On Easter Sunday, Havre's Townhouse Inn featured a brunch buffet of medical marijuana leaves and oils.
That day more than 100 people meandered through the Hi-Line hotel's conference room — some curious, some serious — where a traveling medical marijuana clinic delivered a doctor to their door.
These days events such as the one in Havre are the tip of the iceberg. Medical marijuana is a growing business in Montana, where patients authorized to use it can be found in all but two counties.
In the last year, the number of licensed patients statewide increased from 2,000 to more than 12,000.
The April issue of the pro-marijuana magazine High Times pronounced Montana as the place to get a "Big Sky High."
The dramatic increase in the number of licensed patients is probably fueled by the Obama administration's decision to not prosecute medical marijuana patients under federal law and by traveling medical marijuana clinics that give people access to doctors who see marijuana as a safe alternative to some traditional prescription medications.
"It kind of eased people's minds about participating in it," said Chuck Council, spokesman for the state Department of Public Health and Human Services, the agency tasked with licensing patients and providers. "Through word of mouth, it just started spreading around."
Voters passed the Montana Medical Marijuana Act in November 2004 — with 62 percent approving the measure — making the state the 10th in the country to legalize cannabis as medicine. Four more states have taken the step since then, and similar legislation or initiatives are pending in 14 other states.
Potential patients in Montana were cautious at first — possibly unsure of whether they would be prosecuted under federal law, under which marijuana is considered a Schedule 1 narcotic. Another factor in the small number of patients earlier on is that few doctors were willing to risk their licenses to suggest marijuana as an option.
The number of licensed medical marijuana patients climbed slowly at first. Then the Montana Caregivers Network began its traveling clinics, which provide education on the law and access to doctors willing to help patients get their card to legally possess and use marijuana.
Last September, the month before the Obama administration's announcement regarding enforcement, 735 Montanans signed up to use medical marijuana.
That was almost six times as many people as signed up for a license in September, 2008 but the enforcement announcement opened the floodgates — nearly 8,000 licenses have been issued in the five months since that announcement.
The distribution of Montana's medical marijuana users is roughly proportionate to that of the population, but there's one noticeable anomaly: Gallatin and Missoula counties together account for about 30 percent of Montana's medical marijuana users, but only about 20 percent of the state's population.
Otherwise, a little more than two-thirds of Montana's medical marijuana users live in the six counties where a slightly more than two-thirds of all Montanans live.
Nearly nine out of 10 patients list chronic pain or a combination of chronic pain, muscle spasms, seizures and nausea as their reason for obtaining their patient certification, according to state statistics.
The statistics also show that 21- to 30-year-olds make up the biggest 10-year age segment of patients, followed closely by people in their 50s. Patients in their 20s and baby boomers combined make up more than half of all licensed medical marijuana patients in Montana. The average age of medical marijuana patients in the state is 41.
"Younger folks are more inclined to consider alternative and herbal remedies," Montana Caregivers Network spokesman Doug Chyatte said. "That's what marijuana, or cannabis, is."
Jim Gingery, executive director of the Montana Medical Growers Association, said people in their 20s and 30s are the most likely to work in construction and other jobs that are prone to injuries.
Some younger patients use marijuana to calm seizures resulting from quitting dangerous drugs such as methamphetamine, he added.
On the other end of the age spectrum, one of Gingery's patients is a Vietnam veteran whose legs were crushed when his helicopter was shot down. Traumatized, the man hadn't slept peacefully in years until finally he started using medical marijuana in baked goods.
"There's nothing more rewarding as a caregiver than to hear, 'That worked. I'm finally able to live life again,'" he said.
Though other groups are contemplating traveling clinics, the Montana Caregivers Network is the only one currently bringing doctors who endorse marijuana as medicine to communities across the state.
The group, which is based in Missoula, opened its doors a year ago.
Within its first six months of operation, the network advised approximately 5,500 people on obtaining medical marijuana cards. In the months since, that number has grown to more than 14,000 people.
While only about 100 people checked out the clinic in Havre earlier this month, Chyatte said a typical crowd in Montana's bigger cities is 800. He noted that about 1,000 people waited to meet with one of the three doctors made available during a clinic in Billings.
Chyatte said the network works with 30 doctors, many of whom have private practices. An additional 25 employees staff a call center to answer questions and arrange traveling clinics.
The doctors are able to see so many patients at a single daylong clinic because they're not diagnosing a condition — the patient's regular doctor does that — Chyatte said.
Potential patients don't always have to bring their medical records to the traveling clinics to get a doctor's endorsement, Chyatte said, but doctors do ask for medical records when a patient's condition isn't obvious.
Doctors don't prescribe marijuana, and pharmacies aren't allowed to carry it. The doctors only confirm that a patient has a condition that could be treated with marijuana.
"We have a core group of doctors that are very up to date on their research," Chyatte said. "The doctors understand their role. If you really want medical cannabis treated as a legitimate alternative, you have to treat it responsibly. These doctors are not going to risk losing their license."
Chyatte said the Montana Caregivers Network is beginning to see the number of patients coming to clinics plateau.
However, he said there will always be a need for traveling clinics because state law requires patients to renew their licenses annually.
Lately the network has been branching out into the state's smaller communities, including those in eastern Montana. In addition to Montana's seven biggest cities, stops on the May tour include Shelby on May 11, a return trip to Havre on May 13, and clinics in Sidney and Miles City.
The success of the traveling clinics prompted the Montana Caregivers Network to recently begin offering "teleclinics" between 8 a.m. and 9 p.m. On average, 80 people a day visit with a doctor using an Internet camera.
The organization charges $150 for a doctor visit, but offers discounts for low-income patients and veterans. People can pay in installments, but they won't get a doctor's approval to get a medical marijuana card until the bill is paid.
Chyatte said the state-licensed nonprofit Montana Caregivers Network takes in a lot of money, but it also has a lot of expenses, such as paying doctors and necessary lawyers, travel expenses and rent for facilities used for the clinics.
Any money above the network's costs goes into further educating patients and people who have misgivings about medical marijuana.
"The money generated is phenomenal, and it enables us to help a lot of people," he said.
With its high profile clinics, the Montana Caregivers Network comes under fire from medical marijuana advocates and skeptics alike.
Aaron Wittmer, an officer with the Hi-Line's Tri-Agency Drug Task Force, said he saw four people he previously arrested on drug charges waiting to see a doctor during one hour of observing the clinic in Havre.
At least one of those people — a prospective informant — got a medical marijuana card that day.
"We're not selling tents or T-shirts here," Havre City Councilman Andrew Brekke said. "This is a plant that's highly regulated. We need to treat it with respect. This should not be an assembly-line deal."
According to the state, 295 doctors have signed off on patients' medical marijuana cards. Of those, 14 doctors have more than 100 card-carrying patients and another 23 doctors have between 20 and 100 patients.
"I don't think it's even arguable that people are going to those (traveling clinics) and getting cards that are not the type of patients we were led to believe this program was about," said state Narcotics Bureau Chief Mark Long.
Long noted it is easier to get marijuana today than it was before 2004, but added that he believes prescription pills are more often abused and are more dangerous.
The idea of improving access to doctors isn't what bothers Lincoln's Hiedi Handford. A patient herself, she watched the negative community reaction in Great Falls after Montana Caregiver Network founder Jason Christ was pictured in the Tribune smoking marijuana in front of the Civic Center.
"Making people aware is good, but scaring people is bad," Handford said. "There are people who see it as the traveling toke show. We need to give people a true face of medical marijuana patients."
It's difficult to find a doctor in many small Montana towns, let alone one open to medical marijuana.
Handford, 43, knows how difficult it is. She approached her family physician — a doctor who delivered both of her children — asking to be approved for medical marijuana.
"His answer wasn't no," she said. "It was 'hell no.'"
Handford worked for the state years, scanning water rights claims into a computer. The repetitive motion caused minor carpal tunnel syndrome and severe tendonitis. She said she lost her job in February 2009, when the pain made it impossible to do the work.
She said the anti-inflammatory drugs she was prescribed tore up her digestive system and pain pills made her feel dopey.
Her search for a doctor took time — the state tracks which doctors endorse medical marijuana cards, but those names are confidential.
Handford finally found a doctor more than 100 miles away in Victor who would endorse a card. She waited four months for an appointment.
She finally got her patient card in July, but then had no idea where to buy the medicine she wanted. She eventually found a caregiver in Livingston.
She now knows of two caregivers in Lincoln — a sign of the industry's growth and expansion to more rural communities.
Chyatte said the traveling clinics are important for people in rural areas.
"There's a great injustice in Montana, that people have been denied access to a doctor," he said.
"If there are not enough physicians willing to make the recommendation up front, then we need those traveling clinics," Gingery said.
City and county governments across Montana, are struggling with whether and how to regulate the medical marijuana business as the number of caregivers and patients drastically increase.
Last week, the Kalispell City Council voted to ban any additional providers in the city in the aftermath of a killing linked by police to medical marijuana.
County commissioners and law enforcement officials across the state worry that if cities ban caregivers, they will move into more rural areas.
Montana's smaller cities and towns are at a loss as to how to regulate medical marijuana as they have fewer resources and many small communities don't even require businesses to have a license to operate.
The Choteau City Council considered creating such licenses as a way to bring caregivers out into the open so police and fire officials could inspect them to make sure they are safe and following the law, but feared the license requirement and fee would discourage other types of businesses.
Havre's City Council wrestled with the issue in front of packed and contentious audiences for the past month — in contrast to many of its regular meetings, at which only a news reporter sits in the audience.
"Under the law, there are very few ways local government can regulate this," council member Brekke said. "We can't stop it. We can't change it. We can't ban it or any of these things."
A moratorium was considered, but the council eventually passed an ordinance forbidding people from selling medical marijuana from cars or carts.
Handford fears that the broad bans will push out the businesses that are working hard to follow the law. Patients will still get cannabis, but they will buy from the dozens of caregivers who deliver rather than supporting a local business.
The majority of certified caregivers have one patient, usually themselves.
But a few caregivers, such as Lewistown's Ron Young, have set up storefronts hoping to make a business of selling medical marijuana.
A self-proclaimed beat-up carpenter, Young used marijuana to treat injuries suffered in a 40-foot fall for many of the 20 years he lived in Alaska.
He opened the Cannabis Center of Central Montana on Jan. 1, and for the last four months has cultivated 58 plants, clones and seedlings.
Young hopes to have his first sellable product available by mid-May for the 16 clients who have registered him as their provider. He said his patients range in age from 45 to 71.
"A lot of them have beat-up bodies like mine," Young said. "They want brownies — it's a whole lot better for them than taking prescription pain pills."
Lewistown requires new businesses to get a license and Young happily paid the $55 fee and invited police and firefighters into his business to make sure the building was up to code, he was properly licensed and he had the number of plants allowed by law.
His plan is to sell healing herbs, creams and lotions, and work with a naturopath, in addition to being a licensed medical marijuana caregiver. In the fall, he plans to teach patients how to transplant marijuana and will give other clinics on various strains of medical cannabis.
Lewistown City Council members are planning to tour Young's shop as they weigh potential zoning ordinances that would affect medical marijuana businesses.
Young said he has seen out-of-state providers swoop in to make a quick buck, and he recognizes that some regulation is needed.
"It's going to take some time for everybody to digest it," he said. "I stay out of all these gray areas. I do my best to keep the local police and the City Council involved."
Handford started Montana Connect Magazine as a way to educate medical marijuana patients and the public about the law and the medicinal use of cannabis.
She writes articles about edibles, such as brownies, containing marijuana; encourages patients to develop relationships with their caregivers; and connects patients, doctors and providers.
The idea is to provide people with all the information she didn't have when she became a patient less than a year ago.
The magazine also has forced her into some small-town politics.
To promote the magazine, she "outed" herself on Facebook. Two hours later, when she picked up her child at school, a classmate pointed and shouted that Handford uses drugs.
"There are always going to be people that think I'm peddling drugs out of the back of my car," Handford said, pointing out that she is a patient, not a provider. "If I wasn't doing a magazine, I'd still be under a rock. How I manage my health care is my business."
Another patient in town came to her in fear after hearing that a volunteer firefighter announced that he was going to get rid of all the drug dealers in town.
"Go get 'em buddy, I'm on your band wagon. But medical marijuana is perfectly legal."
She added that she worked with a Lincoln electrician to train the fire department so it could inspect caregivers' growing operations.
"People shouldn't be afraid of it for God's sake," she said. "I remind people that Montana was a state founded by pioneers. These are your pioneers now — they're pioneering a new industry."
By KIM SKORNOGOSKI
April 25, 2010
Great Falls Tribune
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Medical marijuana boom raises questions across Montana