High-stakes marijuana debate coming to a head in Montana

Khronic

Ed Kemmick/Last Best News

Galen Cook, a medical marijuana provider and a user, also owns a clothing store, Khronic Fashion, seen here.

In 2012, after a lifetime fighting alcohol and drug addiction, Corey Wolcott had reached his limit. He had ballooned to 286 pounds, and he essentially died in a doctor’s office, turning blue for 22 minutes.

After he revived, he said, he was told to go home and get his affairs in order. “You won’t make a week,” he said he was told.

Today, at age 65, he is down to 195 pounds. He has broken a 20-year addiction to muscle relaxants and pain pills, no longer needs alcohol, and his pain is under control.

“It’s a miracle,” he said. “It’s a miracle.”

That’s a word that comes up often in discussions about medical marijuana. Dr. Mark Ibsen of Helena, who was working last week at a Billings Alternative Wellness clinic in Billings, said he hears stories of “miracle after miracle after miracle” from use of the drug.

But what’s left of the medical marijuana industry in Montana is under severe threat. Providers and users fear that they could be shut down as early as this week after the Montana Supreme Court upheld a state law severely restricting the use of medical marijuana.

“You’re looking for a weather report?” Ibsen asked. “It’s raining.”

The Supreme Court ruling was the latest chapter in the chaotic history of medical marijuana in Montana. Voters passed an initiative legalizing medical use of the plant in 2004, and use exploded after federal authorities announced in 2009 that they would not interfere with medical marijuana users who complied with state law.

Users expanded from just 3,900 patients in 2009 to more than 30,000 two years later. In response, the state Legislature in 2011 passed the Montana Marijuana Act, which limited providers to no more than three patients; required the Department of Public Health and Human Services to report to the Board of Medical Examiners any doctor who certified 25 or more patients in a year for a medical marijuana card; banned advertising; allowed inspections without a warrant of Montana marijuana businesses; and prohibited compensation to marijuana providers.

The Montana Cannabis Industry Association sued, and a district judge blocked enforcement of the act. But the Supreme Court last month upheld all but one provision of the law, the one barring compensation.

Only one Supreme Court justice, Michael E. Wheat, voted to overturn the entire law. In a dissenting opinion, he wrote, “The State has gone too far in this case by creating a law that focuses so heavily on curbing the abuses of medical marijuana that it violates the rights of patients by so severely limiting or eliminating access to it, which ultimately destroys the law’s purpose.”

Justices in the majority said they did not consider whether the law was an effective policy choice for dealing with medical marijuana. They held only that it was a rational response to problems created by the 2004 initiative, including doctors who approved medical marijuana for patients they had never seen, traveling caravans of marijuana providers promoting its use, and falsified or exaggerated claims of chronic pain in order to obtain the drug.

For people who depend on medical marijuana for pain relief, the decision is a potential disaster. Some, such as Wolcott, say they will leave the state if necessary to keep getting marijuana.

“I’m not going to quit using the product, no matter where I have to go to get it,” he said.

Elizabeth Pincolini, who operates Billings Alternative Wellness, said marijuana providers hope to buy some time by petitioning for a rehearing within the next 30 to 40 days. But she fears that the industry could be effectively shut down in Montana within four to six weeks.

Ibsen

Dr. Mark Ibsen of Helena Ibsen says he has certified about 2,000 patients for medical marijuana.

More than 13,000 Montanans now have medical marijuana cards, she said, but there are only 471 providers, and only about 200 doctors write recommendations for marijuana users. The law’s limits mean that thousands of current users won’t be able to get their cards renewed.

One ironic consequence of the law, Pincolini said, is that the number of marijuana growers could dramatically increase. The law permits patients to grow their own marijuana, and that may be the only alternative for many. But renters often aren’t able to even do that.

Galen Cook, who is both a medical marijuana provider and a user, predicts that many patients will, like Wolcott, do what they have to do to continue getting treatment.

“You know people are going to get prosecuted,” he said.

Medical marijuana providers also are trying to play one other legal card: They hope to use a California case, Conant vs. Walters, to argue that the Montana law violates the First Amendment rights of doctors by limiting how many patients they can recommend for medical marijuana.

In that case, the 9th Circuit Court of Appeals held that doctors could not be prohibited from recommending marijuana to patients, nor could they be held liable if patients relied on a doctor’s recommendation to obtain marijuana illegally. Doctors could be prohibited from prescribing or dispensing marijuana, the court held. The U.S. Supreme Court declined to hear an appeal of the case.

Ibsen said he signed onto a complaint to the American Civil Liberties Union in Montana asking for legal assistance in fighting that provision of the law. Jim Taylor, legal director of the ACLU of Montana Foundation in Missoula, said the ACLU does not comment on complaints unless it decides to take on the case, which could take several weeks.

Under current law, the Board of Medical Examiners is not required to take any action against doctors who certify more than 25 patients a year, but some fear that doctors may be reluctant to test the limits.

Ibsen, who says he has certified about 2,000 patients for medical marijuana, closed his Urgent Care Plus Clinic in Helena last year after he was investigated for overprescribing opioid pain medications, which include oxycodone, morphine and related drugs. He describes himself as “the poster child” for overprescribing opioid medications.

A hearing officer last year found no basis for most of the allegations against Ibsen but did recommend that he be placed on probation until he took a course in recordkeeping.

The Board of Medical Examiners rejected that recommendation and voted to suspend Ibsen’s license until he takes the recordkeeping course. A final order is expected this month.

Some of Ibsen’s supporters allege that he has been singled out because of his support for medical marijuana, which he sees as a way of helping patients get off opioid medications.

“It’s not a gateway drug,” he said. “It’s a way out.”

According to the Centers for Disease Control, “The United States is in the midst of a prescription painkiller overdose epidemic.” Every day, according to the CDC, 44 people die from overdose of prescription painkillers such as OxyContin, methadone and hydrocodone.

According to a 1999 study conducted under a contract from the Office of National Drug Control Policy, cannabis can help control pain and nausea and stimulate appetite in people with eating problems.

Studies in Israel also have attested to the effectiveness of medical marijuana, but it still has critics, including the federal government, which has found no medical benefits to marijuana.

Liz

Elizabeth Pincolini

“I’m not saying I’m more brilliant than those guys,” Ibsen responds. “I’m not. But I’ll tell you who is: the patients.”

“It saved my life,” said Wolcott, a rancher in Silesia who describes himself as “the most addictive personality in the entire world.”

He said that he seems to have born with a penchant for addiction. The first time he drank alcohol, at age 13, he drank so much that he blacked out. He abused marijuana, too, with no goal other than to get hammered.

In 1981, he broke a leg in a skiing accident and underwent six surgeries to repair it. He quickly became addicted to prescribed painkilling drugs and went through Alcoholics Anonymous treatment that he credits with saving his life.

For 20 years, he didn’t drink or take drugs. But in 2007, he said, he drank a Mike’s Hard Lemonade to celebrate 20 years of sobriety and immediately fell off the wagon.

In 2009, he was in a car accident, hitting a Pepsi truck at 50 mph. As he was recovering from that, he fell off a horse in 2011, breaking ribs and puncturing a lung.

By 2012, he had hit rock bottom, strung out on painkilling drugs. Then he found marijuana. His miraculous improvement isn’t immediately threatened by the Supreme Court decision, he said, since his provider has only one other customer. But while he is skeptical about full legalization of marijuana, he is adamant that it should be available for sick people.

“Marijuana shouldn’t be a right-or-wrong issue,” he said.

Galen Cook, now of Billings, tells a similar story. He grew up in Wyoming as a member of the Church of Jesus Christ of Latter-day Saints. After doing missionary work in Mississippi, he began falling away from the church, bringing him into conflict with his wife and into contact with drugs and alcohol.

After she threatened divorce, family members attempted to intervene, and Cook said he took off in his car.

“They were literally chasing after me, trying to help me,” he said.

He drove too fast and rolled the car over, resulting in compound fractures, a dislocated jaw and bleeding so severe that he nearly died.

By the time he got out of the hospital, he was on his way to opioid addiction, a habit fueled in part by his work as a sales representative for a pharmaceutical company. He said he would “go to extreme measures to obtain prescription drugs.”

He said that he was especially vulnerable to the side effects of prescription drugs and began having seizures, along with depression and constant pain.

“It was as close as you can be to being alive and dead at the same time,” he said.

Desperate, he began using marijuana again, illegally.

“I actually went back to marijuana seeking help,” he said.

After his wife divorced him and he became involved in a custody battle, he went into complete abstinence—no alcohol, no drugs. But the pain became more and more severe.

Only marijuana seemed to help. He eventually got a medical marijuana card and began growing his own to save on expenses.

He also married again to a woman, Maggie, who was an alcoholic.

“She didn’t use marijuana, and I didn’t drink, but we met,” he said.

Marijuana has helped his pain and her alcohol-related problems, including eating disorders and trauma from her experiences with alcohol.

“It’s a dirty world when they get really deep into that stuff,” he said. “She was coming from the dead.”

He now pays $1,600 a month for a building to grow medical marijuana for 35 people. Many of those patients also have chronic pain, but at least two women with breast cancer use marijuana to treat nausea from chemotherapy. Others use it to treat seizures and Chron’s disease, a digestive disorder. Nearly all of those patients must now quickly find another provider.

Cook also runs the Khronic Fashion shop on Grand Avenue. But he is afraid he could be out of the marijuana business as early as this week.

“To me, that’s not what America’s about,” he said.

Even if there are people who abuse marijuana, he asked, is it worth passing so strict a law to keep a few people from abusing?

Cook thinks that chronic pain is just a part of the stress and spiritual sickness that plagues the modern world.

“We didn’t evolve for this kind of thing,” he said, “so, yeah, it’s taking a toll on the human body.”

As for marijuana, he said, “I’ve never seen it fail.”

He added, “Do I think people will live forever using it? No, I don’t do that. I expect them to have a better quality of life.”

In a give-and-take world, Cook said, “I’m just glad I’m on the side of the give.”

Cook worries about the complacency of ordinary Americans, but Ibsen said that people suffering from chronic pain are often in a poor position to speak up for themselves.

“Some pain patients are demoralized, and they can’t fight back,” he said. Since pain is so hard to prove, patients sometimes question their own sanity.

“People in pain have been betrayed numerous times,” Ibsen said. “They just want their lives back.”

In a newspaper column, Boone Goddard of Polson, owner of the Valley Journal, said he has been using medical marijuana for a year to treat pain and inflammation from a genetic disease called ankylosing spondylitis.

“Montana’s marijuana program has been gutted,” he wrote. “Those who are sick are the ones who will suffer most.”

He noted that the Montana Cannabis Information Association is seeking 28,000 signatures to place a new initiative on the 2016 ballot. The initiative would set new standards for regulatory reform of medical marijuana laws.

A separate initiative, I-178, would give all Montanans the right to possess marijuana, subject to federal restrictions. And a third initiative, I-176, sponsored by Steve Zabawa of Billings, would make all marijuana use illegal in Montana.

If Ibsen is restricted to certifying just 25 patients a year, what will he tell the other 1,900 or so? Sorry?

“I don’t have to tell them I’m sorry,” he said. “I’m going to tell them to vote.”

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