October 21, 2012

Just a few doctors in Maine appear to prescribe most of the marijuana

By Eric Russell erussell@pressherald.com
Staff Writer

Two years ago, Sharon Gagne of Greenbush discovered she had two herniated disks in her neck. Her doctor told her surgery was not an option and instead encouraged physical therapy and prescribed a painkiller.

click image to enlarge

Dr. Dustin Sulak speaks with a reporter at his Falmouth practice. Sulak, who also has a practice in Hallowell, is one of the most sought after Maine doctors to write prescriptions for medical marijuana.

"I didn't like that," she said. "I know too many people who got hooked."

Gagne, 44, eventually asked about other options. Her doctor referred her to Dr. Dustin Sulak, a Hallowell osteopath who has become known throughout Maine for his willingness to certify patients for medical marijuana. Gagne's physician sent her medical records to Sulak, who then spoke twice on the phone with Gagne.

Without ever having met her face to face, Sulak certified Gagne as a medical marijuana patient. Now, whenever she feels pain, she smokes a little or nibbles a baked good fortified with cannabis.

Gagne's case illustrates the seeming ease with which Mainers with certain conditions can receive medical marijuana. Gradual changes to state law in the past three years have deregulated medical marijuana to the point that there is no way to know how many people are using it, how many doctors are certifying patients for it, and whether the number of users is growing.

Indeed, some doctors are actively recruiting patients. Sulak's practice recently placed an ad in a weekly newspaper offering a $50 discount to students for medical marijuana evaluations.

On Sept. 28, 2011, according to data collected by the state, 263 Maine doctors had certified a total of 2,833 patients. The next day, a law took effect that rendered Maine's medical marijuana reporting requirements optional. That means patients and doctors don't have to check in with the state. Police say the loosened system has made their jobs harder too, because they no longer have access to information that tells them whether someone caught with marijuana plants is growing it legitimately.

There also is no way to know how many patients are being treated for a diagnosis such as terminal cancer, which has been a permissible condition since medical marijuana became legal in Maine in 1999, or for something like intractable pain, which was added as a condition in 2009 as part of a broad expansion of the state's medical marijuana law.

Gordon Smith, executive director of the Maine Medical Association, said recent changes have made it nearly impossible to assess the program.

"Before, we had a handle on it; we could track progress," he said. "Now, we have nothing."

John Thiele, who oversees the medical marijuana program for the Department of Health and Human Services, conceded that the system is far less regulated than it was two or three years ago, but he said it seems to be working. To date, no complaints have been made to the two boards that licenses doctors and no penalties have been handed down for improper use, state officials said.

Thiele did say, however, that a small percentage of Maine doctors appear to be prescribing the majority of medical marijuana in the state.

"I'm not sure that's what the law intended," he said.

History in Maine

Medical marijuana has been legal in Maine since 1999, when more than 60 percent of voters approved a statewide citizens' initiative. The goal was to allow patients with certain debilitating conditions to grow and possess a small amount of medical marijuana for therapeutic use.

Some studies show that marijuana is safe and effective as a treatment for certain conditions. Other studies are not as conclusive. Last week a federal appeals court for the first time heard arguments about whether marijuana should be reclassified from a dangerous drug to a drug with potential medical benefits. That wouldn't necessarily lead to its legalization, but it would change public perception, advocates say.

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