Hawaii's Medical Marijuana Program
Hawaii’s medical marijuana program has sparked fierce debate over the past decade. Some view it—and use it—as medicine, while others contend it is a dangerous drug, widely abused. How does the program work, and who is involved?
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Registration and Compliance
If you have MS like Heede, you have to go through a bureaucratic process to become a medical marijuana patient in Hawaii. First, you must have one of the specified ailments, including glaucoma, seizures, HIV, AIDS, severe nausea, pain or muscle spasms. You must get your condition documented on your medical records. You then have to find a doctor willing to participate—many physicians don’t, for fear of legal repercussions. Heede’s physician didn’t, so she had to find one who did. Then you’d have to transfer your medical records, set up an appointment and then sometimes pay an office visit fee; some physicians charge $175.
Under the law, the physician must work with the Narcotics Enforcement Division, which oversees the medical marijuana program. Unlike most other states, Hawaii’s medical marijuana program falls under the state Department of Public Safety—the people who run law enforcement, prisons and jails—not the state Department of Health. After recommending you for the program, your physician mails an application to the NED offices, a clerk processes it and sends it back to the physician, who signs it and gives it to you. After paying $25, you then receive a blue, business-card-size registration permit with your personal information. Heede says she was first given a temporary permit—only one clerk handles the applications, so there’s a backlog. With your permit you can now own and cultivate up to seven marijuana plants—three that are mature, or flowering, and four that are immature—and possess three ounces of smokeable marijuana.
Getting the card took Heede six months. “I’ve never once had my paperwork processed in a timely fashion, either by the doctors or the NED. It is not a straightforward process.”
One of the biggest complaints from growers like Gonsalves and patients like Heede is the lack of access. While an MS or AIDS patient can legally grow and possess cannabis, they often have to acquire it illegally, since Hawaii law does not allow dispensaries. “Law enforcement would have you believe everyone knows a drug dealer, everyone knows where to find marijuana. I don’t think they’ve met these people who are totally legitimate citizens, who have never broken a law in their life,” says Ohta. “The reason they’re registering is they don’t want to do something illegal, they want to be legal.”
Ohta and others mistrust the NED’s supervision. “The Narcotics Enforcement Division takes an adversarial view of a program it administers. Its control of the program has been scary for both patients and physicians,” she says.
“We didn’t ask for it,” says Keith Kamita, the chief of the NED. Kamita has become the face of the law enforcement’s side of the program. Ohta and Heede say they would love to sit down and debate Kamita on his attitude toward the program his department runs. “It’s like putting the Klan in charge of civil rights,” adds Brian Shaughnessy, a paraplegic medical marijuana patient who smokes to alleviate muscle spasms, a condition of his paraplegia. It was the result of a surgery gone wrong when he was 24.
In Kamita’s defense, some people have fudged their applications or had more than the allotted seven plants. Maj. Susan Dowsett, who heads the Honolulu Police Department Narcotics/Vice Division, confirms this; however, there have only been three cases this year—two people exceeded the plant limit, while a third had an invalid permit.
Kamita also says the NED has noticed a lot of young people utilizing the program for pain—versus older adults with terminal or degenerative diseases and disorders for whom he believes the law was originally intended. “There’s a question of whether it’s severe enough for them to be in the program. If you go on the Internet and punch in ‘Hawaii medical marijuana’ you’ll see a lot of different ads popping up. Sometimes you’ll think, ‘What does this have to do with medicine?’” He is also wary of the participating physicians, especially those on the Big Island. “We have physicians in Hawaii who do this just as a business,” he says. “And you bring in crime with dispensaries [if we allowed them]. You’re not talking about care here, you’re talking about distribution.” He specifically mentions California’s program, which has earned the reputation for being the Wild West of cannabis; you could walk into many dispensaries and buy pot, no permit required.
“We know what doesn’t work with California; we can avoid it,” says Ohta. “Just because California is not running it right, doesn’t mean we can’t have a totally regulated process.” Ohta says she gets phone calls and e-mails from patients daily who have their blue cards but have no idea where or how to acquire cannabis. She recommends patients try to grow it themselves, or find and register a caregiver who can grow and harvest it for them. (A caregiver can only grow for one patient.) Even then, that isn’t always successful. Heede says she was too sick to grow the plants, and admits she bought weed from the black market before finding a caregiver. But for some, finding a caregiver—who is trustworthy, isn’t already growing for someone else and can grow marijuana—can be just as difficult. “A lot of patients [resort to] the illegal market,” says Ohta.
“I’ve tried to talk to my fellow legislators about making medical cannabis more accessible and it’s always very hush-hush,” says state Rep. Joe Bertram III. “We made it legal in 2000! It’s still a hard thing for people to understand.” Bertram continues to introduce bills to amend the law. He also is a registered caregiver for his friend who has MRSA (a bacterium that causes infections and is harder to treat because it’s resistant to commonly prescribed antibiotics). He currently doesn’t grow marijuana for his friend, another man on Maui does, but Bertram keeps his caregiver license, just in case. “You never know. It’s very uncertain.”