The Green Cross helps those in need

In a small West Seattle home, the Green Cross Patient Co-op is buzzing with requests for medicinal marijuana. After the passage of Initiative 692 in November, the organization has mailed out more than 100 applications to inquiring patients, JoAnna McKee, 55, co-founder, said.

"We are very busy, and a lot more patients are availing themselves of our help," McKee said.

At least eight new patients were officially added to the Green Cross within a month after the initiative passed, McKee said.

The Green Cross provides medicinal marijuana access to patients who live in Washington state, Idaho, Oregon and Montana. About 70 percent of the patients have AIDS, McKee said.

Washington state voters passed the initiative with 50.97 percent of votes. Locally, 56.25 percent of Whatcom County voters approved the initiative, according to official results reported by the Whatcom County Election Office.

Although state elections director Gary McIntosh is not aware of current legislation issues with I-692, past state initiatives that were controversial have not been implemented easily without judicial interpretation, he said.

The initiative itself is short and sweet. It legalizes the medicinal use of marijuana for people with terminal illnesses and debilitating illnesses, such as glaucoma, AIDS/HIV, spinal cord injuries and cancer.

With the new law, patients can grow and possess a 60-day marijuana supply, and physicians who recommend the use of medicinal marijuana cannot be prosecuted. Still questions about the implementation of the initiative are expected to linger for months. Dr. Rob Killian, sponsor of I-692, is trying to answer questions concerning issues such as distribution and recommendation of the drug.

Killian is finding that physicians need to learn they are not under federal threat and patients need to learn that the actual prescription of medicinal marijuana is still illegal by federal law, he said.

"Physicians won't be having to change the way they are practicing medicine. They will need to discuss the illness and the way they are treating it with patients and document that in their medical record," Killian said. "We are not reinventing medicine."

The initiative provides that physicians can only recommend, not prescribe, the use of medicinal marijuana. The initiative did not legalize the sale of marijuana, it only legalizes the patient to grow his own marijuana, Killian explained

"It was the only option we had," Killian said.

Killian sponsored a similar initiative in 1997, I-685. It not only legalized medicinal marijuana, but legalized other drugs, such as LSD and heroin for medicinal use. Although I-685 did not meet voter approval, Killian, who has a general practice in Seattle, continued to lobby for the legalization of medicinal marijuana.

Killian said he first witnessed patients using medicinal marijuana when he was a director of a hospice in Rochester, N.Y. The event inspired him to research medicinal marijuana and become an advocate for its use.

Marijuana is a great natural appetite stimulant, Killian explained. "I have seen patients stop throwing up, start eating again and putting weight back on," he said.

The initiative was written by a collective of physicians, attorneys, experts and patients, Killian said.

Following the November election, Killian is working with a committee to put together an informational pamphlet for patients and educational seminars for professionals. Further meetings to discuss implementation are being planned, Killian said.

We have had some initial contact with law enforcement and the state department of health about how to implement the initiative, Killian said.

Some law enforcers question the specifics of the initiative, such as the lack of information about distribution and prescription of the medicinal marijuana and the possible problems that could result.

The initiative was well intended, but lacked detail, Bellingham Police Lt. Dac Jamison said.

"Now it is here, they have a problem of working out the rules," Jamison said.

There is no distribution mechanism in the initiative, which creates an uncomfortable gray area for law enforcement, Jamison said. The initiative needs to be clear cut so it is enforceable, he said.

Hopefully, only the patient will have access to medicinal marijuana and doors to marijuana will not open for all, Jamison said.

"It is totally up to the medical profession to decide what is appropriate and the state to decide how to distribute," Jamison said.

Yet, state statutes do not protect patients from the federal law, Jamison said.

The federal law has already intervened in states, such as California, that have similar measures. Between January and November 1998, the government reportedly has filed suit to close at least six Californian "marijuana clubs" that provide medicinal marijuana to patients.

Federal law still mandates it is illegal to possess and use marijuana. The Federal Food and Drug Administration (FDA) has not yet approved marijuana as a medicine.

Government studies funded by the National Institutes of Health allowed Dr. Donald Abrams, an oncologist at the University of California, to study the effects of marijuana and Marinol in HIV patients, but the research is still in progress, according to the Oct. 22 Seattle Times.

The state does not have the right to approve medicinal marijuana, said Dr. Ian Thompson, a Bellingham radiation oncologist.

"A legislative way is not a appropriate way to determine whether a substance should be used as a medicine," Thompson said. Medications and prescriptions should be handled by the FDA in terms of safety, Thompson said.

"I would like to see it undergo the rigorous testing that all other medications do," Thompson said.

Patients who will be using medicinal marijuana should be studied to document the effects, and he drug should be handled as a controlled substance, he said.

Thompson said he has encountered patients who tried using medicinal marijuana as a treatment during the past year. However, he believes that the drug has a placebo effect. There are other anti-nausea medicines already in existence, such as Marinol, he said.

The FDA approved Marinol, the synthetic version of THC, but some patients found that only the chemical found in marijuana plants worked best for them.

Green Cross patients who tried Marinol did not find it to be effective. Marinol is 100 percent pure man-made THC, versus cannabis which is 5-to-10 percent THC, said Dr. Francis Podrebarac, a Seattle psychiatrist and Green Cross patient.

Podrebarac has AIDS/HIV and suffers from pain and complications in the intestinal area.

"(Medicinal marijuana) relieved the pain better than morphine by far," Podrebarac said.

But McKee at the Green Cross Co-op said people who have stomach problems can't take Marinol. Medicinal marijuana can be smoked and the drug can go directly in the bloodstream, she said.

"The pill is just toxic," McKee said. "A lot of patients can't tolerate it because of nausea, or they are too stoned to function."

Even with the passage of the initiative, McKee doubts there will be a state source for medical marijuana because a doctor cannot officially prescribe the drug, she said.

The Green Cross has struggled to provide patients with a source to medicinal marijuana for the past seven years.

Before passage of the initiative, it operated with only a couple of conflicts with law enforcement. The Green Cross faced police searches twice and the charges were dropped in both cases.

The only thing the Green Cross changed in response to the initiative was the paperwork that is required from the patient and doctor, McKee said.

The Green Cross forms are written in the same format where both the patient and doctor sign. However, some wording has been changed to fit the initiative, McKee said. The paperwork now describes how the health benefits outweigh the risks, McKee said.

Patients pick up marijuana once a week in the amount advised by their doctor. Most patients consume one gram a day, McKee said, but there are some patients who consume more than that.

The marijuana is packaged in child-proof pill bottles with a 24-hour contact number, and each bottle holds about a quarter ounce, McKee said.

Marijuana for patient use is obtained in different ways; the marijuana is donated by growers or other patients or is purchased by the co-op at a discounted price, McKee said.

Patients purchase the marijuana with their own money. "We have a sliding scale for patients. We just ask for donations. People understand if they don't give a donation, the supply will all dry up eventually," McKee said. "It's a donation basis and it all depends on the patient's situation."

The Green Cross will also help patients grow their own plants, but most patients are too sick to grow, McKee said.

"There has to be a supply available for patients who don't have access to medicinal marijuana," McKee said.

Interested patients can access information about the Green Cross at http://www.hemp.net.