Medical-marijuana maze is tricky

August 21, 2006

Maureen O\'Hagan, Seattle Times

Every week, the ad runs on the front page of the Little Nickel:

If you have chronic pain, chronic nausea, muscle spasms, seizures, cancer, AIDS, medical marijuana may help.

Call the number in the ad and you'll find a local clinic where, for a fee, a doctor will write a note saying he believes the illegal plant will help what ails you.

Not long ago, such a business plan likely would have the cops asking a lot of questions. But for two years, The Hemp and Cannabis Foundation has been operating the Bellevue, Wash., clinic completely aboveground, seeing thousands of patients.

It has Washington's 1998 medical-marijuana initiative to thank for that. The law, approved by 59 percent of voters, said people with certain debilitating conditions could use marijuana so long as their doctor said it could help.

The biggest question has always been this: How is a sick person supposed to get the stuff?

"People in the government want the pot fairy to come deliver it," said Douglas Hiatt, a lawyer who crusades on behalf of medical-marijuana patients.

He laments -- curses, actually -- that medical marijuana still isn't a part of the mainstream, that sick people with doctors' authorizations are still getting charged with crimes, that some police officers don't even remember that the law was passed.

Ad Hoc Network

Despite the problems, however, patients are finding their way to marijuana. Over the past eight years patients and entrepreneurs have pieced together an ad hoc network of products and services ranging from cookbooks to co-ops to classes that help patients get their voter-approved medicine.

Parts of this world are discussed only in whispers. Others are quite open.

None is perfect.

Ask Hiatt about The Hemp and Cannabis Foundation's Bellevue clinic and he'll roll his eyes. "Pothead capitalists," he calls them. "Doc-in-the-box."

Indeed, if you look around the clinic, that's pretty much what it seems. You won't find any examining tables. There's not much aside from several dozen chairs, piles of file folders and buckets of pens. That's really all you need for the business model devised by Paul Stanford, president of the nonprofit that oversees clinics in Washington, Hawaii, Oregon and Colorado. Altogether they've seen 14,000 patients in four years, he said.

The organization's financial filings for 2003 show revenue of $352,000 -- and for most of that year, its only operation was in Oregon. "It just kind of snowballed and we're doing pretty well," he said.

A marijuana advocate since the 1980s, Stanford, of Portland, long ago realized that a lot of doctors are skeptical of marijuana. Providing a friendly doctor, he thought, would fill a niche. He placed an ad and soon hired Dr. Thomas "Tim" Orvald, a heart surgeon.

Stanford's clinics do not provide marijuana. Instead, they exist solely to provide doctor's notes for patients who qualify.

A good chunk of their business comes from the 1-inch ad in the Little Nickel.

On a typical day, Orvald sees 30 to 40 patients. (The clinic is open just one or two days a week.) Patients first must show medical records that prove they've been diagnosed with one of the conditions covered under the law. They'll fill out a bunch of paperwork and watch a video that provides information on everything from growing marijuana to jury-rigging a heat gun and a dimmer switch to make a pot vaporizer.

Then a nurse gives a brief physical. Finally, the patient sees Orvald, who after confirming the patient has a standing diagnosis that's covered under the law, writes a letter stating he or she could be helped by marijuana. The charge is $150 to $200, depending on income, although Stanford said they see some low-income patients free of charge.

Patient Co-Ops

Patients are also provided a list of organizations that might help them find pot.

Green Cross. Emerald Cross. The Wormhole.

These are just a few of the patient-run clubs throughout Washington.

Commonly called co-ops, they bring patients together to get their "medicine." Exactly how that's done usually isn't discussed openly.

That's because it's easy to run afoul of Washington's medical-marijuana law. It doesn't legalize the sale of marijuana, even to qualified patients. And patients can grow it only for themselves. The exception is that patients can designate a caregiver, who can grow for them and only them.

This leaves the co-ops playing a game of semantics. Patients don't buy their marijuana; they make donations. Growers don't sell it; they're patients helping other patients. Even the larger-scale operations are labeled "P-patches," where several patients tend to the crop.

The co-ops have helped thousands of patients. But to some, this route isn't all that comforting. Hiatt said one Seattle P-patch was busted by police last year; prosecutors are still deciding whether to file charges.

In addition, patients say they're sometimes provided poor-quality marijuana; some complain about "moldy pot." Quantities are variable.

Mark Wachter, a 46-year-old multiple-sclerosis patient from Renton, Wash., who uses the drug to battle constant pain, has encountered all of that.

"You feel pain coming on, and you know a lot's riding on this coming through," he said.

Meanwhile, all the patients want is a straightforward way to get what the voters said they could have.

"The frustrating part to me is being a sick person and having to go out and find my medicine," Wachter said. "It's not like you can go to Bartell's (drug store)."



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