By: Jean Johnson for Medtech1Clifford Spencer, 52, is one of more than 5,000 unpaid volunteers or “caregivers” that grow and transport medical marijuana to card holders in Oregon. On a Portland afternoon, before he pulls the 7 gram bags of Wonderbud and Dam (short for Amsterdam) from his briefcase, he quizzes 39 year old Mike who suffers from a spinal cord injury resulting from a car wreck.
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Spencer asks how often Mike is medicating (which is daily starting first thing in the morning), and how he rates symptoms like nausea, neurological pain, muscle spasms and anxiety on a scale of 1 to 10. Mike is on the low side of the scale in everything but the muscle spasms. He says, though, that the marijuana is “very effective” and has enabled him to cut back on prescription drugs like Valium and Vicodin. Seven years ago in 1998, voters approved the Oregon Medical Marijuana Act. Since that time patients whose physicians verify that they have a “debilitating medical condition” that produces nausea, severe pain, or persistent muscle spasms among other symptoms, can apply to state Department of Human Services for an Oregon Medical Marijuana Program (OMMP) card.
Applicants must be Oregon residents and have a qualifying debilitating medical condition attested to by an M.D. or D.O. Naturopaths, chiropractors, and nurse practitioners cannot sign applications. OMMP does not provide physician referrals or supply cardholders with seeds or starter plants, or give advice on how to grow medical marijuana plants. Either the card holder or a specific caregiver designated to grow the marijuana for the patient must be identified along with a grow site address.
The application fee is $55, a figure that was reduced from the initial $150 because during the first several years of the program that gets no state assistance and is supported solely on the fees, OMMP built up a surplus budget of nearly a million dollars. High fees, however, are only part of the problem with OMMP say advocates.
To date the law allows cardholders to possess from an ounce to a pound of marijuana and to have seven plants growing at a designated site – three mature and four immature. Yet, when patients are issued their cards, they get no information about how they might access the drug. Non-profit organizations including Voter Power, Oregon Green Free and Life with Dignity currently assist with these transitions, although advocates are pushing for the creation of dispensaries from which cardholders could obtain medical marijuana instead of the black market.
Spencer delivers marijuana to 17 patients in eight places – nursing homes, group homes and adult foster care – a project that between growing the plants and travel time, takes about 20 hours weekly. John Sajo of the Life with Dignity Committee and longtime activist for medical marijuana who supports the creation of dispensaries noted that caregivers are in short supply. “The whole structure of the program is based on patients growing their own or designating a caregiver who cannot be reimbursed,” said Sajo.
OMMP advocates would also like to see the amount of marijuana patients and caregivers can have increased. Spencer says that since he’s only allowed to carry 3 ounces at a time, he has to make extra trips back home on his deliveries. A 2004 ballot measure that would have increased the amount of marijuana cardholders could posses from 3 ounces to 1 pound failed in a vote of 57 percent to 43 percent. If the measure had passed, it also would have increased the number of plants growers can have from seven to 10, along with allowing naturopaths and nurse practitioners to sign a patient’s application.
Another difficulty with state medical marijuana laws is physician uncertainty over the legal implications of federal marijuana laws. After a federal appeals court in California ruled in 2003 against the Bush administration’s attempt to punish physicians who sign off on medical marijuana applications for their patients, though, fewer doctors are fearing federal reprisal, according to Jim Kroneberg, the Oregon Medical Association’s chief operating officer.
Despite problems, OMMP has enjoyed high rates of success that is catching the attention of other states. To date 10,000 patients are enrolled in OMMP, a figure that doubled over the course of the past two years. So while advocacy groups continue to build support for refinements that could make OMMP more user-friendly, volunteers like Spencer continue to make their rounds.
“We’ll be supplementing with some baked goods later in the week,” Spencer tells Mike. Brownies, Morrocan candy with raisins and nuts, and banana bread. Also a “green butter” that patients can use in cooking. “It works well with Rice-A-Roni,” said Spencer.
