cannabisnews.com: Prosecuting The Pot Doc





Prosecuting The Pot Doc
Posted by CN Staff on October 12, 2003 at 14:25:19 PT
By Ann Harrison
Source: San Francisco Bay Guardian
Berkeley medical marijuana specialist will lose his license if the drug warriors get their way.The Medical Board of California receives complaints against about 11,000 doctors every year, most of them generated by unhappy patients. But no patients have yet suggested they were harmed by Dr. Tod Mikuriya, California's foremost medical-community proponent of medical marijuana. In the board's current investigation of Mikuriya, all the accusations against him have been generated by law enforcement.
Mikuriya, 70, a Berkeley-based psychiatrist and author of widely read books and papers on therapeutic cannabis, has been accused by the Medical Board of "extreme departure from the standard of care" in 16 of his 7,500 medical cannabis recommendations permitted under the 1996 Compassionate Use Act (Proposition 215). Mikuriya is one of nine doctors being investigated by the Medical Board who together have written more than half the estimated 50,000 medical marijuana recommendations in California. In a series of hearings in Oakland last month, prosecutors from the state Attorney General's Office tried to prove the complaints against Mikuriya, which include negligence, incompetence, and furnishing dangerous drugs without prior examination. The doctor charges that he is the target of malicious prosecution by rogue law enforcement officers who are seeking to undermine California's medical marijuana laws. "Coming here is really quite dishonest because none of the patients have complained," Mikuriya said during his hearing. "They have all come from sorehead law enforcement people who could not prosecute and get me in their jurisdiction, and they have used the Medical Board apparatus to get back at me." Medical Board spokesperson Candis Cohen told the Bay Guardian she could not comment on the motivation of law enforcement in Mikuriya's case. But she acknowledged that "different views are held by different agencies regarding the validity of medical marijuana." Cohen said the board itself takes no position regarding the efficacy of medical cannabis. But the California Narcotics Officers Association couldn't be clearer about how its members feel. "Marijuana is not a medicine," the group says on its Web site, and there is "no justification" for using it as such. Cops play doctor In an apparent attempt to assume the role of doctors in determining just who is sick enough to use medical marijuana, California law enforcement officers targeted 48 of Mikuriya's patients in eight counties for arrest and investigation. Records for 45 of these patients were subpoenaed from Mikuriya, and 16 were examined. "These persons do not appear to have any serious medical problems," Sgt. Steve Mason of the Nevada Sheriff's Department Narcotics Task Force Office wrote in Mikuriya's investigation report. "The recommendations were issued not for a medical purpose, but as an excuse for their otherwise criminal possession, transportation and/or sale of a Schedule 1 drug," the report summary reads. Despite these allegations, the deputy attorneys general who prosecuted Mikuriya's case determined that testimony concerning interaction with law enforcement was irrelevant. Mikuriya charged in turn that they were holdovers from former state attorney general Dan Lungren's administration, which vigorously opposed Prop. 215. Prosecutors Larry Mercer and Jane Simon argued that the investigations should focus entirely on medical practice standards, the focus of most of the Medical Board's 2,000 pending cases. Presiding administrative law Judge Jonathan Lew largely agreed. "The defense has attempted to try a case other than the one we charged," Mercer said. "Regardless of the motivation of the complainant, a physician will only be disciplined if he or she has violated the Medical Practice Act.... This case is about if Dr. Mikuriya provided good medical care." "If we appeal this ruling to the Superior Court, it will be overturned," Mikuriya's attorney Susan Lea countered. "We were not allowed to bring in relevant facts." What standards of care?The Medical Board released a statement in January 1997 announcing that since marijuana is classified as a Schedule 1 drug under the federal Controlled Substances Act, "no objective standard exists for evaluating the medical rationale for its use." But the statement also says, "there are certain standards that always apply to a physician's practice that may be applied." The prosecution's expert witness, Kaiser HMO psychiatrist Laura Duskin, does not recommend medical cannabis and declined to interview Mikuriya's patients. But based on her review of their records, Duskin alleged that the psychiatrist failed to conduct adequate physical exams, specify treatment plans, order tests, and adequately document his cases. "From day one in medical school they teach us 'If you don't write it down, it didn't happen,' " she testified. But nine patients who testified on Mikuriya's behalf said the doctor carefully reviewed their medical histories and dispensed caring advice during his 15- to 20-minute exams. Many were visibly sick and brought records from other doctors confirming their illnesses. All were self-medicating with cannabis when they came to see Mikuriya. They included a man who said he had exhausted all other medical options for his disabling nausea. He said Mikuriya was the one doctor who took the time to thoroughly discuss his illness. "When you call Kaiser, a nurse takes your info, and they call you back, and you pick up some medicines," said the patient, who, due to medical concerns, was identified only by the initials R. B. Mikuriya contested the charge that he failed to perform adequate physical exams on patients. While he frequently does not touch patients or take their vital signs, the psychiatrist said he carefully observes their physical demeanor, asks them to fill out a research questionnaire, and relies heavily on their self-reported symptoms. Edward W. Miller M.D., a retired cardiac and thoracic surgeon and family practitioner from Marin County, notes that the type of scrutiny Mikuriya is undergoing is not applied to doctors who cut corners due to the demands of managed care. "If I go to Kaiser, I'm lucky to have five minutes with my urologist," Miller told us, adding that he was surprised to hear that Mikuriya still does house calls. "The care that he took, that has disappeared from medicine under this grab for the buck." Lying patientTestimony against Mikuriya by Steve Gossett, an undercover deputy sheriff, showed that doctors can be lied to. Gossett, who heads Sonoma County's marijuana investigations unit, traveled to Oakland medical marijuana clinic Marijuana Referral Services in January and lied about a shoulder injury, stress, and sleep disorder to secure a cannabis recommendation from Mikuriya. Gossett testified that he was coached through his intake form by a clinic staffer and later offered free samples of cannabis. John Fleer, an attorney for Mikuriya's malpractice carrier, Norcal Insurance, says Mikuriya was not aware of these actions, nor legally responsible for them. The psychiatrist, whose patients have a number of self-reported conditions such as migraine and back pain, says he assumes patients are truthful. Prop. 215 permits doctors to recommend cannabis for any illness for which marijuana provides relief – a clause Mikuriya wrote into the bill. But Dr. Philip Denney M.D., a family practitioner from Loomis, testified during the hearing that the Medical Board was attempting to enforce a set of standards against Mikuriya that do not yet exist. Denney, who recommends medical cannabis, argued that Mikuriya is conducting a "medical cannabis consultation practice," a new model of care that strictly determines whether patients have a medical condition for which cannabis might be a useful treatment. At the California Medical Association convention last March, Mikuriya offered a proposal for "minimum practice standards" for medical cannabis providers. Denney criticized the Medical Board for failing to embrace these guidelines, despite Mikuriya's repeated requests. Denney added that he was "scared to death" by the possibility of reprisals from law enforcement for testifying on Mikuriya's behalf. But he disputed the Medical Board's classification of cannabis as a "dangerous drug" and determined that Mikuriya had sufficient documentation to justify his cannabis recommendations. What's next?Cohen said the Medical Board and the CMA are currently "fleshing out" guidelines on medical cannabis practitioners. But if Judge Lew suggests the revocation of Mikuriya's medical license, the decision could have a chilling effect on the willingness of physicians to recommend cannabis for their patients – the key to upholding Prop. 215. Fearful of reprisal, only about 15 California doctors are willing to go public now with their medical cannabis recommendations. But asked by Lew if he would be willing to modify his practice to conform to a set standard of care, Mikuriya answered, "Yes! And I have some ideas." Lew will issue a proposed decision on Mikuriya's case by the end of the year, which will be voted on by the Medical Board. Source: San Francisco Bay Guardian, The (CA)Author: Ann HarrisonPublished: October 8, 2003Copyright: 2003 San Francisco Bay GuardianContact: letters sfbg.comWebsite: http://www.sfbg.com/Related Articles & Web Site:Tod H. Mikuriya, M.D.http://www.mikuriya.com/ Mikuriya Case - It's The Judge's Turn http://cannabisnews.com/news/thread17496.shtmlDr Mikuriya Defends His Practice http://cannabisnews.com/news/thread17264.shtmlDoctor Litigates With State Medical Boardhttp://cannabisnews.com/news/thread17224.shtml
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Comment #8 posted by Marc Paquette on October 13, 2003 at 06:34:25 PT:
I FULLY SUPPORT DR MIKURIYA
Thank you for your comment Max Flowers. Leaders of countries that doesn't care of the good and welfare of ALL it's citizens and acts in the sort, should be put behind bars or impeached! Since marijuana improves the quality of life of the sick and dying, and since marijuana never killed anyone, the only way I think to make it legal is declassification from narcotic to natural health product. In this way, our international drug conventions that were signed with the UN would still be respected. We could not say the same about cocaine and heroin which are narcotics and can kill. But, the whole prohibition idea is bad and not delbt with in a proper way. A government cannot wage war against it's own citizens through punishment and incacerations.As for the pharmaceuticals, I think they are pretty blind because there is more money for them to make if marijuana would be legal because there are over 6,000 strains of marijuana these days and each one of them is like a different medication. They could develop hundreds of new medications based on these different strains in co-existence with the actual good pharmaceuticals. An example of this is Professor Raphael Mechoulam (the discoverer of the THC molecule in 1969)which developed dozens of cannabis-based medications in Israel and they are very effective medicines. You can take a look if you wish on Professor Mechoulam's website which is posted as one of my 103 Super Links at www.medpot.net . I will add this link here.I think there is a greater threat to the paper and textile industries. The hemp or marijuana plant can become a tree in a summer! The textile industry would also take a hard hit with the hemp fiber...but they just have to ajust. The food industry would profit greatly because the oil in hemp and marijuana seeds is 8 times more nutritious than eggs! With this oil, they can make milk, cheese, ice cream, etc. Talking about a solution to the world's hunger?
Hemp can also make fuel. You probably knew all this :o)Peace,Marc
http://www.medpot.net
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Comment #7 posted by arthur on October 12, 2003 at 19:34:11 PT:
Virgil
dronabinol (Marinol)Drug description
Dronabinol is a synthetic version of substance called THC. THC is the active ingredient in Marijuana. It produces a high or stoned feeling but also stimulates appetite and soothes nausea. Dronabinol was approved by the government in 1985 for treating the nausea produced by chemotherapy in cancer patients. In 1992 it was approved for prescription to people with AIDS to stimulate appetite and combat weight loss.Side effects
The most common side effect is feeling euphoric or high. Other side effects include dizziness, drowsiness and abnormal thinking.Dosage
Dronabinol is sold in 2.5 mg, 5mg and 10mg capsules. Doses used in studies ranged from 2.5 - 20 mg a day.How long it may take to work
An increase in appetite 1-2 hours after taking drug would demonstrate that the treatment is working. Managing side effects
Side effects often go away after a few days of continued use. If they donít, taking the drug one hour before lunch and one hour before dinner often helps. If side effects continue despite this dosing schedule, taking one 2.5 mg capsule before going to bed has been successful in some people.This information is specific to the use of this medication for HIV-related conditions. For additional information about this drug for other conditions, refer to: www.nursespdr.com/The drug descriptions on these pages are intended for informational purposes only. The Network does not promote or endorse the use of any specific treatment for any health-related condition. The medications described here can only be dispensed by a licensed health care professional. The information may have changed since these pages were updated, though every effort is made to keep these pages current. Please contact The Network at (800) 734-7104 to make sure you have the most up-to-date information
 
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Comment #6 posted by arthur on October 12, 2003 at 19:21:24 PT:
Dr. Mikuriya
None of the patients who allegedly received sub-standard care from Mikuriya has filed or expressed a complaint against him (not counting an undercover narcotics officer from Sonoma County, whose name was added to the complaint after Mikuriya nixed the settlement offer).All the patients named in the Board’s accusation had been self-medicating with cannabis before consulting Mikuriya. Many have reported that Mikuriya was the first and only doctor with whom they could discuss the fact that they’d been using marijuana medicinally.It is a well-settled rule that the law varies with the varying reasons on which it is founded. This is expressed by the maxim: "Cessante ratione, cessat ipsa lex." This means that no law can survive the reasons on which it is founded. It needs no statute to change it; it abrogates itself. If the reasons on which a law rests are overborne by opposing reasons, which, in the progress of society, gain a controlling force, the old law, though still good as an abstract principle and good in its application to some circumstances, must cease to apply as a controlling principle to the new circumstances. See Beardsley v. City of Hartford, 50 Conn. 529, 541-42 (1883); see also Funk v. United States, 290 U.S. 371, 385 (1933) (Sutherland, J.) (quoting with approval the Connecticut Supreme Court's interpretation of the maxim); Marshall v. Moseley, 21 N.Y. 280,292 (1860) ("[W]hen the reason for the rule ceases, [judges] have the right to renounce it."). More recently, this precept was fortified by Justice Carro. See Thomas Crimmins Contracting Co. v. City of New York, 530 N.Y.S. 2d 779, 782 (1st Dept.. 1988) ("It should go without saying that when the reason for the rule ceases, the rule also ceases. ..."). 
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Comment #5 posted by Treeanna on October 12, 2003 at 18:46:37 PT
That's my Doctor :)
He is a great guy :)Very fierce too! We are enriched to have such a champion.
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Comment #4 posted by Max Flowers on October 12, 2003 at 18:26:10 PT
Marc
The answer to your question is that the Bush administration, and indeed every US administration, is not really all that interested in improving the quality of life for sick and dying people. Their interests instead lie in making their huge corporate lobbyist buddies happy and continuing the big sleazy graft party that's been going on for decades. The pharmaceutical industry plays a major role in this. They know what a threat legal cannabis would be to a huge part of their product lines. Lots of medicines that exist are filling the void that exists specifically because cannabis is not widely available to people. For example, I'm sure sales of PMS/menstrual remedies like "Midol" will plummet, never to return, once cannabis is available and destigmatized for women to use regularly. That's just one example, there are many, many more. Analgesics, anxiolytics, antidepressants, antispasmodics, antivirals, the list goes on and on and don't think for a minute that those guys (big pharm tycoons) don't know it damn well. They know their annual sales will crash once cannabis becomes legal. That's why they're such idiots that they're not trying to get in on the wave ahead of time.I hope that clears it up a litte Marc.cheers,
MF
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Comment #3 posted by Virgil on October 12, 2003 at 18:15:07 PT
Is this correct
The article released today makes the statement- Dronabinol is a synthetic version of delta-9-tetrahydrocannabinol (delta-9-THC), the active ingredient in marijuana. Isn't THC and dronabinol the same thing? Is the synthetic the same molecule as the natural? 
ACCP: Nebulized Dronabinol Has More Rapid Absorption than Oral Formulation
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Comment #2 posted by Marc Paquette on October 12, 2003 at 17:09:37 PT:
I FULLY SUPPORT DR MIKURIYA
I hope that he wins in court and keeps his license to practise his medicine. Marijuana is surely natural health product medicine. I'm legal for it in Canada since almost 4 years and 11 medical exemptions. When your liver is infected with Chronic Hepatitis C, cannot methabolize any pharmaceutical narcotics and medications without giving you excrutiating pain and make you puke...when you suffer from fibromyalgia with horrible muscle spasms, arthritis, chronic pain, cervical and lumbar herniation with that..marijuana is the only natural herb that will improve your quality of live and also increase the quantity of your life.Prohibiting the access to medical marijuana is genocide to the sick and dying. Saying that marijuana is not a medicine is pure ignorance. We must not forget that there hasn't been any marijuana deaths or overdoses reported anywhere in the world. The authorities are so hypocrit and lies so much that they associated the marijuana smoke with tobacco smoke. Tobacco kills 400,000 North Americans every year. Walters say that Canada's marijuana is a dangerous as crack..but crack and cocaine kills...alcohol too! All "legal" narcotics like Vallium, Percocets, Morphine, Flexiril, Demerol, Codeine and others are very addictive and can kill too. Why does Bush and the DEA ignores this? Why do they ignore relief and improvement of the quality of life for the sick and dying?
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Comment #1 posted by goneposthole on October 12, 2003 at 16:48:21 PT
In Dr. Mikuriya's own words
NON-MEDICAL DRUGS, SOCIETY AND MEDICINE: A PERSPECTIVE WITH SUGGESTIONSTod H. Mikuriya, M.D.originally written January 1968 Revised: August 6, 1974       Despite continuing efforts to suppress the practices of taking psychoactive substances other than alcohol through enacting and enforcing punitive laws, the number of illicit users continues to grow. Born out of the activism of the sixties, fed, nurtured and encouraged by the mass media, there is little else that we could expect form a generation that has learned form their elders and from TV commercials the benefits of taking psychoactive substances have been around for some time, the new fanciful semantics such as “psychotominetic”, “psychedelic”, “psychotoxic” and “fantastica” actively encourage interest and experimentation. These words produce expectations of exciting new, yet frightening worlds of introspection. Some advocates of these drugs imply, if not actively sate, that individuals who take these substances will learn new insights and thus grow toward self-individuation.      Defenders of the status quo, on the other hand, regard these non-alcoholic drugs with fear and describe them as destructive poisons of the mind, personality, or career. They understandably seek ways to suppress and discourage their use. This latter group is generally older and empowered with the ability to generate formal social sanctions; i.e. laws.      Somehow, in the climate of heated advocacy, scientific fact, medical knowledge and principles of human behavior are either distorted or forgotten. This is indeed unfortunate, as effective means of dealing with the situation are thus made impossible. The extent of ignorance throughout the general public as well as the healing professions staggers the imagination.      Much of the ignorance may be traced to false assumptions. One of these specious beliefs is that punishing individuals will deter them form the use of drugs. Lessons from the failure of prohibition in this country, with our continuing diet of the bitter fruits of organized crime nurtured under those experimental laws, seem to have been forgotten.      A corollary to the assumption that enforcement of punitive laws will deter the use of illicit drugs is that the nature of the “problem” is moral. While physicians, legislators, educators, and enforcement officials speak of non-alcoholic drug use as a “medical problem”, the nature of the rules of the game, wherein the user is defined as a criminal, contradict in a real and crippling way, such hypocritical statements. It would be interesting to compare the number of “social casualties” resulting from arrest and incarceration compared to the number of physical or psycholic disasters due to eth effects of non-alcoholic drugs.      This confusion of disease with moral transgression is, perhaps, the keystone of our current difficulties in dealing with the non-alcoholic intoxicants.      In order that a disease is amenable to treatment, both physician and patient should be in agreement as to the existence of disease. When the non-alcoholic drug user does not see himself as suffering from disease, he sill hardly be willing to submit himself to the rigors of “treatment” with coercion and incarceration of one kind or another. Currently, the physician finds himself in the uneasy situation of collaboration with enforcement where he becomes an “enforcer” himself. The Hippocratic Oath with its admonishment to “Above all, do no harm” is often difficult to reconcile with practices of imprisoning individuals for “treatment” who have chosen to use non-alcoholic drugs and who do not see themselves as patients in the usual sense.      It would appear that emphasis upon the choice of a drug in itself, in the definitions of drug abuse, is misplaced. It is unfair and incorrect that criteria of behavioral nature are applied to the abuse of alcohol, whereas the use of marijuana, LSD, mescaline, etc., per se, is considered to be abused.      Considering what is known scientifically about the effects of the various intoxicants, it is bizarre to overlook the ten million or so alcohol addicts and the over fifty per cent alcohol-involved traffic fatalities, while regulating this substance in lenient, casual manner. Although less is known concerning some of he other mind altering drugs, their effects on the body are no worse than alcohol. In many instances, especially with marijuana, the toxicity appears to be significantly less than that of alcohol.  Chromosomal effects with LSD or marijuana are, at this writing, not proven.      If rational principles are to be entertained in coming to grips with non-alcoholic euphorients and society, certain incisive steps must be taken:1.   It must be recognized that the individual has the right to introduce any substance into his veins, stomach or lungs. As with the ingestion of alcohol, the individual does not relinquish responsibilities for his behavior while under the effects of the substance.2.   Stringent restrictions must be placed on advertising of every psychoactive substance, including aspirin products, proprietary stimulants, proprietary tranquilizers and sedatives, alcohol and tobacco.3.   Enforcement functions must be limited solely to the tasks of preventing illegal diversion of psychoactive substances and ensuring purity, accurate labeling and freedom from adulterants.4.   Systems of regulation parallel with these as applied to alcohol and tobacco must be developed but with advertising strictly forbidden. Taxation, standards of assay and control of distribution are integral parts of such control methods.5.   The role of medicine is to educate and council society as to the dangers of drug dependence and toxic effects, and to treat inevitable individual casualties.6.   Development of massive educational programs for both the public and healing professions based on scientific fact must be undertaken without further delay.While these suggestions may not be feasible in our contemporary context ofignorance, advocacy, fear, and political expedience, it is hoped that leaders of circumspection and empathy may work towards the enhancement of society through recognition of, and respect for, the varied individual proclivities of its embers for the various practices.  Medicine must reassume its mandated responsibility to council society on hazards involved in the injudicious use of drugs with material based on scientific fact. Failure to do so will allow other entrepreneurial groups to further erode aesculapian authoritativeness by defining psychopharmacologic casualties as criminals.      We have seen over 60 years of failure to deal with non-alcoholic social drug use by enforcement, the courts, and corrections.      The enforcement-correction solutions to the drug problem have failed miserably with central policy-making a shambles. The country enters a period of malign neglect unless medicine can appropriately respond to the challenges.http://www.mikuriya.com/nonmed.html
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