The public health advocate says drug laws do more harm than good
POSTED: 1:30 a.m. HST, Apr 8, 2011
LAST UPDATED: 1:39 a.m. HST, Apr 8, 2011
After Gov. Linda Lingle declined last year to set up a task force on medical marijuana as provided by the Legislature, Senate Public Health Chairman Will Espero took it upon himself to create a private study group, co-chaired by Pamela Lichty, president of the Drug Policy Forum of Hawaii, to do the job.
The U.S. Supreme Court ruled in 2005 that the federal government may prosecute medical users of marijuana, but the Obama administrative has decided not to seek such prosecutions. The Hawaii Legislature had legalized medical use of marijuana in 2000 but the sale of marijuana remains illegal in the state.
Lichty earned her master’s degree in public health at the University of Hawaii in 1987 and became involved in reducing the spread of AIDS/HIV among drug users and their sexual partners in the 1990s. She met the late Don Topping, director of UH’s Social Science Research Institute at a conference in Washington, D.C., in 1993.
“Don and I talked about the war on drugs and how we thought it was harmful, and doing more harm than good,” Lichty said. “After we both came back from the conference we had a preliminary meeting and we started the Drug Policy Forum of Hawaii.”
She became immersed in a public health approach to drug problems and drug policy.
The Drug Policy Forum has advocated the legalization of marijuana and, in particular, medical use of cannabis, now legal in 15 states and the District of Columbia. It supports Senate Bill 1458, which would authorize 22 medical marijuana distribution centers in the state and transfer the program from the state Department of Public Safety to the Department of Health. A House version, supported by the Abercrombie administration, would limit it to a five-year pilot program limited to a single distribution center and keep it at Public Safety. The dispensary would grow the marijuana and sell it to patients.
Question: What exactly would the House medical marijuana bill do?
Answer: It would permit one dispensary as a pilot project on an unspecified location on one of the islands … which means that 8,000 patients on other islands will not have any access to it.
It’s a five-year pilot program, which is extremely long for a pilot program. It means, in effect, that the whole thing is on hold for five years.
Our argument is that there are good dispensary systems in other states; we hear about the bad ones, but there are lots of good ones. And all the new states that have come on board since we passed our law have dispensaries — New Mexico, Arizona is the most recent, New Jersey. New Mexico has a really good one; Colorado has one that this original (Hawaii) bill was based on, and their’s is pretty good as well. There are a lot of good models out there. The only weak thing we have is our geographical issues. People cannot drive from Oahu to wherever to pick up their syringes.
Q: Keith Kamita, the deputy director for law enforcement in the state Department of Public Safety, pointed out that the bulk of the marijuana permits are to residents in their 20s and 30s, the suggestion being that these are recreational users rather than medical users. How do you respond to that?
A: Of course there’s no way of knowing. The physicians are the gatekeepers on this issue, and I think that’s appropriate. They’re the ones who determine whether or not people have a legitimate use for it. So, essentially, Mr. Kamita’s stance is very adversarial on this. He’s looking at it, I think, with a jaundiced eye.
But the fact is that the majority of the people who use it are using it for pain, which is one of the indicators; severe pain is an indicator of the law. There’s no way of objectively sensing anyone’s pain. If you go in to a doctor, he says on a scale of 1 to 10 how bad it is. You can’t look at me and tell me that my elbow isn’t killing me right now. It’s sort of a matter of trust, and it’s also of trust in physicians. There are now 175 physicians, I believe, who are participating in the program, and maybe there’s a couple of them who are pretty lax, but I would guess that with the scrutiny that they’re getting from the Department of Public Safety, they’re being pretty careful.
So I would argue that we should leave it up to the physicians and their relationship with their patients.
Q: In Colorado, the proportion of patients with conditions like cancer, glaucoma and AIDS has been diminishing, and those using it for severe pain has been increasing; 94 percent of patients claim it is for severe pain. How do you interpret that?
A: Actually, it’s proven to be pretty efficacious for pain. It works … Sometimes it’s useful for nerve damage, especially of your extremities, where opiates don’t work. A lot of patients are telling us that they can’t completely stop using narcotics, but they’re able to cut it way back, and their quality of life is better because they’re not so zonked out (on opiates).
Q: Why are most patients in Hawaii on the Big Island?
A: I don’t think anybody knows the answer definitively, but they’ve had a lot of cannabis for a million years; it used to be a big area for growing it … So I can only think there’s a higher level of awareness of it.
Q: Should the program remain in the Department of Public Safety or be operated by the Department of Health?
A: That’s another thing that’s been changed in the latest draft (of SB 1458). It was supposed to be under the Department of Health, and in this latest draft in the House Judiciary Committee they changed it to the Department of Public Safety, which I think is a real problem, because we already have the issue of the fox guarding the henhouse, in my view. …
I just can’t see them doing a dispensary system in good faith. … We hear in all the hearings that Health doesn’t know how to handle this, but they’re doing it in all these other states. We are the only state that has a registry system that has it with a law enforcement agency, except for Vermont. They seem to have managed to figure out a way to contact the police, to have a 24/7 access, anything they need; they’ve managed. Why our Department of Health can’t do it, I don’t know.
We’ve been very disappointed by the governor’s stance on this, because we assume the Department of Health is taking their lead from him, and they have opposed any kind of dispensary system. In fact, they’ve opposed all of these bills whenever they’ve been mentioned all along. We think that’s very disappointing. During his campaign, the governor made what we thought were very positive statements about the medical cannabis program. One time, in response to a query, he said he didn’t think criminals should be in charge of managing people’s pain. That’s exactly where we are right now. Patients are forced to go to the black market to obtain their medicine, and we think that’s unconscionable, and it could be remedied.
Q: Why can’t the Department of Public Safety be fair and objective in operating the program?
A: They certainly don’t love the program. If you look at Mr. Kamita’s statements in the past, he’s said things like, “This was dumped on us.” (When it was enacted in 2000) Mr. Kamita testified as a private citizen against it. So it kind of tipped his hand at that point on where he stands personally on this.
In our view, it’s antithetical to the mission of the Narcotics Enforcement Division. That’s the division that helps the doctors to get their DEA (U.S. Drug Enforcement Agency) permit, without which they can’t practice medicine, and so they have a lot of control over doctors, and they can withdraw that permit. So physicians are somewhat intimidated by its placement there, and patients are definitely intimidated. …
I just got a call last week from a woman who has liver cancer, who just moved here from California, and she said, “What do I do now?”
Well, you register with the Narcotics Enforcement Division.
“What, really? And then after I get approved, then where do I get my medicine?”
Well, that’s a problem. We get these calls all the time. It’s a terrible situation.