Physician, patient, voters offer I-182 viewpoint

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Valley Journal

MONTANA — On Nov. 2, 2004, voters of Montana passed Initiative 148, legalizing the use of cannabis as medicine for various conditions and diseases. The vote was 62 percent yes to 38 percent no. It eliminated criminal sanctions for medical cannabis authorized by a patient’s physician.

Patients were able to choose a caregiver to assist in obtaining the medicinal plant and dispensaries were established throughout the state, enabling a larger group of patients access. Patients were required to carry a medical card determining their eligibility that would be issued by their physician.

On July 1, 2011, Montana’s senate passed Senate Bill 423 which repealed the original medical marijuana act voted in by Montana’s citizens. The new bill put restrictions on both physicians, limiting doctors to 25 medical marijuana patients in a 12 month period, and also on distribution of cannabinoid medicines limiting caregivers to the distribution of only three patients; making it harder for Montana residents requiring medical marijuana to be treated and prescribed cannabis based medicines and angering many citizens.

Arguments include the cruelty of denying patients a safe medicine vs. opiates, which have dangerous side effects and addictive properties, and also from of the side of citizens that simply believe the government overstepped boundaries by overturning and changing a voted in bill.

With I-182 on the ballot this election, voters will have the opportunity to overturn SB 423, easing the restrictions to allow physicians to treat more people and for patients to safely attain cannabis prescriptions.

Dr. Michael Uphues is a Billings based physician hoping to educate the public about the benefits of medical use of cannabis. As a family physician that is also certified in cannabinoid medicine through the American Cannabis Institute, Uphues’ other specialties include osteopathic manipulation therapy, opioid addiction therapy, men’s health and hypnotherapy. He is also a certified personal trainer.

Uphues’ interest in Cannabinoid Medicine began in the 1990s while working on the Fort Peck Indian Reservation treating patients as both a family and emergency room physician. When a cancer patient of his was arrested after being pulled over by the police and was found with a small amount of marijuana the patient had been using to combat the effects of chemotherapy, Uphues decided to pursue the medical uses of marijuana.“He was suffering from a lot of nausea, decreased appetite and pain issues as well so he would use cannabis to alleviate those effects with, of course, great success,” Dr. Uphues said. “They threw the book at him and ultimately I think he got out of it but it was after much expense and going to court. And I thought this was silly. I mean you’ve got a cancer patient and (cannabis) is the only thing that’s helping him. There’s never been a documented death from cannabis overdose in the history of man.”

A couple of questions that have been plaguing the debate is why marijuana has such stigma surrounding it and why cannabis therapy is used by only a handful of doctors in the state. Dr. Uphues believes that a mixture of history, lack of education and strict political statures in the medical community stops physicians from exploring cannabis as an option.

The Marihuana Tax Act of 1937 might help to explain some of the historical mistrust around the use of cannabis both medically and conventionally.

Harry J. Anslinger, head of the Federal Bureau of Narcotics, believed the use of marijuana had increased to “dangerous levels” among US citizens and proposed a taxation making it illegal to sell cannabis or even hemp products without purchasing a tax stamp. This new tax law made it virtually illegal for all but a few hemp producers to sell or even possess any form of the plant, including physicians who were currently treating their patients with cannabis regimens.

Dr. William Creighton Woodward, legislative counsel for the American Medical Association, objected to the bill on the grounds that it had been drawn in private without giving the AMA time to prepare their own opposition. He noted the AMA had found no evidence of addiction, overdoses or violence with the use of cannabis and argued because the word “marijuana” was a rarely used word at the time that the doctors had no idea they were losing the right to administer cannabis to their patients, stating, “Marijuana is not the correct term, yet the burden of this bill is placed heavily on the doctors and pharmacists of this country.”

Hemp made from the fibers of the marijuana plant had also been widely used to make fabrics, rope and other textiles. Some argued that an ulterior motive of the Marihuana Tax Act was to slow production of hemp to make room for big companies like DuPont, which at the time had political figures invested in their company, to move their new nylon products. Others believed it was due to the fear of hemp being a cheap alternative to timber used in paper manufacturing and still others believed that the smoking of marijuana induced hysteria, crime and mental illness in the youth of America. The latter was reinforced to the public with films like “Reefer Madness” used as documentaries, which sent misinformation to parents, teachers and law enforcers.

Today’s critics still question how cannabis therapy can be used for such a vast array of conditions including cancer, PTSD, pain, MS, glaucoma among many other diseases.Dr. Uphues is happy to explain.

“The Chinese, back 5,000 years ago, had 100 different uses for cannabis,” he said. “I’ll tell you why. It’s because in our bodies we have what’s called the Endocannabinoid System. We make our own cannabis.”

There are two cannabinoids that humans make, Dr. Uphues said. One is called Anandamide, the other is called 2-AG. There are also two receptors that have been identified in the human body. One is called the CB1 receptor or Cannabinoid One and the other the CB2 receptor. Cannabinoid One receptors are primarily in the brain while CB2 receptors are primarily in the immune system: the spleen, all the lymph nodes, the gut, the liver, all over the body.

“The cannabinoid receptors are responsible for mediating our metabolism and all of our metabolic functions so it’s no wonder that it has that many uses,” Dr. Uphues said.

By the 1980s the “War on Drugs” was in full effect and programs such as D.A.R.E as well as TV ads labeling the use of marijuana as a “gateway drug,” further fueled the public’s negative view of the medicinal properties of cannabis, and with a Schedule One drug label — lumped together with drugs such as heroin, morphine and codeine — the argument has been that marijuana is dangerous, addictive and can cause adverse effects on its users, although morphine and codeine are prescribed every day.

Dr. Uphues disagrees and in fact uses cannabinoid therapy for opiate addictions to help ease withdrawal symptoms. He said in his experience cannabis has actually been a “gateway off these things.”

“Everybody hears about these opioid or heroin overdoses and the reason that people die from these overdoses is because in the mid brain, where your respiratory center is located, there is a very rich concentration of receptors or places for opioids to attach to,” he explained. Medicines like hydrocodone, oxycodone, morphine, fentanyl and heroin attach to these receptors. “If you take too much (of these drugs), those receptors in the respiratory center get saturated with the opiate and then slows down and will stop people’s breathing. That’s how people die from an opiate overdose,” Dr. Uphues said. “In that same area of the brain, there are relatively no receptors for cannabis. So if it can’t attach there, it can’t kill you.”

For patients, I-182 means much more than historical facts or medical terms. For cannabis therapy patients, it could mean relief. For Polson resident Kimberley Rosalez, relief couldn’t come soon enough. After suffering from migraine headaches since the age of 10, Rosalez has been prescribed a multitude of medications and treatment programs. “I’ve tried a whole double column page of things to alleviate the migraines or prevent them,” she said. “I’ve been on anti-seizure medications, I’ve been on high blood pressure medications, I’ve been on anti-depressants to try and treat the migraines and I’ve been on Triptans which were designed specifically for migraines.”

Rosalez, who also suffers pain from fibromyalgia and arthritis, said the side effects she has tried have ranged from severe nausea to suicidal thoughts. Also, she said some medications did nothing for her pain. She has been using medical cannabis for a about a year and a half and said her pain has significantly improved.

“Before I started using the medical marijuana, I was taking a minimum of 30 Vicodin, which is an opiate pain reliever and I was taking 30 a month,” Rosalez said. “Now with the medical marijuana I’m down to less than two a month.” Rosalez also explains the difference between the opiates and cannabis as almost a freedom not just from the pain but also from the medication itself. She said the opiates would cause a haze that could last up to 24 hours but with the cannabis, after three or four hours the effects wear off and if her migraine has subsided, she is able to continue on with her day and perform tasks she wouldn’t be able to do with the pain or the haze of the opiates. And, Vicodin gives her an allergic reaction.

What I-182 means for both the patient and the physician is the ability to cultivate and create medication - making it easier for the patient to obtain. There are also safety regulations on the production process - carrying a guarantee that the product was produced organically and pure — something you can’t get by turning to the “Black Market.”

Dr. Uphues believes Black Market cannabis can be dangerous with added chemicals and also creates an environment where patients decide their own prescriptions without a physician to help them understand the different strains and dosing procedures. “I’ll give you a great example of the dangers,” he said. “We happen to know of a person who was growing illegally and it wasn’t the cleanest environment and he would have a spider mite problem in his plants and he would spray his plants with Raid and then sell that to people. That just shows you, when you have no quality control, it’s not just the type of cannabis you don’t know you’re getting but also what they put on the plant, poisons, pesticides and so forth.”

Why should non-patients and citizens of Montana I-182 be concerned with a bill that may not pertain to them?

Uphues and Rosalez both believe voters’ rights have been violated and the people of Montana have been deceived.

“In 2004 the voters voted it in and in 2011 the congress, single handedly and very deceptively slipped in 423, so basically they went against the will of the people,” Dr. Uphues said. “They have taken a law that people have voted in and they single handedly do away with it by deception and just by abuse of their power. I think we need to send them a strong message that when we vote for something, we mean it and it is to remain there.”

Uphues believes I-182 shows compassion for the sick and dying people of Montana.

The other reason people should be voting for it? “God forbid they ever need it,” Dr. Uphues said. “Believe me, I would never want a patient to need it but I’ll tell you what, it has been a very safe alternative for people and much more effective and not as addictive.”

For Rosalez, the reason voters should consider I-182 is clear. “I’ve been very vocal about it and I’ve been urging everyone I know to vote for I-182,” she said. “I hope in the future that as more research goes forward ... that people will more widely accept it.” She added that once the stigma has been overcome, she hopes people “will accept it as a medication, which I believe it truly is.”

As for SB423 she added, “I just think it’s sad that so many of us have lost our dispensaries or our providers, especially after Montana voted for medical marijuana use and I just think, it’s bordering on criminal that we don’t have access to our medication at the moment.”