Medical Marijuana Dispensary. It is what it is, for now. My pessimistic view of the current setting.

SB 1458

UPDATE: Oct 2016.  Dispensaries will not be open until the second quarter of 2017 due to lack of labs and State software. As of Oct 2016, they are not even growing yet. These groups have to grow their own and make their own products. These are not like dispensaries in Colorado or California where they have a horizantal system, performing a retail function, and providing products from many sources. I poll nearly all my patients and it appears that unless the prices are right, not many will be using them. The established supply system, developed over many decades, will not be going away. It does not take much work to tap into that supply system at some level. There are groups out there to hep with safe sources, so if you are ill, there is NO NEED to wait until the dispensaries are open. 

Patients need a place of legal and safe access. The fear and shame has got to stop. Patients also have a right to safe organic pesticide free fresh raw plants in large enough numbers to allow for a proper juicing regimen. This requires about 30 plants. Hawaii's plant limit of 7 is NOT ADEQUATE, and not based on medical science. The state came up with a system yet to be implimented due to significant delays...poor planning and implimentation!.  I am not happy with the mechanism that is being established. I feel it is not sustainable nor financially feasible, unless the patient population is greatly increased by more liberal diagnoses qualifications, or the legalization of cannabis with recreational sales and tourist sales. A minority of patients in certain areas, mainly urban will use them, but at what prices?

Fear of Shame Prevents Solutions

As posted: I have spoken fairly often with those who represent the upper echelons of the political "Pain Medicine" world, and they are the same very conservative academicians as found everywhere else. They are also on the payrolls as speakers of most of the big pharma companies, and receive millions of dollars of research money from them. You won't find quick progress and support there. They are not necessarily against it, but many have bought into the cannabis as a "drug of abuse" mantra, because of their training. They are also extremely fearful of the DEA and its power and ability to shut down their practices, and therefore their livelihoods, without cause.

Most feel that they are taking too many risks already by prescribing larger amounts of opioids and other controlled substances, required by real pain patients in real life to warrant the additional risks of medical cannabis. It is the political pressure of the Federal Government that weighs upon them. And who controls the Federal Government....?

PJ Cohen, an MD/lawyer, summarized this work in two sets of papers presented a few years back and should be available through PubMED. ("Medical marijuana: the conflict between scientific evidence and political ideology".) Fundamentally, this is a people's movement and the power of people to determine their own path, as is supposedly the American Way. When enough people stand up and not be ashamed or fearful, then progress will be made. I am hopeful that Hawaiians can feel some independent strength to self determine their own path in this issue.

Need for Support

Law Enforcement, however open and Hawaiian they may feel, are still under the heavy influence of the FBI, and DEA. I am hopeful that President Obama remains in office to continue his support, even if it is only holding back these entities to some semblance of moderate control. The laws still have to be respected and changed per the will of the people. It seems that the same people are fighting the battle every year, and then everyone complains when no progress is made.

More people and support are needed until there is a critical mass. There should have been tens of thousands of testimony on these bills. What did we get, a hundred, 150? I hear way too many people say that they don't want to be targets of law enforcement. We do need research and that takes money. Where does the money come from? Who has the money? Just guess. Yes, and it is not disabled, chronically ill, and dying people.

Roadblocks Ahead

Everyone seems to be against these types of things like pain pills and cannabis, calling doctors "pill pushers" and such, even in the medical community, but that lasts only until they need it themselves, or for a loved one. I see that all the time, both in the pain medicine world and this one. Then they are surprised by all the blocks that have been put in place. I am especially disappointed in the failure, so far, of this type of bill. I have other ideas as to how it should be implemented, but I am still disappointed for my cancer, very sick, and ill patients who are unable to grow their own medical marijuana or don't have ready access from friends.

I agree to the thinking outside the box, because even in the pain medicine world, there are very few effective answers for so many painful and disabling conditions. SO, we will deal with the abuse issue and see what that is about. We will answer their questions with real answers. We will set the discussion in real life terms, and put things in real life perspective. We will split off the issue of the recreational user, which befuddles and clouds the discussions, and concentrate on the needs of the truly pained and disabled medical user.

We challenge those who are against medical cannabis and the improvement in the laws, as to why, with real information, data, and statistics that can be analysed independently and truthfully. And NOT in the economic, make the numbers look good, dishonest government way. WHY IS IT LAWFUL TO USE, BUT WITH THE "CATCH 22" OF SAFE ACCESS AND SO MUCH FEAR AND SHAME.

Voices Unheard

The truth is that if all the disabled, chronically ill, and aging people got together and felt well enough to be supportive, they could have their own political party that would represent the needs of real people. I would think that those who have had a tougher existence on Earth would be wiser and more compassionate toward others. Especially on the Big Island, where one community activist told me, there are nearly 60,000 to 80,000 disabled people. I would think that the Big Island politicians would be aware of such a thing. Please, stand up and be counted! Aloha, Medical Marijuana of Hawaii, and the Hawaiian Pacific Pain and Palliative Care ____________________________________________________________________ Update: Reply from Dr/Sen. Josh Green of Kona concerning the medical marijuana program and SB1458: “Sadly over 50% of those prescribed medical marijuana are under age 30, with no concrete diagnosis... 97% of all scripts statewide had no medical diagnosis other than pain or spasm, which is not medically sound practice. A few doctors and individuals are ruining the program for others. There were 1500 new scripts on Big Island last year, up 50% in ONE year... this is a problem. Please share this info with those who are abusing the system and jeopardizing the proper use of medical marijuana. Sincerely, Sen. Josh Green, MD“ There clearly needs to be put in place safeguards that guarantee safe access for legitimate patients, yet satisfies the desires of the Hawaian Legislature. However, I would urge that the statistics derived from the NED be better analysed so that they give us a clear picture of the different populations that exist between the islands. Both sides of the argument need to come together and work things out in a sensible and compassionate manner! ___________________________________________________________________(Update: Dr Green's stated numbers above were from the NED at that time, and do not match the current DOH numbers published. The median age for card holders is in the 50s, not under 30s years of age).

Worry from Hawaii State Legislature's members about illegal marijuana sales prevented needed Marijuana Dispensary Reform in the past.

The State of Hawaii continues to maintain antiquated and obsolete medical cannabis laws with "Catch 22" consequences. It is okay to possess and grow, but still illegal to buy seeds or clones to get started. Worse, 75% of law abiding and qualified patients (roughly what I estimate by what I am told by patients in my own practices on Oahu, Kauai, and Maui) are still forced to buy their cannabis "off the street" where type and quality are unknown. Just the act brings fears and shame to disabled, chronically pained, and ill patients, who are law abiding and deserve better. How do you feel about a law that makes your ill grandma or grandfather act like a drug seeking addict; put at the mercy of a dealer when seeking pain relieving Cannabis medicine "on the street"? How about your wife or other loved one, stricken with cancer, without the time and knowledge to start and grown cannabis, or lucky enough to get a good quality, symptom ameliorating crop. SB1458 is currently in conference with panels from the Senate and House negotiating the final wording which they will hopefully correct to allow for safe and equal access of high quality medical cannabis on ALL the islands. We will have to wait and see what they come up with. Otherwise, it may be better to start over next year with a better bill, than to muddle through with Pilot programs and other delays. Many people have come to this conclusion already. I am still supportive of this year's effort and have faith and hope that the right thing will be done. Please join us in getting out and talking to your elected officials, in the Hawaii State House of Representatives. Let them know how you feel. If everyone starts letting them know their mind and will, something good will result! Tell them you want SAFE ACCESS on your Island!! Jeane Ohta and Pamela Lichty OF THE DRUG POLICY FORUM summarize the most recent activity at: May 1, 2011: April 27, 2011: April 26, 2011: 1) 2)