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Boulder Magazine Winter/Spring 2009-2010 Medical Marijuana, Colorado Green Relief: Growing Pains Behind the "Pot Amendment" Story and Photos by Geof Wollerman In May 2008, Steve was in a car accident. One of his vertebrae was shattered, and surgery left him with two rods and 12 screws in his back. Once out of the hospital, he began taking the prescription painkiller Percocet—sometimes 10 a day. After three months he began cutting back, rapidly reducing his intake to a couple of pills a day. Nausea followed. Then he stopped taking the painkiller altogether, which is when he awoke in the middle of the night.
“Inside every one of my joints in my body, it itched,” says Steve, who lives in Longmont. “I was like, ‘What’s wrong with me?’” He realized it was the Percocet; he had developed a physical addiction and was now experiencing withdrawal. Despite the pain and discomfort—he went days without sleeping—he refused to take any more pills: “I just knew I needed to stop.” These days Steve finds relief with medical marijuana, which he describes as “a little more gradual and not quite as intense” as painkillers. “For me it’s a better alternative,” he says. And it’s legal. Thanks to Colorado’s Amendment 20, approved by voters in 2000, Steve is registered with the state, grows his own “medicine” and acts as a “primary caregiver” for a handful of other “patients.” The Language of the Law According to Amendment 20, a patient is anyone with an approved debilitating medical condition who has a recommendation from a doctor. The amendment allows patients to designate a primary caregiver who can grow or provide medicine for them. A primary caregiver is defined as a person other than the patient or the patient’s physician who has “significant responsibility for managing the well being of a patient.” However, the question of exactly what “significant responsibility” entails is central to the ongoing debate over how to regulate medical marijuana—a debate that is not likely to be resolved until Amendment 20’s language is more clearly defined.
Since 2000, state officials have tried, without success, to limit the amendment’s scope, and several municipalities have placed moratoriums on “dispensaries”—the storefronts that provide pot to registered patients. (In Boulder, until the City Council can establish permanent regulations, new dispensaries are prevented from opening up near schools, daycare centers or each other, and they are not allowed to operate in residential zones.) Dozens of them have opened across Colorado in the past year, with some estimates putting the total number of dispensaries at more than 100. Because dispensaries are not specifically mentioned in Amendment 20, the issue now being addressed by the state and local communities is whether they are legal and, if so, how they should be regulated. If the word “dispensary” is not in the amendment, should dispensaries be allowed to operate? According to Brian Vicente, the director of Sensible Colorado, a nonprofit medical-marijuana advocacy group, the answer is yes. “I’ve talked to the guys who wrote this law,” Vicente says. “They absolutely did have dispensaries in mind. The law sets up a system of caregivers who can sell medicine to patients, so it seems to make sense that they can do that in a storefront location.” The problem, Vicente says, is that the term “dispensary” wasn’t in use when the law was written. “The writers just kind of worked with what they had in terms of the language,” he says. “A dispensary is a caregiver.” Language interpretations aside, one thing has been made clear in recent legal skirmishes: The state cannot limit a patient’s right to access marijuana, and any regulatory move that infringes on that right will likely be met with a lawsuit. Boulder County District Attorney Stan Garnett says his office is not interested in pursuing prosecutions of dispensaries, but that some kind of regulation of the industry is in order. “I think it’s inevitable,” Garnett says. “The problem is figuring out how to do it.” Smoke Report: ‘Hey Man, the Blueberry ... ' Boulder Alternative Medicine is a dispensary located on Boulder’s University Hill. After checking in, patients are admitted to a waiting room that resembles most doctors’ offices, except for the television in the corner. Patients are called individually into the storeroom, where they get to peruse available strains and discuss the merits of each with an employee. To discourage resale, everything is sold in grams, with prices ranging from $6 to $20 per gram (the going street price of high-grade marijuana is a little more than $14 per gram), and patients are not allowed to buy large quantities, something the Boulder Police Department appreciates. Cookies and brownies made with THC, or tetrahydrocannabinol—marijuana’s active ingredient—are also available. A “smoke report” hangs on the wall, and patients can comment on the effects of particular strains. “We get people that are like, ‘Hey man, the Blueberry—I gained like five pounds!’” says co-owner J.P. Stoermer. BAM is an “open model” dispensary, which means it will serve any legally registered patient. Other dispensaries are private and will only serve patients who are part of their care network. Open models are the norm these days, Stoermer says, in part because patients are beginning to realize that they themselves have “value.” Indeed. By designating a private dispensary as a primary caregiver, a patient is allowing that dispensary to grow an additional six plants—the number of plants each patient is allowed under the law. Depending on yields from those six plants, one patient can represent thousands of dollars in additional revenue for a dispensary. These days patients aren’t “signing that over so freely just to join a club,” Stoermer says.
Because BAM does not grow its own marijuana, it helps introduce patients to caregivers who do. Some of these caregivers are interested in developing different strains that could target patients’ specific symptoms. The dispensary prides itself on the relationships it maintains with these caregivers, Stoermer says. “We know all of them. We trust them,” he says. “If people are coming here and the meds are crap, it’s going to be all over the Internet … it’s going to impact business.” And right now, business is good. “There are days when the waiting room’s packed with people,” Stoermer says. “It just comes in waves.” Despite the brisk business, BAM has no plans to expand. Stoermer says he is satisfied with the dispensary’s model and its relationship with law enforcement; he doesn’t want to upset anyone or push any legal boundaries. Still, he realizes that regulation may be on the horizon and he says BAM is prepared to act accordingly if the state redefines the role of dispensaries. For the moment, he and his business partner are just happy to help out. “We see people every day that are so thankful, so happy that we’re here.” A World of Pain More than 13,000 patients are on the medical marijuana registry, which is run by the Colorado Department of Public Health and Environment. The department estimates that it receives hundreds of new applications every day, and it is, in part, this rush of interest, coupled with the rise of dispensaries, that has lawmakers clamoring for regulations. The top three conditions declared by patients are: severe pain (90 percent), muscle spasms (27 percent) and severe nausea (23 percent). Advocates for tighter regulation say it is suspicious that so many people complain of severe pain. However, many caregivers I spoke with, including Steve, say the pain complaint makes sense. Larry Eckstein, M.D., who practices general and holistic medicine in Boulder, has written medical-marijuana recommendations for about 30 of his patients. “In my practice—because I don’t see patients with AIDS or cancer—pain management is usually the most common reason I will sign off on the marijuana registry,” Eckstein says. Some of these patients don’t want to take synthetic pain medication, or they want to reduce the amount of pain medication they’re already on, Eckstein says. Others want to alleviate side effects of their conditions, such as nausea, loss of appetite, muscle spasms or sleep difficulties.
“It all depends on the patient,” Eckstein says. “You look at what’s wrong, what they need, what’s worked for them before.” Eckstein might be willing to recommend marijuana to certain patients, but he is highly skeptical of any patient who comes to him with an “agenda.” “If someone comes in just to get on the marijuana registry specifically, I usually don’t see patients like that,” he says. “I don’t just have a marijuana sign-off practice.” Here to Stay Like most of the patients and caregivers I spoke with, Steve, who asked not be identified by his last name because he grows in his basement in a residential neighborhood, was growing and using pot before his accident. And like most of the patients and caregivers I spoke with, Steve doesn’t have a problem with legalizing marijuana altogether. In fact, some opponents argue that medical marijuana is just a step toward eventual legalization. And they may have a point: Are these ex-stoners really medical patients, or do they just enjoy getting high? In Boulder County, where 6 percent of the state’s population is home to 11 percent of the state’s medical-marijuana registry, the answer is probably a little bit of both. Whether you agree with medical marijuana or not, your neighborhood might have a dispensary in a few years, and one of your co-workers already may be licensed to grow a few plants at her house. If Boulder’s approach to regulation is any indication of how other municipalities will handle the issue, there will probably be a distinction made between small home-based caregivers, commercial storefronts and large growing operations, and zoning laws will regulate all of them. There’s also the possibility that the state will take over, dispensing marijuana itself and collecting the much-needed tax revenue that this growing industry is sure to provide. One thing’s for sure: Barring a voter revolt, medical marijuana is here to stay. “If you’d asked me two years ago, I’d have said ‘We’re in for a long road,’” says Vicente of Sensible Colorado. “Now I think we have reached the tipping point.” He notes that 15 state legislatures are considering medical-marijuana bills this year, and polls suggest that a majority of the country supports some kind of patient access to marijuana. “You do see a lot of science coming out about the efficacy of marijuana as medicine for treating Alzheimer’s, preventing cancer, all kinds of stuff,” Vicente says. “It makes sense that people would want to talk to their doctors about it.”
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