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Minutes from March 11, 2005 Meeting

Attending: Dr. Akbar, Dr. Bannister, Dr. Cotsirilos, Dr. Ellis, Dr. Hergenrather, Dr. Lucido, Dr. Mikuriya, Dr. O’Connell, Dr. Toy, Fred Gardner, Dale Gierenger, John Trapp, and Michael Trapp

Introductions, accomplished round table.
Review and approve agenda, so approved.
Review and approve minutes, minutes approved.

O’Shaugnessy’s Journal – Fred Gardner
The Reich case special issue was presented & distributed, with much praise by all. 15,000 issues were printed. Mr. Gardner discussed printing problems and the need for an art director/layout person. He also discussed distribution and the need to highlight patient education as a caregiver function of dispensaries. O’Shaugnessy’s is also available on the CCRMG website in partial form and most distribution will be completed in the next three weeks. Subscriptions will no longer be taken as Mr. Gardner is only committing on an issue-to-issue basis. He is aiming for a Summer issue after the Reich decision and one for the ICM meeting in the Fall. Fundraising was discussed and there was a clear consensus to make O’Shaugnessy’s a financial priority, as this is the only forum for this type of information. Dr. Denney spoke on medical marijuana at a medical school and there was support for a speaker’s bureau to raise funds and awareness. Dr. Bannister announced his annual benefit for his legal defense fund on June 3-5 and offered to make CCRMG a beneficiary next year if it makes a profit.

Medical Board Updates – Frank Lucido
Dr. Lucido gave updates on the 11/5/04 and 2/18/05 regular Medical Board meetings as well as the 1/21/05 special meeting of the Board on the enforcement monitors and the 2/22/05 meeting between the Medical Board leadership and Senator Figeuroa’s committee all of which are posted on www.medboardwatch.com. The 1/21/05 special meeting involved the entire Board including division of licensing. The largest problem was identified as the length of time to pursue cases. The enforcement monitors, “independent contractors” directed by the Medical Board legal staff, are promoting “vertical prosecution” where more investigations will be moved to the Attorney General’s office. The Dr. Lucido made public comment that this change would eliminate doctor participation in investigations. Despite several objections presenters cited “unanimity of opinion” and urged the Board to “focus on the concept and not the details” and the plan was accepted. During Senator Figeuroa’s all public comment went against the enforcement monitor’s proposals. One complainant testified that prosecutions were too slow to remove bad doctors, but not cannabis physicians which is a “witch hunt”. Dr. Lucido raised the issue of the “revolving door” between the Medical Board, Attorney General’s office, law enforcement, and possibly the DEA. Dr. Mikuriya handed out and discussed copies of the city of Sunnyvale’s Planning and Management System (PAMS) and it was discussed as a model of quantifiable goal based planning and accountability. Dr. Mikuriya has contacted Senator Figeuroa’s office to try to schedule a meeting to discuss and Dr. Lucido will join him in those efforts.

California Research Programs Update – Dale Gieringer
Mr. Gieringer, advisory board member to CMCR, reported that there has been little progress on the research programs. Most studies are still recruiting patients at a rate of one or two a month because of the sharply defined populations and California patient’s ability to get higher quality cannabis than is available in the studies. Some studies may be completed by the end of the year. Dr. Abrams pilot study on Aids-Neuropathy should have some preliminary results and his vaporisor study is going quickly and there should be some results this summer. The office staff is extremely cautious and there will be no press releases until studies are published. Mr. Gieringer suggested an epidemiological study based on the huge pool of existing medical marijuana patients and one researcher was interested, but office staff did not take it up. CMCR has used up their funding with only money set aside for existing studies. The University of Massachusetts is seeking approval to grow marijuana for research purposes, as NIDA cannabis is inadequate. There was also discussion on Ramonaban, a cannabis antagonist drug and Dr. Mikuriya reported on his submission of objections to the FDA from CCRMG. Dr. Bannister discussed 300 pain patients who have an average pain reduction of 4 on a 10-point scale from using cannabis. An epidemiological study was discussed, with MPP being a potential funding source, and Mr. Geiringer agreed to work on a proposal if an experience epidemiologist were willing to work on the project.

Data Collection and Research – Jeff Hergenrather
Some doctors are using new forms with a clause allowing non-identifying information to be used for data analysis of cannabis using patients. Approximately 3,000 patients have completed the latest version of the shared forms. The Health and History Questionnaire has not yet been posted on line, but will be shortly. The coding of ICD-9s was encouraged, as this is the only readily usable data without massive data entry. The International Cannabinoid Research Society is accepting abstracts until 4/1/05 for their meeting in Leyden on 9/5/05. Dr. Hergenrather wants to do a paper next year.

DBAs SCC and CCRMG
DBAs were obtained for both names. John Trapp put out a call for submissions for a statement of purpose for SCC to be posted on the website.

Outreach to Cannabis Clinicians beyond California – Tod Mikuriya
Dr. Mikuriya discussed Dr. Wolman’s and Dr. Sterner’s cases which were both DEA investigations. Dr. Mikuriya met with the attorney in the Sterner case and learned urinalysis and a psychiatric interview were stipulated. Dr. Fry settled her case, pleading at the state level, and was given a $1,500 fine and ordered to take a record keeping class. The DEA agent in the case was not forthcoming under cross-examination and the DEA physically removed patient records and submitted them to the Medical Board. Dr. Bannister completed his probation. Dr. Mikuriya has changed attorneys and is continuing with his appeal.

New Business

MedicoLegal Practice Standards – Frank Lucido
Minimum Practice Standards/Credentialing – Dr. Mikuriya
Dr. Lucido reported he sent out an email and published in O’Shaugnessy’s on practice standards. He discussed his own standards, highlighting the need to avoid association with dispensaries. Chains and franchises were discussed. For example, UMCC in LA has three doctors’ offices at their dispensary and advertises on youth oriented radio stations. Medi-Can was de-listed from the Cal-NORML website of cannabis physicians. No dispensaries in the Bay area have on-site doctors. Dr. Hopkin’s case was discussed as another example. One of his marijuana patients was on trial and Dr. Hopkins exercised his 5th Amendment rights after the DA stated he was handing out marijuana recommendations like candy. MedicoLegal practice standards will help protect patients while Minimum Practice Standards will help protect doctors from the Medical Board. Only CCRMG/SCC has the credibility and standing to move on credentialing. There was some discussion on what the process for credentialing would be. Levels of membership, some demonstration of knowledge of the law and facts on marijuana, and the need to bar cross referrals, real and hidden, were all discussed. A Credentialing Committee, headed up by Dr. Lucido, was created. Dr. Bearman was proposed as a member as well as an attorney (Panzer and Figeuroa were suggested). There was also some discussion on the voluntary state ID card. The law requires confidentiality but the process being created involves a secure website the police can access as well as the state sending out the ID cards further eroding confidentiality. SCC took a position of maximum confidentiality and Dr. Hergenrather was empowered to create and distribute a draft position for SCC on this issue.

Next Meeting
The next meeting will be held on Friday June 17, 2005 at 11:30 am 513 El Cerrito Plaza.
Bring your own bag lunch.

The meeting was adjourned.

 

 

 

 

O'Shaughnessy's
O'Shaughnessy's is the journal of the CCRMG. Our primary goals are the same as the stated goals of any reputable scientific publication: to bring out findings that are accurate, duplicable, and useful to the community at large. But in order to do this, we have to pursue parallel goals such as removing the impediments to clinical research created by Prohibition, and educating our colleagues, co-workers and patients as we educate ourselves about the medical uses of cannabis. Read O'Shaughnessy's Online
 
SCC
The Society of Cannabis Clinicians (SCC) was formed in the Autumn of 2004 by the member physicians of CCRMG to aid in the promulgation of voluntary standards for clinicians engaged in the recommendation and approval of cannabis under California law (HSC §11362.5).

As the collaborative effort continues to move closer to issueing guidelines, this site serves as a public venue for airing and discussing these guidelines.

Visit the SCC Site for more information.