Bill is wrong path for medical marijuana 

click to enlarge Senate Bill 1262 would add new oversight to medical marijuana in California, including auditing doctors who prescribe it more than 100 times a year. - ELAINE THOMPSON/2013 AP FILE PHOTO
  • Elaine Thompson/2013 AP file photo
  • Senate Bill 1262 would add new oversight to medical marijuana in California, including auditing doctors who prescribe it more than 100 times a year.

Senate Bill 1262 was introduced to the state Senate on Feb. 21 by veteran legislator Sen. Lou Correa, D-Santa Ana. It is a medical marijuana bill designed to regulate physicians, dispensaries and cultivation sites via rigid government oversight.

Sponsored by the California Police Chiefs Association, SB 1262 promises to "provide a clear road map for the responsible implementation of Proposition 215 in California since voters approved it in 1996."

The Compassionate Use Act of 1996 (Health and Safety Code 11362.5) ensures that seriously ill Californians have the right to obtain and use marijuana for medical purposes when the use is deemed appropriate and recommended by a physician.

As a licensed physician with a registered medical practice in San Francisco, I have reviewed the wording of SB 1262. The bill is highly punitive, clearly seeking to punish doctors who recommend medical marijuana. SB 1262 concerns me most because it duplicates and violates existing state and federal statutes that clarify physicians' role in recommending medical marijuana.

In Conant v. McCaffrey (2002), the federal government was enjoined by the 9th U.S. District Court in San Francisco from punishing physicians for recommending medical marijuana. That ruling affirms physicians' First Amendment right to make recommendations.

SB 1262 requires the Medical Board of California to audit any physician who recommends medical marijuana more than 100 times a year. On April 2, the U.S. Supreme Court struck down limits on federal campaign donations under the auspices of First Amendment rights to free speech. Thus, a U.S. Supreme Court precedent was set that can be legally interpreted to defend a physician's free-speech right to authorize as many patients to use medical marijuana as deemed medically necessary.

SB 1262 establishes requirements for prescribing and record keeping for physicians who recommend medical marijuana in a bill sponsored by law enforcement officials lacking medical training -- and often a college degree!

Guidelines and accepted standards for recommending medical marijuana were developed by licensed California physicians and adopted by the Medical Board of California on May 7, 2004.

SB 1262 violates the California law that protects the privacy of patient medical information, the Confidentiality of Medical Information Act, as well as federal law protecting health information, by mandating that physicians report to the Medical Board all medical marijuana recommendations along with private patient records. The Health Insurance Portability and Accountability Act (HIPAA) requires patient authorization for disclosure of patient health information. HIPAA is a federal regulation and the state Medical Board has no authority to evaluate HIPAA violations.

SB 1262 mandates a training and certification requirement for any doctor who recommends medical marijuana, with a $5,000 fine for non-compliance.

I support SB 1262's efforts to establish standards for quality assurance and testing of marijuana cultivated for medical use. The prohibited use of nonorganic pesticides and the security of cultivation sites will promote cultivation of pharmacological-grade strains analyzed by uniform lab standards for reliable dosing.

SB 1262, however, duplicates Guidelines for the Security and Non-Diversion of Marijuana Grown for Medical Use, developed for the California Department of Justice in 2008 by then-Attorney General Jerry Brown. The 10-page Department of Justice summary of all applicable law does not require redundant language in a Senate bill to be enacted by Gov. Jerry Brown.

As a profession, physicians are capable of regulating their practice standards without law enforcement oversight, and SB 1262 is opposed by the California Medical Association, which issued guidelines for physicians recommending medical marijuana at www.mbc.ca.gov/Licensees/Prescribing/medical_marijuana_cma-recommend.pdf.

On May 7, 2004, the Medical Board adopted accepted standards for recommending medical marijuana that include:

n History and good-faith exam

n Treatment plan and objectives

n Informed consent

n Periodic annual review

n Consultation

n Proper record keeping

n A physician who recommends medical marijuana for a minor must offer parents or legal guardians full informed consent, and should do so with the approval of the treating pediatrician as a professional courtesy

The American Academy for Pain Medicine issued guidelines for medical marijuana at its March 2011 meeting.

A Digest for Medical Marijuana Clinics is a 20-page document that affirms, "Medical marijuana evaluation clinics are engaged in the practice of medicine, and physicians are responsible for their patients."

Marijuana remains listed in Schedule 1 of the federal Controlled Substances Act and has no accepted medical use. The lack of dose response-curve research conducted in large-population controlled trials coupled with the lack of standardized cannabinoid profiling and potency, pesticide and microbiological testing make it difficult for the physician to offer dosing recommendations for medical marijuana short of the adage "Start low, go slow."

The federal government recently patented the unique cannabinoid cannabidiol for its neuroprotective benefits in stroke and trauma. The American Public Health Association, American Academy of HIV Medicine and many other medical institutions join Americans for Safe Access -- the largest national member-based organization of patients, medical professionals, scientists and concerned citizens promoting safe and legal access to medical marijuana for therapeutic uses and research -- in promoting safe and legal access.

According to the April issue of Culture Magazine, 72 percent of Republicans believe cannabis has legitimate medical properties.

Dr. Ahimsa Porter Sumchai is an expert in conventional and alternative therapies, and runs a private practice in West Portal.

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