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CORRECTION -- 09/03/09 -- In a Sunday Living story about medical marijuana, a Metropolitan Police Department spokeswoman described buying an ounce or less of marijuana seeds from another country through the Internet as legal. However, federal law prohibits the mailing of marijuana seeds. Obtaining seeds or clones, for free, from another medical marijuana cardholder is the only legal way for Nevada cardholders to begin growing their own marijuana. In addition, the last name of Dr. Paul Michael was misspelled.

MARIJUANA AS MEDICINE: Legal process requires paperwork, overcoming physician resistance

DOCTORS SAY THERE ARE MORE EFFECTIVE WAYS TO TREAT GLAUCOMA

The debate over the legalization of marijuana in Nevada overlooks one significant detail: It's already legal.

An estimated 1,530 Nevadans have obtained permission to lawfully possess and use pot since NRS-453A was signed into law in 2001, according to the Nevada State Health Division. (Nevada is one of 13 states with a medical marijuana program.)


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  • But a medical marijuana card does not read: "Get Out of Jail Free." Medical marijuana can never legally be purchased, or smoked in a public place. It must be grown and inhaled (or ingested via baked goods) at the cardholder's residence.

    The process begins with a written request and $50 check sent to the state Health Division in Carson City. This gets prospective patients an application and a physician's statement that must be taken to a doctor willing to recommend marijuana. (According to FDA guidelines, it's a Schedule 1 drug, which makes it illegal to prescribe.)

    The legal conditions recognized by Nevada to medicate with marijuana are restricted to AIDS, cancer, glaucoma, weight loss, severe nausea, severe pain, seizures and persistent muscle spasms. (Each has a box on the form for the physician to check.)

    If the application is approved by the Health Division, patients then pay a further $150 processing fee, which covers a background check for the one crime that will get them rejected: selling, or intending to sell, a controlled substance.

    After fingerprinting, notary public and Department of Motor Vehicles fees of about $20 each, the DMV issues a card good for one year. (The card must be renewed annually for another $150 fee and signed physician's statement.)

    The trickiest part is finding a doctor. Most will not sign off on the card, according to Bruce Mirken, spokesman for the Washington, D.C.-based Marijuana Policy Project advocacy group.

    Las Vegas ophthalmologist Dr. Kent Wellish, director of the Wellish Vision Institute, and oncologist Dr. Paul Michaels of the Comprehensive Cancer Centers of Nevada have never signed off -- although both are occasionally asked.

    Wellish said laser treatment and the eyedrops Xalatan, Lumigan and Travatan are much more effective for glaucoma.

    "For marijuana to work, the patient would have to be stoned around the clock," he said. "When you're not stoned, the pressure goes back up, and that's when damage occurs to the optic nerve."

    Michaels prefers Zofran and Compazine for the short-term nausea associated with chemotherapy. (He said that marijuana has "no effect whatsoever" on cancer pain.)

    Michaels has prescribed marijuana to five of his chemo patients with long-term nausea, but only in the form of Marinol pills, which concentrate the drug's active ingredient, THC, and do not require a medical marijuana card.

    "Marijuana inhalation or baking is not a good idea," Michaels said. "Funguses and bacteria grow on plants very easily, and sometimes you don't kill them with heat. And the immune system of chemo patients is shot, so they're more susceptible."

    Difficulty finding a doctor is why advertisements for medical marijuana appear in the back of Nevada's alternative weeklies.

    "We stand behind you and your right to choose alternative medicine," read a recent CityLife ad from the Hemp and Cannabis Foundation. An ad on the same page from DrReefer.com announced: "Get legal today!"

    These companies -- which charge $200 to $300 on top of the required fees -- promise to refer patients to sympathetic physicians such as Dr. Rabia Ahmed, who practices at the Hemp and Cannabis Foundation's clinic at 10161 Park Run Drive. (Ahmed would not respond to the Review-Journal's request for an interview.)

    Ivan Goldsmith, an internal medicine physician who operates three valley medical centers, said he has recommended marijuana for all six of the customers referred to him by DrReefer.com.

    "They all qualified and have appropriate radiographic or medical records to justify the recommendation," he said.

    Goldsmith calls marijuana "highly effective" and said that studies back him up.

    "The research is now catching up that the cannabinoid system is very important in a lot of body functions," he said. "They're finding that if you stimulate the cannabinoid system, you can block neuropathic pain."

    When asked to respond to the opinions of Drs. Wellish and Michaels, Goldsmith said doctors frequently disagree on diagnoses, and that all safe options should always be available for them to try.

    Once Nevadans receive their cards, one step remains. Unlike California, Colorado, New Mexico and Rhode Island -- which permit convenient medical marijuana dispensaries -- Nevada requires that patients grow their own. The law limits each cardholder to seven plants on his or her own property: three mature and four immature. Another Nevada resident can be designated to grow for a marijuana cardholder, but that grower must obtain a card, too.

    The difficulty of growing one's own marijuana transcends the plant's finicky light, heat and moisture requirements. It happens to be illegal to sell seeds in the United States. (Not even DrReefer.com or the Hemp and Cannabis Foundation offer to help with this problem.)

    The only legal ways for cardholders in Nevada to begin growing, according to Metropolitan Police Department public information officer Barbara Morgan, are to purchase an ounce or less of seeds from another country via the Internet, or to obtain seeds or a cutting from another plant, for free, from another cardholder.

    Once cardholders meet all the above requirements, police officers cannot detain them for any suspicious green baggie found during a routine traffic stop -- as long as that baggie weighs less than an ounce and the motorist doesn't appear under its influence.

    "I wouldn't be surprised if it happens quite often," Morgan said.

    Even if patients don't have their cards on them, they're not arrested, because the DMV notes their existence in its computer record.

    This begs the question of how many, if any, medical marijuana patients are actually illegal drug users who exaggerate or fake medical symptoms to get impunity for their habit.

    "Every medication has potential for abuse," Goldsmith said. "But a patient can easily go on the street, buy the marijuana and not seek medical evaluation. So if he has enough moxie to come in and want to do it through legal channels, you have to respect that."

    When asked for her take, officer Morgan replied: "All we do is enforce the law. We can't personally have our opinions."

    Contact reporter Corey Levitan at clevitan@reviewjournal.com or 702-383-0456.

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    adrienne wrote on November 18, 2009 02:44 AM: medical marijuana helps people with lots of life altering diseases amd disorders, i recently found i have Crohns disease which is a life long challange of food and the intestines and bowls. it helps me with nausea, helps so i can eat because crohns makes u loose weight rapidly. it helps with the pain of some bowl movementsthat leave me nauseous and very dizzy. And before i obtained my card or even knew what crohns disease was i still used marijuana to help with these symptoms unfortunently it took me almost dying from perfriated intestine and emergency surgery and 1foot of intestine removal for a medical dr. to take me seriously about my symptoms of this condition. Just a suggestion to all non believers think back when we didnt have dr or medicines dummed up by pharmisudical companies to make us even sicker and or dependent there was holistic medicine, our creator has put everyhting we need to surive on earth, chemicals in the medications often cause worse side effects than the symptoms, and that is wrong. The drug companies know exactly what they are doing. I suggest finding a dr that also believes in holistic side of healing not just text book cuz in my expierience my holistic healer has helped me more than any dr could. They are"Practicng" medicine..


    Granville Savidge wrote on September 23, 2009 11:17 AM: This problem of ignorance, marijuana inexperience, and suspicion is systemic.

    In Medical Colleges, often for very practical reason, Doctors are programmed and driled to deal within the box.

    They are in bed with convention and the "pharma" industries. They have a hard time dealing with anything that may invoke "congative dissonace" as they must be right as lives are depending upon it.

    Just look to the progress made in Isreal and Canada and the lack of progress in the US medical studies. Doctors must be made aware of their own bias instead of being silent or yesed to death. I want a doctor that I can feel safe telling about current drug usage. They should know to better do their job. Too bad when they have the all too typical zero tolerance it actually means "don't tell me" to avoid the issue.


    Tom Hamilton wrote on September 09, 2009 12:27 PM: I don't know anything about glucoma, all I know is that marijuana when smoked,(or better yet eaten, in cookies, cakes, brownies,etc. works quite well to keep my stomach from becoming upset from medications, thereby allowing me to keep much needed food , and medications, down and effective inside my body, rather than thrown up,rendered ineffedtive, and flushed down the toilet. I think MANY Doctors Know that Marijuana IS INDEED EFFECTIVE, and will sell out and say otherwise, for other than medical reasons. (possibly to sell new and often more dangerous drugs for their kick-backs


    mvieira wrote on September 07, 2009 08:50 PM: Nevada Marijuana Policy Regulation:

    Personally, I feel that Nevada’s Policy on medical marijuana is very effective. The process of obtaining pot seems extensive and quite drastic as well as ridiculously expensive and a huge hassle. It seems almost easier and not as pocketing to buy it illegally. Although, I like the intense system; it keeps the “posers” away. The background check is a wonderful idea. The one part I disagree with is the expenses, but that comes along with any drug prescribed today. I feel that if someone is in that much pain to where they will use an “illegal” drug, they really need it. Let the dying patient some slack and let them smoke some pot!

    Should the federal government legalize marijuana? What benefits or drawbacks would that pose to society?

    I think marijuana should be legalized for certain cases. Last year, my grandfather died from stage 4 cancer and everyday I looked at him with his eyes drowning with tears from the pain he had to endure everyday. His last 2 months of his life were in a hospital bed, covered with IV’s and medicine that did not do him much good. In those types of situations, I think an individual has the right to smoke whatever he or she wants. I don’t necessarily think it will benefit our society or have any drawbacks. To me it is that simple; if you are in that much pain at the end of your life getting high will not hurt you anymore than the damage done previously.


    Eddie Gin wrote on September 06, 2009 06:23 PM: "For marijuana to work, the patient would have to be stoned around the clock," he said. "When you're not stoned, the pressure goes back up, and that's when damage occurs to the optic nerve." Isn't that what we are talking about?


    reno wrote on September 03, 2009 07:01 AM: we have medical and scientific proof that medical marijuana does help chemo/cancer patients as well as many other ailments and illnesses, what proof {if any} do they have that it doesn't? in the pros and cons of medical marijuana, the pros have given full proof of it's potential, the cons have yet to give us any proof that it does'nt except for thier own private opinion, which can't be weighed as evidentual proof.


    Kevin Lee wrote on September 03, 2009 05:32 AM: Dumber by the second. Yeah that seems to fit you.Maybe that's why you don't seem to understand that just because a doctor chose to specialize in a certain field , it does not exclude the fact that the doctor in question DOES happen to be one of the LEADING internists in Las Vegas. Enjoy your next visit to your Proctologist!


    stacey wrote on September 02, 2009 08:32 PM: I am very sick. I have lupus sle, for starters, and it has attcaked my digestive system, I have herniated and torn disc's in my back ,etc... The only other thing that helps is marijuana,not only for the pain but for my nausea,etc...


    Dumber by the second wrote on September 02, 2009 01:50 PM: Kevin Lee, so your new doctor is a pediatrician? LOL!!!


    David wrote on September 02, 2009 11:52 AM: PFIZER is paying a $2.3 BILLION FINE for its illegal kickback scheme to Doctors. There's one of your Drug Lords and the Doctors are the dealers! What kind of f*cked up world is this?

    Marijuana works better that all the chemistry that the Pfizer chemists can cook up.

    http://uk.biz.yahoo.com/02092009/325/factbox-pfizer-settlement-drug-promotion-compliance.html


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