records. "If the feds decide to pay us a visit one day, so be it." The attorney general's memo to federal prosecutors is not all that reassuring. "If it's not set in stone and not a signed document, you've got to take it with a grain of salt," he says.
He plans to keep an eye on the stances of Mayor-Elect Richard Berry and also his chief public safety officer Darren White, a noted opponent of marijuana legalization and medical marijuana. "I have to take it as it comes," he says. “I wouldn't say I'm scared or that I don't feel safe. Whatever happens happens. I'm not going to let that stuff scare me into backing out.”
For answers to frequently asked questions about New Mexico’s Medical Cannabis Program, visit www.health.state.nm.us/IDB/medical_cannabis.shtml