When Del. Dan K. Morhaim is in the emergency room, he can administer cocaine to anesthetize a patient. But he cannot write a prescription for marijuana as a pain reliever or nausea remedy.
That's just one of the flaws in Maryland's narrow medical marijuana law that Morhaim (D-Baltimore), an emergency physician at Sinai and Northwest hospitals in Baltimore, is out to fix during next year's legislative session.
"Physicians prescribe drugs that have risks and benefits, and we make those judgments all the time," he said. "There's a whole method of accountability and responsibility and constraints that control that."
While budget discussions will take center stage in Annapolis, medical marijuana advocates believe the momentum for their cause has never been greater.
U.S. Attorney General Eric H. Holder Jr. has said federal narcotics agents will not crack down on pot dispensaries or prosecute users in states where the drug is allowed for medicinal purposes, reversing a Bush administration policy.
And last month the American Medical Association shifted its stance in urging the federal government to reclassify marijuana as a Schedule II controlled substance, which is less restrictive than the Schedule I group it is currently in, alongside Ecstasy, heroin and PCP.
"Public perception has indeed been on our side," said Michael Meno, a spokesman for the Marijuana Policy Project in Washington. "There are still those politicians that still think it's politically risky to come out in favor of laws that will protect sick and dying patients from arrest."
Under current state law, Marylanders can be arrested and charged for possession of marijuana, but they can avoid jail time and receive a maximum $100 fine if they can prove they have it for medicinal use.
In the proposal, companies that want to grow the plant would have to bid for a license and be regulated by the state to ensure it is being done in a safe location and properly manufactured. Producers would then give a portion of gross sales revenue to the state.
Regardless of the drug's potential upside, marijuana contains potentially harmful carcinogens, said Del. Adelaide C. Eckardt, who was a nurse for nearly three decades.
She recently visited a hospice facility in Salisbury where the subject of legalizing marijuana came up in a conversation with a physician who was wary about the lasting effects on patients and favored newer pharmaceutical approaches.
"You can get a quick relief from inhaling many things, but the issue is the management over time," said Eckardt (R-Middle Shore). "He was of the opinion, as I have been, that there are certainly other interventions in which you don't have to deal with adding more toxins to the body."
For Morhaim, it boils down to the medical value that marijuana offers and giving physicians another tool to prescribe when appropriate. Doctors wouldn't administer it to combat an upset stomach, he said.
"Marijuana, to me, is just another medication. It has risks, it has benefits, it has side effects and appropriate uses when other things don't work," he said.
December 23, 2009