ORIGINAL REPORTING / ANALYSIS
- Adieu, Rimonabant
- 02.08.11 The Situation in Montana
- 02.07.11 Black History Month
- 05.10.11 CB KO'd in MT
- 05.06.11 Fry and Schafer
- 03.30.11 Allen Frankel, MD, Pt. 2
- 01.31.11 Allen Frankel, MD
- 01.21.11 Tucson
THE CONTEXT OF PROHIBITION
May 10 Medical Cannabis Severely Restricted in Montana
Earlier this week, Governor Schweitzer of Montana gave the go ahead for SB 423 to become law. SB 423 is the "regulations" bill that makes Montana's medical Cannabis law the most restrictive in the country. The Governor did this the day after he examined the bill and called it "unconstitutional on its face". Just two weeks before, he had vetoed HB 161 that would have repealed Montana's medical marijuana law completely (see back story here).
As of July 1, physicians who recommend Cannabis to more than 25 patients in one year will be subject to investigation by the board of medical examiners. Chronic pain patients will now need to be examined by two separate practitioners, unless they have "proof" of their pain. Given that doctors are only allowed to approve use by 25 patients per year, getting a medical Cannabis recommendation for chronic pain will arguably become very difficult to impossible. Many patients with chronic pain also have mobility issues, and would be deterred by having to travel long distances. (Montana is the fourth largest state in the union.) Those who are unable to get a recommendation will will not stop using their medicine --they will simply use it illegally and risk prosecution.
Under the new law, there will be no monetary compensation involved with growing or providing Cannabis. This may seem like a good idea to some, but it is not as if the politicians who added this to the bill were hip to a gifting economy. With the restriction of monetary compensation for medical Cannabis, both dispensaries and Cannabis testing labs will most likely have to close their doors. It means that growers will have to eat the cost of production --including the cost of nutrients, electricity, and rent. These factors will surely serve to deter caregivers from growing medicine for the patients that need it. There is a good chance that Cannabis will go back to being imported into the state. As of July 1st, all current growers have to turn in all of their equipment and products and apply for a new license. If they are approved, only then would they will be allowed to begin again on October 1st. This would make it almost impossible to provide clones or products in the meantime, since they all would already have been theoretically turned in.
According to MT rules, caregivers are not allowed to grow for more than three patients. Growing collectively is no longer allowed. Restrictions are set on the ways the plant may be used -- the Cannabis plant has to be grown and used for non-smokable items (edibles, tinctures, etc) OR for flower, not both. Whereas certain ailments are best relieved by the immediate intake/effect of Cannabis, smoking and/or vaporizing is best at providing this effect. Edibles are most useful for those people who are averse to smoking Cannabis or who require a non-inhaled route of administration. Edibles allow a person to ingest high concentrations of Cannabis without inhalation, often required to treat certain chronic conditions. However, the two methods are not mutually exclusive. Some patients need both, or one or the other at differing times. This new legislation fails to keep this truth in mind.
Further, plant limits have been altered under SB 423. Under these rules, one would not be allowed to have more than an ounce of medicine, or more than four mature plants and up to 12 "seedlings". Finally, prospective patients on probation would be deemed unable to obtain Cannabis as medicine. (For other components to the new medical Cannabis law in Montana, see SB 423 here.)
Schweitzer had hoped to amend Senate Bill 423 to make changes on allowing for more patients per caregiver and to allow compensation for growing. The Governor did not agree with the bill's clause on privacy and believed it was what made the bill unconstitutional. Under the original version of SB 423, a patient's private medical records would have been viewable by law enforcement. Schweitzer made these three changes and then SB 423 went back to the MT House and Senate to be reviewed again. The amendments dealing with patient privacy were accepted but the changes to the three-patient limit for caregivers and not-for-profit growing provisions were rejected. The privacy of caregivers was not maintained. Those granted permission to grow will nowhave to be fingerprinted and pass a background check. Law enforcement is now allowed to come and inspect grows "during business hours". SB 423 is still unconstitutional.
While Montana State's medical Cannabis law needed modification, the very serious problems with SB 423 are evident. The adoption of the "no payment for Cannabis" clause has serious implications. No dispensaries means that it will be more difficult for patients to access their meds. Patients will have to rely on one person to provide their entire supply of medicine, which is both inconvenient and inconsistent. The closing of dispensaries will have a strong economic impact on Montana as a whole, as dispensaries provide valuable jobs to a state that has always had economic troubles --arguably worse than most of the country. Dispensaries owners and staff will now be out of a job.
As an even greater sign of ignorance, the closing of the state's analytical Cannabis testing labs is truly a blow to common sense. No Cannabis testing facilities means that the quality control of Cannabis in Montana is effectivly gone. No more research and development can be done with CBD or other components of the plant. People won't know what is in their medicine. It is a crap shoot, the same as it is on the black market. The new regulations put in place by the Governor and the MT House and Senate will encourage patients to go back to a black market method for obtaining their medicine. It seems that SB 423 will deter people from profiteering from medical Cannabis, as was the goal of SB 423. But more than anything else, it will simply hurt patients and restrict those who need Cannabis for medicine, to use it without the fear of prosecution.
Prior to the Governor's "acceptance" of SB 423, patient advocacy groups, grower's coalitions, and testing labs throughout the state issued a joint statement explaining their request for Schweitzer to veto the bill:
"We came to the 2011 session seeking to work constructively with legislators, law enforcement and numerous civic groups to develop smart regulations that would close loopholes, end abuses, and create a strictly regulated program that would serve legitimate patients and meet the needs of law enforcement and local community values. Unfortunately, the Legislature roundly rejected a number of bipartisan proposals that had strong support from all concerned. Ultimately, the views of physicians and patients were dismissed and the opinions of growers with a unique knowledge of the challenges involved in growing medical-grade Cannabis were ignored."
Schweitzer "metaphorically" did not sign the bill into law. In Montana, if the Governor doesn't sign a bill within 10 days, than it becomes the law of the land. Despite his reluctance to approve the bill and his attempted amendments to SB 423, Schweitzer failed to acknowledge the remaining serious problems with SB 423. The Federal government will be able to monitor the growing of Cannabis in Montana. The bill is still unconstitutional. The Governor's decision shows a clear lack of understanding of the needs of Montana's patients, and seems to exhibit a purposeful neglect to listen to those who had attempted to educate both his office and the MT legislature.
Patient activist Hiedi Handford says people are outraged and that there are "patients puking across the state". Those opposed to Schweitzer's decision will encourage the governor to veto the Bill until the 10 day grace period is up. If the bill is allowed to pass, people across the state are gathering, collecting signatures, and creating citizens referendum campaign to fight SB 423. Handford advises those wanting to get involved with the effort to stay informed on her blog. Further useful information may be found at Montana NORML's website.
Schweitzer explained that he didn't veto SB 423 because he couldn't let the unregulated medical Cannabis law go on until the next legislative session in two years. While the Governor is acting like the victim, the future of medical Cannabis in Montana is in his hands. The need for regulations should have been done without penalizing patients. Governor Schweitzer should have examined SB 423 and rejected it. The bill is beyond workable. Schweitzer and the Montana legislature do not understand anything about Cannabis as medicine and are apparently unwilling to listen. Top
May 6 U.S. Imprisons Mollie Fry, MD, and Dale Schafer
Marian "Mollie" Fry, MD, and her husband Dale Schafer, an attorney, turned themselves to U.S. marshals Monday, May 2 and were taken to the Sacramento County jail where they await transfer to federal prisons. They have begun serving five-year terms —ostensibly for the crime of Cannabis cultivation (growing plants), but actually for the crime of political organizing (educating people).
Mollie Fry is a founding member of the Society of Cannabis Clinicians, the group organized by Tod Mikuriya, MD, in 2000 to enable doctors entering the field to share and publish findings and observations —and defend themselves against persecution. Law enforcement at the state and federal levels loudly opposed Proposition 215, the measure enacted by voters in 1996, and has curtailed its implementation ever since.
Fry, 54, is a breast cancer survivor. She will be going to the Federal Correctional Institution in Dublin, which is in visiting distance for the kids and grandkids. Schafer, who turns 57 this month, will be sent Taft, near Bakersfield. His looming concern is medical care —he's a hemophiliac with severely painful, blood-swollen joints, and is currently taking high doses of morphine and other analgesics.
I asked Dale how he was going to be spending his last weekend of freedom. He said, "Hugging my family."
Mollie and Dale raised five kids who are now grown-ups —Heather, 35, and Jeremy, 34, from Dale's first marriage, and Jeffrey, 24, Carol, 20, and Tyler, 18, from their union. Heather and Jeremy have kids, 10 and 11. Carol is going to have a baby in October. The extended family, minus mama and papa —which is what the grandkids call Mollie and Dale— will be together in the house in the foothills west of Auburn.
"We've got to keep paying the bills while our parents are gone," says Heather. "The government took all their savings, everything but the house." An insurance policy has been paying the mortgage ($3,500/month) since 2007, when Mollie stopped practicing due to disability. Dale doesn't think the company will use her imprisonment as an excuse to stop paying, but he lined up a lawyer just in case.
Jeffrey has gone to work for the CannaCare dispensary in Sacramento, and feels grateful to have a job. Jeremy is going to be traveling with a country-jazz band. "They've got a big bus and gigs lined up throughout the south," according to Dale. "He can't get wait to hit the road. I told him, 'If that's your dream, man, jump on it and do it. If you don't do it right now..."
Mollie Fry says proudly that there have been doctors in her family since the Civil War. Her mother, a research psychiatrist, died of breast cancer at age 42. Mollie, then 13, started using Cannabis to deal with her grief. It didn't impair her academically. She graduated from UC Irvine School of Medicine in 1985 and did an internship at UC Davis in psychiatry. She switched to family practice when she began practicing in Lodi in '87. It wasn't until 1999 that she became a Cannabis consultant —a decision stemming from her own illness.
In December, 1997, an exploratory procedure (which Mollie had insisted on against the advice of an oncologist) revealed a malignancy that had spread to three lymph nodes. Her breasts were removed and she underwent extensive radiation treatment. She used Cannabis to deal with the nausea and anxiety. "It was hard to get," Dale says, which is why he grew a few plants in their garden in the summer of '98.
Dale had observed the medical use of marijuana first-hand when he was in the Navy, a lanky 19-year old assigned to Oak Knoll Hospital. He has indelible memories of assisting surgeons trying to "perfect" the stumps of sailors whose limbs had been amputated en route from Vietnam. "People who were in radiation therapy would go down the back hallway to smoke," he remembered. "We knew that it was the only thing that helped."
Dale worked in Kaiser emergency rooms to put himself through college and law school. "I wasn't naïve, I knew that marijuana had medical benefits," he says, "But it wasn't until Mollie got cancer that I really started digging into what Prop 215 was all about."
It's difficult to picture now -now that doctors willing to issue Cannabis recommendations are advertising in the media- but when Prop 215 passed there was only one physician proclaiming his willingness to approve Cannabis use for conditions other than AIDS or cancer: Tod Mikuriya, a Berkeley-based psychiatrist. As of 1999 the number was not in double digits, although demand was enormous. Most pot smokers were embarrassed or afraid to ask their regular doctors for letters of approval, and most doctors were unwilling to write them. Some were afraid of getting in trouble with the medical board or the DEA and jeopardizing their livelihoods. Others were too conscientious to recommend use of a medicine they had learned nothing about in medical school and couldn't discuss in terms of proper dosage, side effects, etc.
Bobby Eisenberg, an acquaintance whose son played on a Little League team that Dale coached, put him in touch with Tod. "Mollie called him and he invited us to visit him." Dale recounted. "We saw his office, then visited him at home. I started reading everything I could find on medical marijuana because I wanted to know how to advise people to do it right. And the cops wouldn't tell me. Nobody will tell you to this day how to do it right. That's the problem. They want you go to go out and fuck up and then come and arrest you. Every other law that the government passes, they tell you how to make it work. They won't tell you. They want to keep it that way, they want everybody to be afraid, to be afraid that if there's a slight change, they could go down."
In the summer of '99, Dale and Mollie opened adjoining offices in a small foothills town called Cool. She did Cannabis consultations, he advised patients of their rights. They were growing 20 plants on their property when two El Dorado County Sheriff's deputies paid a visit. The next day, Dale says, "Mollie called the head narcotics detective, Tim McNulty. She told him, 'Don't waste your money snooping around. I've had cancer, I'm growing pot, and we want to talk to you about it. Get up here.'
"McNulty came to the house and I took him up to the garden. I used to represent cops. I thought they trusted me. I talk their language pretty well. He took a look at our paperwork and said it looked fine. He even said I was a good grower! But he made a request that Mollie wasn't willing to grant. He said, 'You should help us separate the 18-year-old skateboarders from the people with cancer.' Mollie said 'I'm a doctor, not a cop. I'm willing to see people and determine if they're qualified. I'll do my job, you do yours.'"
Dale and Mollie felt confident that their medical/legal practices were appropriate under Prop 215. In addition to seeing patients in Cool, they leased space in Oakland and Lake Tahoe to conduct one-day-a-week clinics (again following Mikuriya's practice model). In Tahoe they met a young couple, Paul Maggy and Tracy Coggins, who came to work for them as office managers. Maggy was facing a cultivation charge from a 900-plant grow -which is not something Mollie and Dale held against him. During the seven months he would work for them, Maggy helped them grow marijuana (they grew 43 plants in 2000) and in distributing the surplus to patients of Mollie's.
In this period Mollie encountered Attorney General Bill Lockyer at a VFW fundraiser and told him about her practice. "Lockyer said 'Okay, go for it,'" according to Mollie, "'but be low-key.' He said something to imply, not that I should hide, but that I should be discreet. Maybe that was the word he used... But the problem was, I had staff and office rents, and how do you let patients know that you're available without advertising?"
Dale arranged a meeting with Dave De Alba, the senior assistant AG whom Lockyer had put in charge of medical marijuana cases, trying to confirm that Mollie's procedures were legal under state law. The only thing DeAlba advised doing differently, Dale says, was "stay the hell away from Tod. He said that Tod is targeted, and that Tod is a problem. We ignored that, of course, because we liked and respected Tod."
As for federal law, Dale was relying on a 1999 ruling by the 9th Circuit Court of Appeals in the U.S. v. Oakland Cannabis Buyers Co-op case that made "medical necessity" a possible defense for marijuana distribution. Dale says he told the deputies who inspected his grow in 2000 and again in 2001 that any surplus would go patients, and they told him that as long as the plant total was below 100, the feds would not take notice.
In July of 2001 Dale —increasingly convinced that marijuana was safe and effective medicine— announced that he was running for District Attorney of El Dorado County. In September the DEA raided his property, confiscating 34 plants and 6,000 patients' files. In November he got 15% of the vote for DA.
Mollie recalls the raid: "I was going to bed with a migraine headache and they came running up my driveway with their guns in their riot uniforms. I opened my arms and said, 'I entirely submit. You are welcome in my home.' And they still forced me to the ground and handcuffed me for two hours. My hands turned white. I was so cold, my hands were shaking... So they moved me into the trailer. Then I had to change our granddaughter's shitty diaper while in handcuffs. I couldn't quite wipe... I said to the agent, 'It's so hard having five children and a baby to take care of and cancer...' And she looked at me and said, 'You have cancer?' And I go, 'Of course I have cancer, why the hell do you think I'm doing this?
"Not even the staff that raided me and was abusing me knew the truth."
Mollie and Dale believed that El Dorado County DA Gary Lacy had sicced the feds on them —not just because Dale had run against him, but because Mollie had been testifying successfully in support of her patients. "Mollie testified in about 25 cases," Dale would recall, "and almost every one resulted in an acquittal. Cops and prosecutors were simply not accustomed to losing marijuana cases. It used to be that they could convict just about everybody they arrested. Prop 215 changed that, and they took it personally. They hated Mollie the way they hated Tod."
Neither Mollie nor Dale was indicted at the time of the September 2001 raid, but the DEA notified Fry that her prescription-writing privileges would be revoked: "It is inconsistent with the public interest for a DEA registered practitioner to live in a residence wherein large quantities of a controlled substance are being stored, cultivated, manufactured and/or processed for distribution and/or sale. In addition, it is inconsistent with the public interest for a DEA registered practitioner to be engaged in the illegal sale of a Schedule I controlled substance such as marijuana at the practioner's registered location."
It wasn't until June 22, 2005 —two weeks after the U.S. Supreme Court ruled in the Raich case that an individual's right to use marijuana as medicine under California law was superseded by the federal prohibition- that Fry and Schafer were indicted. The charge was conspiracy to grow ("manufacture") and distribute marijuana between August '99 and September '01. Because they had grown more than 100 plants in this period, they were facing five-year mandatory minimums. Dale says he was completely blindsided by the feds basing their charges on a cumulative three-year total.
The U.S. attorney offered a deal that would have meant 18 months in prison for Schafer and no prison time for Fry. "But if she couldn't practice and I was gone," Dale says, "we would have gone bankrupt and lost the house. So we said 'Thanks but no thanks.'"
A 10-day trial was held in August 2007. Schafer was represented by Tony Serra, Fry by Laurence Lichter. Opening arguments hadn't concluded before Judge Frank Damrell instructed the jury that any references to the medical use of marijuana were irrelevant under federal law, and that they absolutely had to abide by his instructions. Damrell also forbade the defense from citing their belief that "medical necessity" on the part of patients justified marijuana production and sales. (In 2003 the U.S. Supreme Court had overruled the 9th Circuit's recognition of "medical necessity" as a defense in the Oakland CBC case.)
Paul Maggy was the star prosecution witness. He had gone to prison in connection with his earlier grow op, and been released after serving 13 months of a five-year term in exchange for his testimony. Maggy swore that on behalf of Mollie and Dale he had sold processed marijuana, clones, and "starter kits" consisting of lights, plant nutrients and clones.
According to Bobby Eisenberg, whose account of the trial is trustworthy,
"Several patients were brought in to testify that they'd purchased their marijuana from Dr. Fry or her staff. Jody Bollinger testified that she purchased a half ounce of medicine from Mike Harvey with a check made out to Schafer for $40. Keep in mind the going rate for a half ounce of bud is closer to $200. Harvey testified that some patients received their medical marijuana for free and in some cases they paid only $10 as a delivery charge.
"Another patient, Jeff Teshera, a convicted robber, got leniency for testifying that Fry examined him on Nov. 30, 1999, and that she and Heather Schafer then sold him marijuana. It turned out that Heather Schafer had given birth to her daughter on Nov. 29 and that Mollie was with her at UC Davis on the 30th, all day. Dr. Fry had her Physician's assistant, Rob Poseley, working in clinic on the 30th and he testified that he, and not Dr. Fry, had examined Teshera. No marijuana was sold.
"El Dorado County sheriff's deputy Bob Ashworth told the jury that he had deceived Fry and Schafer for over a year and a half leading them to believe that everything they were doing was legal under state law and safe, given federal policies. He observed their marijuana gardens in 1999, counting 20 plants and in 2000 when he counted 43 plants. He spoke with Schafer on the phone numerous times, right up until a few days before the raid on September 28, 2001, with assurances that everything was fine. It turned out that El Dorado County deputies were working hand in hand with the DEA and the prosecutor to entrap Fry and Schafer throughout the investigation.
"Jacob DuCharme had been employed by Fry and Schafer just after Paul Maggy had been hired. Jake wanted to testify that he and his wife had been unwilling to work for Fry and Schafer because Maggy and his girlfriend, Coggins, were up to no good. The DuCharmes knew that Maggy and Coggins were out to sell marijuana to Fry's patients without Fry's knowledge. DuCharme was silenced by prosecution objections. He never got to say that Fry and Schafer had gone to great lengths to insure that everyone in the office understood and upheld the law in California. The jury never heard the truth."
The Real Crime
Why did federal prosecutors add up plant counts from three years of cultivation to push the total over 100? Why were they so bent on making Mollie Fry and Dale Schafer face mandatory-minimum sentences? Why were Mollie and Dale a much more important target than Maggy, the freed informer, who had grown 900 plants and had numerous other offenses on his record?
Because unlike Maggy, Mollie and Dale were political organizers.
Anybody who joins a movement or a party has been organized by another person or persons. Being organized (in the sense I mean it) is not the same as being moved by a speech or a leaflet (no matter how brilliant the orator or writer). It involves a closer, more direct connection. There's always a person who confirms your inclination to throw in with the group, or convinces you by example or explanation that the cause is in your interests. That's what Mollie Fry and other MDs following Mikuriya's leadership did with their patients —they organized them. They did more than define the patient's pain (emotional and/or physical) in medical terms, they enabled the patient to tell the truth about their illegal drug use, i.e., their subversive behavior. They substantiated the notion that the government lies, the government is prejudiced, the government is not operating in the interests of the American people.
Mollie Fry and her colleagues have helped organize hundreds of thousands of legal medical marijuana users in California. This was the insight of Phil Denney, MD, a neighbor of Mollie's. A brief conversation with her at the mailbox in 1999 led Denney to get into the field, too.
In November, 2006, when Prop 215 had been the law in California for 10 years, O'Shaughnessy's collected data from members of the Society of Cannabis Clinicians. Mollie Fry's response to that survey follows:
Approvals issued: 12,000
Previously self-medicating: >80%
Conditions being treated: Chronic pain, 85%. Includes all etiologies from systemic diseases, i.e., Fibromyalgia, Lupus, Rheumatoid Arthritis, to physical injuries such as fractures incurred in motor vehicle accidents, gunshot wounds, failed surgeries, Post-Traumatic Arthritis, Osteoarthritis and work-related problems, Psychiatric disorders, 15%. Includes PTSD, Depression, Anxiety, Insomnia, Panic Disorder. Other illnesses include AIDS and Cancer (2%-3%), Glaucoma (1%-2%), Psoriasis and Eczema (1%-2%).
Patients report feeling better able to face whatever illness they are dealing with.
The majority of my patients report a decrease in the use of conventional pharmaceuticals. Approximately 90% of those using narcotics decrease their usage, and about half discontinue them altogether. Patients report feeling better able to face whatever illness they are dealing with. Many express relief that their pain and anxieties are being treated through a God-given plant. Cannabis enables them to feel a part of their own treatment and a part of their own healing.
Health is a state of mind, body and spirit. By restoring their connection to nature, Cannabis helps patients on all three levels.
Medications discontinued or reduced include Oxycontin, Norco, Percoset, Vicodin, Flexeril, Soma, Valium, SSRI antidepressants, and blood-pressure medications Norvasc and Hydrochlorothiazide.
Approximately 1% of my patients report reduced reliance or discontinuation of seizure medication by substituting Cannabis for Dilantin and remaining seizure free. Many of my Glaucoma patients no longer require their Timoptic drops and are able to maintain normal pressures with the use of Cannabis. Many of my patients who have lost hope in conventional pharmaceutical treatments report enhanced health, decreased pain, decreased depression and an overall sense of well-being despite chronic illness.
Unusual conditions successfully treated with Cannabis? Eczema, Psoriasis, and dermatitis of all types are being treated successfully. Also, skin reactions associated with Agent Orange.
Although it is not a medical condition per se, parenting problems are alleviated by the use of Cannabis. Mothers and fathers report enhanced flexibility and an ability to identify the child’s needs as those of a separate and unique individual. Parents are able to interpret the child’s behavior in an age-appropriate manner. Improved communication leads to shared experience. The parent becomes present and the child benefits from the increased positive attention.
Many patients report that Cannabis stimulates their interest in art, music, poetry, writing, and other creative endeavors. Insight is manifested by an ability to recognize one’s place in the universe. Patients say Cannabis makes them less self-centered and egocentric and more aware of the needs of other people. It makes them aware of how their own behavior affects other people and how they may be contributing to a negative interaction. Cannabis can be a useful adjunct in the marital-counseling process.
Comments re strains and dosage?
As a result of Prohibition, not enough information is available regarding strains and I don’t feel comfortable making a comment on this subject. Regarding delivery methods, I feel strongly that edible Cannabis is under-utilized. As noted in a previous communication (Spring 2006), oral ingestion involves processing by the liver, which minimizes the differences between strains. Oral ingestion is recommended for those seeking longterm relief from chronic physiological problems such as pain, glaucoma, diabetes, lupus, rheumatoid arthritis, and multiple sclerosis.
Just as patients who smoke Cannabis learn to inhale as needed to achieve and maintain their desired effect, patients who use oral Cannabis can employ an analogous titration process. If a patient is using a vegetable-oil extract, s/he calculates the amount needed to produce the desired effect without over-sedation (the “loading dose”). By determining how long it takes for the effect to come on and wear off, patients can schedule a subsquent “maintenance dose” to keep on an even keel.
The sedation that may be perceived as a negative side effect during waking hours is precisely the effect that chronic pain patients and others require for a good night’s sleep.
Orally ingested cannabinoids can exert their effects for close to eight hours —adequate sleep for most patients— eliminating the need for a maintenance dose in the middle of the night.
The efficacy of Cannabis applied topically as an ointment or tincture is similarly underrated. Dose is controlled by the individual monitoring the effects on the skin lesions being treated. My patients have had great success with using 1/4 cup of extracted Cannabis oil in a hot bath for overall distribution, followed by localized applications to severely inflamed areas. Cannabinoids and possibly other healing components of the plant are absorbed directly through the skin; the anti-inflammatory properties are outstanding, reducing recovery time from injuries and promoting healing of lesions. Topical Cannabis has also been used by my lupus patients and rheumatoid arthritis patients to increase the function of joints and decrease nodule formation. Many recipes are available for both vegetable-oil-based and rubbing-alcohol-based preparations.
The most significant negative reactions are due to fear of incarceration and the results of abuse by officers unwilling to honor California law.
My office does not compile this data, but I can generalize with some assurance that my patients are about two-thirds male and more than half are over 50 years old. They are predominately white, with the majority having completed high school and beyond. Those patients who are not disabled do not report problems getting and maintaining satisfactory employment. Most use Cannabis in the evening for relaxing and for chronic stresses and pains associated with the workday and are not under the influence during work hours.
ADHD diagnoses are misleadingly low. There are many high- achieving successful, adults who use Cannabis for other problems but in fact meet the criteria for an ADHD diagnosis. Most ADHD patients in my practice are teenagers with parental consent to substitute Cannabis for more dangerous and addicting drugs like Ritalin, Dexedrine, etc. These patients do much better with Cannabis, show marked improvement in appetite and sleep, and are more successful in school.
Substitute for alcohol?
More than half my patients express a preference for Cannabis over alcohol. Those who have been alcoholics as evidenced by DUI and other court proceedings find that substituting Cannabis for alcohol makes it much easier to remain sober. Ample research demonstrates that excessive alcohol use often results in domestic violence and motor vehicle accidents. This is not the case with Cannabis use from my experience.
Fred Gardner is the editor of O'Shaughnessy's, the journal of Cannabis in clinical practice. He can be reached here. Top
March 30 Medical Board Loses Case Against Dr Frankel. But…
TheMedical Board of California has accepted Administrative Law Judge Susan Formaker’s proposed decision [PDF] In the Matter of the Accusation and Petition to Revoke Probation Against Allan I. Frankel, MD. Formaker found that the Board’s expert witness, a Beverly Hills psychiatrist named Daniel Fast, had been “substantially discredited on cross-examination.” Her comments regarding Fast jibe with the reports we received from people who attended the four-day hearing in Los Angeles.
The board had relied on Fast’s assessment, based on one 70- minute interview with Frankel, to establish the latter’s unfitness to practice medicine. “However,” wrote Formaker, “in view of Dr. Fast’s problematic perceptions regarding Respondent [Frankel], Dr. Fast’s admittedly ‘inaccurate Cannabis-related diagnoses and GAF scores assigned to Respondent, and the insufficiently supported diagnosis of Personality Disorder Not Otherwise Specified, Dr. Fasts’s conclusions regarding respondent’s inability to practice medicine safely cannot be considered convincing.”
Formaker went on to weigh “the question of whether a physician may violate a probationary order issued by the Board solely through the use of medical marijuana authorized pursuant to the Compassionate Use Act..” Her answer was yes —“technically.” But in this case, when Frankel and the Board entered into a stipulated settlement in 2009, Frankel agreed to abide by a disciplinary order that did not specifically rule out his using medical Cannabis (which the board knew he was using). “Fundamental principles of due process require,” opined Formaker, “before the Petition to Revoke Probation was filed, Respondent should have been notified… that his use of medical Cannabis, in and of itself, constituted a violation… of the Disciplinary Order.”
So in the future when Pro-Cannabis MDs get put on probation, expect them to be duly notified that they have lost the right to use Cannabis as medicine under California law.
Unless I’m reading Formaker’s 46-page decision incorrectly, Dr. Frankel has won a personal victory but the Board has honed a weapon for future use against pro-Cannabis MDs. Top
February 8 The Situation in Montana - By Sarah Russo
There is a chance that the people of Montana will see medical Cannabis become illegal. In 2004, the Montana Medical Marijuana Initiative passed with 62% of the vote. Since then, some 28,000 Montanans have gotten physician approval and registered with the state program.
On February 4, 2011, The House Human Services Committee voted 10-5 to repeal the law Montana's voters had enacted. The 10 supporters of the Repeal Bill (all Republicans, the five opponents were Democrats) gave the go-ahead to send House Bill 161 to the Senate. If passed by the Senate, the bill would go to the Governor for his signature. If the Governor decided to veto the bill, the House may have enough votes to override him; (The Repeal Bill’s sponsor is House Speaker Mike Milburn.) If and when it passes, HB 161 would criminalize medical marijuana and once again put it in the category of a “dangerous drug.
How can a voter-passed initiative be at risk of being reversed? Unlike California, in Montana, the state legislature has the ability to repeal or change any initiative. The people have spoken but the politicians are following another master. Media coverage of the repeal bill is biased at best. Patient advocate, Hiedi Handford, comments on the television news stations and newspapers covering the story in the state, “we have reefer madness prevalent in Montana, especially with our media. They are behaving just like in 1937. It is all negative propaganda, and there are no human interest stories. The only person they followed was the one that is destroying the industry. It is shameful.”
At the State House meeting on February 2nd, public opponents of the repeal bill outnumbered supporters 3-to-1. House speaker Milburn stated “there are no scientific studies that prove marijuana has any medicinal value." Apparently, Milburn did not read “The 2011 Legislators’ Guide to Medical Cannabis” given to him by Jim Gingery, Executive Director of the Montana Medical Growers Association. Nor did he listen to the many patients who testified that medical Cannabis has vastly improved and/or saved their lives.
Claims that marijuana is harmful came from a representative of The Rimrock Foundation, a Montana addiction treatment center. “Marijuana is a very addictive drug," she asserted. "Today’s pot is 25 percent stronger than the pot of the ’60s and the baby boom generation. …”
It's ironic that repeal of Montana's medical marijuana law would cut off research aimed at introducing less- or non-psychoactive strains into the grassroots supply. Three labs are now testing medical Cannabis in Montana, and they have identified two CBD-rich strains —"Misty" and "Good Medicine." Handford says, "People are doing some amazing things in this state relating to Cannabis research. We are just in the beginning of discovering CBD rich strains and promoting them. If we get repealed, we would have to stop, and everything we have done is gone. We shouldn’t have to be criminals to promote science.
Not surprisingly, the Montana public wants its law to be left as they voted for it: a recent poll by the Montana Standard showed a strong majority 52%, opposed to repeal. Only 24% believed it should be “tossed out."
Another threat to Montana's medical marijuana law comes from Senate Bill 154, which will be heard in committee Feb. 11. SB-154 would assign the Department of Revenue to oversee the use of medical marijuana. It would require growers of medical Cannabis to have a specific license, pay a 10 percent tax on their sales, and submit quarterly reports. It would also change how patients become eligible for medical marijuana. It would require a person with severe chronic pain to have recommendations from two separate doctors before they were eligible legally able to use Cannabis medicinally.
These proposed regulations would interfere in the doctor-patient relationship and make the patients’ task of obtaining medicine more difficult. SB-154 would also shrink the list of conditions that qualify medical Cannabis patients for the program. Conditions that would qualify under SB-154 would be as follows:
(1) "Debilitating medical condition" means:
(a) cancer, glaucoma, or positive status for human immunodeficiency virus, acquired immune deficiency syndrome, or the treatment of these conditions;
(b) a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following:
(i) cachexia or wasting syndrome;
(ii) severe or chronic pain;
(iii) severe nausea;
(iv) seizures, including but not limited to seizures caused by epilepsy; or
(v) severe or persistent muscle spasms, including but not limited to spasms caused by multiple sclerosis or Crohn's disease; or
(c) any other medical condition or treatment for a medical condition adopted by the department by rule.
Blatant disparities would result. A medical patient from California could legally use Cannabis for anxiety in Montana, but a Montana resident could not. The original medical law allowed for “a chronic or debilitating disease or medical condition or its treatment that produces one or more of the following [above listed conditions]”.
While many medical Cannabis advocates in the state believe that regulations need to be incorporated into the existing law, HB 161 and SB 154 would steal the voice of the populace. A few decision makers would take away the right of over 28,000 registered patients to use the medicine of their choice. Montanans would have to wait two years until they could try and get another medical Cannabis initiative on the books.Top
February 07 A Note on Black History Month
If you happen to be a teacher looking for a lesson plan, or a student looking for a topic on which to write a paper in connection with Black History Month, we're posting some material from O'Shaughnessy's that is worth checking out.
* John C. Merritt, MD, was a young opthalmologist on the faculty at Howard University College of Medicine who, in the 1970s, conducted pioneering studies establishing that smoking marijuana lowers intraocular pressure and could be a treatment for glaucoma. "My interest in marijuana's IOP-reducing properties was twofold," said Merritt. "First, glaucoma is a leading cause of blindness and improved medical treatments for the disease are critically needed. Second, glaucoma disproportionately affects people of color." Read Marijuana in the Treatment of Glaucoma: an Affidavit by Dr. Merritt.
• James A. Washington was the Washington, DC Superior Court Judge who presided over United States v. Robert Randall. It was Judge Washington's acceptance of Randall's "medical necessity" argument that led to the federal government's begrudging creation of an "investigational new drug" protocol in the late 1970s. Read James A. Washington: Unsung Hero.
• Louis Armstrong so openly discussed the benefits of Cannabis that historian Michael Krawitz calls him "the first activist. Read some of Armstrong's riffs on the subject in "Tight Gage —More a Medicine Then a Dope."
• Undercover police investigators determined in the late 1930s that some 500 "teapads" were operating in Harlem —about as many dispensaries as in LA nowadays. The cops were unbiased, out to determine the actual impact of marijuana use. Their findings are quoted in Marijuana Use in NYC… All Those Years Ago.
• Ricky Williams' decision to quite football in 2004 was recounted in Ricky Williams Protests Drug Testing by Quitting Football; Calls Marijuana "10 Times Better for me Than Paxil." When Williams returned to the NFL in 2005 to fulfill his contract to the Miami Dolphins, Mike Wallace gloated on 60 Minutes that the power of money had prevailed. Our follow-up story quotes Williams: "My loyalty is to the truth, not to consistency."
I'm so old I can remember when it was Negro History Week. Seriously. And two verses of—
Lift every voice and sing, till earth and heaven ring
Ring with the harmonies of liberty…
Fred G. Top
January 31 The Medical Board of California vs. Allan Frankel, MD
The Medical Board of California is trying to revoke the license of a pro-Cannabis doctor —for using Cannabis. A hearing held in Los Angeles in late December is supposed to determine whether or not Allan Frankel, MD, is fit to practice medicine.
Frankel is 59, barrel-chested, curly-haired, and jolly —amazingly so, given that his parents were Holocaust survivors. His looks and something about his manner remind me of the comedian Albert Brooks. He is divorced with three grown children -two who are practicing MDs and one with a business degree. (The businessman, Josh Frankel, was the place-kicker for the University of Oregon Ducks. In 1999 he booted the winning field goal against USC in triple-overtime.)
Most of Frankel's career was spent practicing internal medicine. "I had a hotsy-totsy office on Wilshire Boulevard in Santa Monica," he says, and an affiliation with UCLA. In 34 years of practice Frankel never had a problem with the medical board. He used marijuana on rare social occasions, and knew nothing about its medical aspect. In 2001 Frankel underwent disk surgery for intractable back pain. In 2002 a viral infection of the heart almost killed him (he was given a prognosis of one year to live) and left him "in general, permanent discomfort."
He was disabled —bedridden for most of the ensuing three years. Relief came when some of the cancer and AIDS patients for whom he had written recommendations urged him to try Cannabis. "My patients did a reverse intervention on me," Frankel recalls. "Cannabis helped me get better. A part of me thinks it saved my life."
During his prolonged recovery, Frankel designed software that is still used to run the Bowyer Cancer Center at UCLA Hospital. He describes it as "a specialized medical language that enables them to build very complex what-if scenarios involving drug interactions, allergies, insurance, all the factors that have to be taken into account in a treatment plan."
In March, 2006, Frankel opened a new office in Marina Del Rey dedicated to Cannabis consultations. "I really didn't know anything about Cannabis except what I learned from my patients," he reflects. He joined the Society of Cannabis Clinicians, read the relevant medical and scientific literature, attended conferences, and did everything he could to educate himself about the body's cannabinoid signaling system. He began tracking strain differences and encouraged patients to find the type of Cannabis and the delivery system best suited to alleviating their symptoms. In other words, Allan Frankel was serious about mastering his new specialty.
Early on, Frankel says, "I realized that my patients were lying about how much they used —as if they feared my disapproval. Finally I would tell them, 'I use an ounce a month. How much do you really use?' And then they would level with me -about dosage, about everything."
In June 2007 two agents from the medical board's enforcement division "walked into the office and announced that I was under investigation," says Frankel. "They showed their badges in front of all the patients —it was terrible." A vindictive ex had filed a complaint against him. In addition to several false charges, he says, was a true one. As he would eventually acknowledge when he agreed to accept probation from the medical board, he had prescribed Vicodin for himself, "less than one pill a day on average," while recovering from back surgery.
Although the self-prescribing had occurred years before Frankel become a Cannabis specialist, the terms of his probation included a punishment never before imposed on a California MD: for one year "Respondent shall not issue an oral or written recommendation or approval to a patient or a patient's primary caregiver for the possession or cultivation of marijuana for the personal medical purposes of the patient."
Friends and colleagues urged Frankel not to accept this punishment, which the med board had recently added to its arsenal. He says he didn't have money to fight it (having just put two kids through med school) and he felt truly foolish and embarrassed about his self-prescribing. Cannabis had politicized him and he had become self-critical. When he accepted probation it was partly by way of penance.
As of April 22, 2010, Allan Frankel, MD, stopped issuing approvals for patients to use Cannabis. Other terms of his probation, which have been met, included taking courses in "prescribing practices," "medical record keeping," "ethics," and "professional boundaries;" undergoing a psychiatric evaluation by a psychiatrist chosen by the board; seeing a psychotherapist on a regular basis; abstaining totally from alcohol (which had never been a problem for him); and submitting to random "biological fluid testing."
The probation requirement that Frankel has allegedly violated reads, "Respondent shall abstain completely from the personal use or possession of controlled substances... and any drugs requiring a prescription. This prohibition does not apply to medications lawfully prescribed to Respondent by another practitioner for a bona fide illness or condition."
Frankel was and is using Cannabis with the approval of Christine Paoletti, MD, and Cymbalta and Dalmane prescribed by Robert Gerner, MD, for anxiety and insomnia. He was first prescribed Dalmane when he was in his twenties to quell "recurrent nightmares I'd been having since I was a kid in which the Nazis were coming to get me."
The case developed by med board investigators against Frankel is being prosecuted by lawyers from the state attorney general's office. (His name is Jerry Brown and he approved this prosecution.) The key witness against Frankel has been Daniel Fast, a psychiatrist chosen by the board for this purpose. Fast is a member of numerous establishment and gay psychiatric associations. On his resume he lists participation in "National Depression Screen Day," an Eli Lilly scam intended to boost the number of Americans getting Prozac prescriptions.
"I actually knew him slightly when I was at UCLA," says Frankel of Fast. "Like I'd nod to him in the cafeteria." On April 28 Frankel went to Fast's Beverly Hills office for "a 70-minute talk session." Fast subsequently reported to the board that Allan Frankel was unable to practice medicine safely because of impaired cognitive function and "chronic marijuana usage."
Frankel's lawyer, John Fleer, has been handling cases before the med board for more than 20 years and says he has rarely seen an accusation as "desperately flawed" as the one the med board is pressing against Frankel. "The board is ignoring its own prior Decision and Order," says Fleer, "by overruling Dr. Frankel's personal physicians" in regard to appropriate treatment for his condition.
The hearing before Administrative Law Judge Susan Formaker began Monday with opening statements, followed by Daniel Fast's testimony. Cross-examination began in the late afternoon and resumed Tuesday (see below). Frankel's expert witnesses are set for Wednesday: Robert Gerner, MD, a psychiatrist who sees Frankel regularly and does not discern cognitive impairment, and Christine Paoletti, MD, who approved his Cannabis use and will testify that it does not render him unsafe to practice medicine. Then the ALJ will recommend to the board whether they should or shouldn't revoke Frankel's license. The board, which consists mainly of ambitious MDs appointed by the Governor, can accept, reject or modify an ALJ's recommendation.
"The irony is," says Frankel, "that all my work is directed towards safety. Finding the right strain, the right delivery method, the right dosage ... Working with an analytic chemist so that potencies can be known and consistent... Promoting cannabidiol in hopes of developing less psychoactive strains... Always issuing warnings and reminders to patients... It's just ironic."
HUMAN SMOKE: Some might call it coincidence but in fact it's a politically consistent pattern: Frankel is the second member of the Society of Cannabis Clinicians (1) whose parents were Holocaust survivors, (2) who practiced medicine for decades without running afoul of the medical board, (3) who got investigated and charged soon after becoming a Cannabis specialist, and (4) against whom the board deployed a veteran of Eli Lilly's National Depression Screening Day. The other was Hanya Barth, MD, whose cruel ordeal was reported in O'Shaughnessy's, Spring 2007... Frankel says that the "Nazi dreams," which he hasn't had since he was 30-something, are waking him up again. You don't have to be a psychiatrist to figure out why.
This article ran in CounterPunch, December 27, 2010. The second part, below, ran Jan. 3, 2011:
Beverly Hills Shrink
Imagine having to attend a public hearing at which a psychiatrist to whom you told the unguarded truth discourses on your "anti-social personality disorder." That was Allan Frankel's plight as his fitness to practice medicine was debated before an administrative law judge in Los Angeles Dec. 27-30. (CounterPunch recounted the background of the medical board's case against Frankel as the proceedings began.) Lucky for Frankel he was surrounded by anti-social friends, including Tyler Strause, who kept Frankel's whole anti-social community up-to-date by Twitter.
The board's expert witness, a Beverly Hills shrink named Daniel Fast, was supposed to reiterate and explain the diagnoses he had conferred on Frankel after a 63-minute "psych eval" last spring. Here are some informative gems from Fast's written report:
• Dr. Frankel was born in New York City and moved to Redwood City, CA at age 7. He was captain of the football team and valedictorian in high school but never had sex. His father, who had lost a son in the concentrations camps, was never happy…
• Of these relationships, Dr. Frankel said "I'm attracted to borderline women" and that it was "sloppy and wrong" [to prescribe for her and her daughter] but he was "in love" and "will never do it again."
• He has a good relationship with his sister, several old friends, his three adult children and a 16-month old grandson.
• He loves his work as CEO of Green Bridge Medical Services. 25% of his referrals are from doctors in the community. He loves to help patients, especially those with MS, HIV and cancer. He is active and excited about his new ventures -testing, developing tinctures [solutions of active Cannabis] and medical education about Cannabis. He currently acts as a "greeter" in his business and has hired another physician to see patients.
• He reports that "life is good, even now." The worst is the "humiliation" by the Medical Board which he believes is "political." He has no issue with the Medical Board restrictions, i.e. to prescribe no scheduled medication or to give marijuana recommendations... He accepts being unable to enjoy wine and won't go back to doing what he was doing.
• Affective status: Mood is cheerful, optimistic and confident, inappropriate in this context. [Emphasis added.]
• There is no evidence of alterations of reality testing --no hallucinations, illusions or delusions. There is flight of ideas... There is preoccupation with the medical uses of marijuana.
Fast's bottom line: "I believe that Dr. Frankel suffers from a variety of psychiatric conditions which significantly interfere with his ability to process information, form judgments or relate a coherent history."
Diagnosis based upon DSM-V Criteria:
• 304.30 Cannabis Dependence
• 305.20 Cannabis Abuse
• 292.89 Cannabis Intoxication
• Rule out underlying 296.89 Bipolar II Disorder or 301.13 Cyclothymic Disorder, Hypomanic.
• Rule out 314.9 Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified.
• 301.9 Personality Disorder Not Otherwise Specified with Antisocial, Histrionic and Narcissistic features.
On direct examination by Deputy Attorney General Edward Kim, Fast testified that he had done eight previous psych evals for the med board. He always asks doctors to come 15 minutes early to fill out some paperwork, and most arrive 15 minutes earlier than requested. Allan Frankel, however, arrived at Dr. Fast's office seven minutes late. And he was not wearing a coat and tie, he was wearing slacks and a sports shirt. [Rosie asks, "Who wears a coat and tie in LA?" And, "Those doctors who came a half hour early —how guilty were their consciences?"]
Frankel, according to Fast, was dismissive of the medical board's charges against him. He believed the prosecution to be "a witch hunt" that was "politically motivated." Yes, Frankel was contrite about the self-prescribing episode and some bad choices he'd made involving women, but not sufficiently contrite. In other words, Frankel, even facing loss of his license, remained his brash and breezy self.
The expert Fast testified that he himself had never approved marijuana use for depression, anxiety, or insomnia, preferring to prescribe pharmaceutical-industry synthetics. The psychoactive effects of marijuana, he mentioned, last for 14 days. An anti-social friend of Frankel's whispered, "Where can we get some of that stuff?"
On cross-examination Fast would retract all the Cannabis-related diagnoses. Fleer began by calling Fast's attention to the fact that the Diagnostic and Statistical Manual itself requires the doctor to select two of the three conditions that he had pinned on Frankel. Fast said, "Oh, you're right. Well, I'll choose Dependence and Abuse."
Fleer then had Fast read aloud from the DSM —the so-called "Bible of the American Psychiatric Association"— all the symptoms and traits that characterize Cannabis Dependence and Abuse, and got him to admit that Frankel did not manifest them! According to Tyler Strause, "Fast was kind of puny to begin with and he seemed to be withering away on the stand. He wound up saying, 'I was incorrect. I'm sorry.'"
Fleer matter-of-factly termed Fast's inaccurate diagnoses "irresponsible" and moved on to the "Not Otherwise Specified" personality disorder. Fast testified that he had based his assessment on traits he observed in Frankel such as "impaired judgment," "flight of ideas," "poor impulse control," and "lack of concentration."
Fast had been consulting some notes while testifying. Fleer asked about them. Fast said they were notes he had made during his 63 minutes with Frankel. Fleer asked for and got copies. (No notes had been provided to the defense on "discovery," the legally required pre-trial sharing of potential evidence.) He then led Fast through a review of the notes, which revealed that Frankel had proceeded from topic to topic in a logical order.
How often, Fleer asked, did people in the general population exhibit aspects of an unspeficied personality disorder? This brought the stunning concession that Allan Frankel did not exhibit more signs of a disorder than most people Daniel Fast has met! "I couldn't believe what I was hearing," says Fleer, who has handled med board cases for more than 20 years.
And there went the last of the prosecution case, if Med Board v. Frankel was being tried in the Court of Common Sense. But an administrative law hearing is more like the Court of Alice in Wonderland, on it went.
In Defense of Frankel
The doctor who approved Allan Frankel's Cannabis use, Christine Paoletti, MD, is a Santa Monica obstetrician whose practice has expanded to include Cannabis consultations. Her testimony was "considered and deliberate," according to our source in the gallery. She had recommended that Frankel seek out and use CBD-rich Cannabis, which is reported to be more effective against anxiety than high-THC strains. The judge picked up on this and Dr. Paoletti got to explain how Cannabidiol had been bred out of Cannabis grown for maximum psychoactivity, but that CBD-rich strains were now becoming available for medical users.
According to Paoletti, the judge took over her cross-examination from Deputy AG Kim because "he wasn't cutting to the chase and she got frustrated. She knew very little but asked good questions. She asked why I hadn't asked for a note from his psychiatrist [confirming his diagnosis]. I had asked, but he hadn't brought it. But he did have his primary care records documenting Insomnia and Anxiety. And that was substantial enough to justify the recommendation."
Paoletti also noted that she had attended meetings of the Society of Cannabis Clinicians at which Frankel took an active part "and was always very cogent."
Paoletti was asked by ALJ Formaker whether she had questioned Frankel about his past drug dependence. She said, "'No, he volunteered his history. I asked him to elaborate on certain aspects of it. When he was recovering from his cardiomyopathy he became concerned about addiction to Vicodan and went through a program."
Paoletti considers Frankel's use of Cannabis as an alternative to Vicodin "a classic example of harm reduction. I have several patients who have been able to get off their pain medications thanks to Cannabis."
Formaker asked Paoletti if she had drug-tested Frankel. She said no, but she knew that he was being drug-tested as a condition of his probation. "My job," she informed the judge, "was to determine 'Did he have a medical condition that merits the use of Cannabis?' And 'Is he stable?' Yes and yes."
Two other MDs testified that Frankel is fit to practice: Robert Gerner, a psychiatrist who is seeing Frankel on a weekly basis (in according with the terms of his probation), and Glenn Gorletski, an internal medicine specialist who praised Frankel's character and skills as a physician. Gerner said that Frankel was coping very well while on probation. "His treatment regimen is working," he said. "My advice is: 'don't change anything.'"
Frankel himself took the stand to state that he was aware of his prior transgressions and appropriately remorseful. His goal was simply to show the judge that he could think and speak coherently. By design, he did not expound on medical Cannabis. Fleer was concerned that his expertise could be mistaken for a preoccupation.
Kim's cross-examination was "lame," according to Tyler Strause. "I was amazed how much of his time Kim devoted to flipping through his notes and papers trying to find some point with which he could contradict Dr. Frankel. He would flip through his papers for 30 seconds, then ask a three-second question. Over and over."
Kim's closing argument, says Fleer, revealed an assumption that Frankel had been "high" when he went for his appointment with Fast and will be "high" when treating patients, if allowed to practice again. Kim repeatedly reprised Fast's complaint that Frankel had been seven minutes late and casually dressed. "Kim got very worked up," says Fleer, "trying to say that if you don't wear a coat and tie, it means you're high." (Move over, Johnnie Cochran.) "He really couldn't accept the idea that Dr. Frankel could use marijuana and see patients. He had to be 'high' and therefore dysfunctional."
At the very end of the hearing, the judge told the lawyers there was an issue on which she needed clarification, either via briefs or right then and there. Fleer said best to deal with it now if we can, what is it? The judge asked whether Depression and Anxiety were conditions to which Prop 215 applied. The relevant sentence was read to her —the first sentence of the initiative— and she acknowledged that the conditions were covered. Frankel's friends were shocked by her level of... let's call it naivete at that late stage of the proceedings.
In both his written report to the medical board and his direct testimony before ALJ Formaker, Daniel Fast lingered on the transgressions involving women and prescription drugs that got Allan Frankel in trouble initially. But Frankel hasn't skirted any med board guidelines since he started Green Bridge Medical Clinic in 2006, and he isn't accused of having done so. The present accusation boils down to an insufficient show of remorse over things that happened before Frankel became a medical Cannabis user and proponent.
The judge has 30 days to write a "proposed decision," and the med board has another 30 days to decide whether to accept, reject, or modify it. The whole board then has to vote on the decision at a quarterly meeting. If the decision isn't favorable, Frankel will seek a writ in Superior Court to overturn it.
Fleer doubts that Attorney General Jerry Brown was aware that his office was prosecuting the med board's case against Frankel. In fact, says Fleer, the doctors who make up a majority of voting board members may not be aware that Frankel's license was —and is— at risk. Board members come and go, while the staff, which is dominated by investigators from the Enforcement Division, stay unto retirement (and beyond, thanks to double-dipping). Fleer says he is "almost certain it was the head of the Enforcement Division who chose to go after Dr. Frankel" for taking the same medicine he recommends to patients.
—Fred Gardner Top
January 21 Marijuana's Role in the Tucson Shooting
Why is the Huffington Post running propaganda from Joe Califano, a leading strategist for the Prohibitionist Cabal? The above-titled opinion piece ran January 21 on the supposedly liberal website.
After blowing politic kisses towards Barack Obama and John Boehner, Califano changes tone to dis "the thousands of pundits, left and right, arguing about the meaning of the tragedy in Arizona," who missed a lesson "as important as any other lesson to come out of this tragedy. It's about the relationship of marijuana use to psychotic illness."
After another shot at the pundits preoccupied with laws that allow automatic weapons and super-size ammo magazines, Califano makes his pitch: "I haven't seen press reports or talking heads discuss their concern about how easy it has been for this mentally ill young man to get marijuana. And there has been no mention of the potential of marijuana to spark latent psychosis and exacerbate schizophrenia and other mental illnesses.
Califano cites a study in "the British Medical Journal Lancet [The M and the J should be lower case, since he's referring to a piece in the Lancet. Califano or the staffer who writes his stuff must have vaguely remembered a publication called the British Medical Journal and conflated the two] and two other studies suggesting that using Cannabis leads to psychotic breaks. Califano does not allow that these studies are considered inconclusive at best by many psychiatrists, including Lester Grinspoon, whose textbook on Schizophrenia has been the standard text. [See Grinspoon's unbiased commentary on Cannabis and Schizophrenia in O'Shaughnessy's Summer 2008.]
Califano quotes reports that Loughner once used marijuana while ignoring the reports that he quit three years ago and that his drug of choice was Salvia Divinorum. Califano wants the question settled: "If the police have any of the hair shaved from Loughner's head, they can easily find out if marijuana was in his system at the time of the shooting. They may even be able to do so from hair that grows back in."
It seems like an easy test to rig if one were so inclined. And we know Joe Califano of old, he has few qualms about manipulating the facts. The following is from our report on the Prop 215 campaign (the ballot initiative by which California voters legalized the medical use of marijuana on November 4, 1996):
In the final weeks of the campaign some leading drug warriors from Back East —stunned that the people of California were on the verge of rejecting a lifetime of their propaganda—decided to step in. Joseph Califano, president of the National Center on Addiction and Substance Abuse at Columbia University, flew out to Los Angeles on Tuesday, Oct. 28 to warn Californians that they did not understand the open-endedness of Prop 215. Califano had hired two pollsters to query 800 residents over the weekend. He must have been very confident of the outcome because arrangements for his press conference were made before the questions had been asked. "It was a push-pull," explains Paul Maslin, a San Francisco pollster. This is a type of survey in which the questioner, after getting an initial response, provides additional information and then asks again, evoking a changed response. Califano announced at his press conference that 46 percent of the respondents supported Prop 215 when first asked, but only 36 percent after its inherent looseness had been pointed out to them. Califano's goal in commissioning the poll, according to Maslin was to make voters think that the "no" side still had a realistic chance on Election Day and to minimize any bandwagon effect that would magnify the "yes" vote.
Flash-forward to the Huffington Post, Jan. 21. Califano concludes: " we should be asking this question: Is Jared Loughner an individual whose psychosis was prompted or exacerbated by the use of marijuana? Whether or not he is, it is important for the press and parents to see this horrendous incident not only as a teaching moment about the easy availability and dangerous potential of automatic weapons, but also as a teaching moment about the easy availability and dangerous potential of marijuana to spark and exacerbate psychosis and schizophrenia in individuals with latent mental illnesses.
"The missing story line in existing news reports and television chatter shows is about the terrible trinity of easy availability of guns, easy availability of marijuana and mental illness. The question for all of us, especially parents of teenagers, to ask is this: Is the media's failure to acknowledge this tragic trinity due to its tendency to overlook or underplay the dangers of marijuana use?
"Joseph A. Califano, Jr., Founder and Chair of The National Center on Addiction and Substance Abuse at Columbia University, was Secretary of Health, Education, and Welfare in the Carter Administration, and served from 1965 to 1969 as chief domestic affairs assistant to president Lyndon B. Johnson." At which time one of his top aides, a Harvard honors and future corporate CEO, used to roll amazingly perfect joints with hospital corners. Califano never thought his aide was impaired at work because he wasn't.
—O'Shaughnessy's News ServiceTop