Journal Staff Writer
PROVIDENCE — Last month, the Department of Health gave the go-ahead for the opening of three medical marijuana dispensaries that were authorized in large part to give patients a safer and more accessible way to obtain what the federal government still classifies as an illegal substance.
But the opening of the dispensaries may not necessarily make it easier for patients to get marijuana. Thanks to a law enacted by the General Assembly in the waning days of last year’s session, most information about the medical-marijuana program, including the names of doctors who certify patients for marijuana-use cards, is now secret.
As a result, patients who want to obtain medical-marijuana are depending on word of mouth to find a doctor in Rhode Island who’s willing to certify their need.
“They’re not going to be able to find them in the Yellow Pages, that’s for sure,” says Steven R. DeToy, spokesman for the Rhode Island Medical Society.
There are currently 465 doctors who have certified 3,351 patients for the five-year-old medical-marijuana program but, since the Health Department and the Medical Society are prohibited from making referrals, they’re telling patients to go to the Rhode Island Patient Advocacy Coalition (RIPAC), the support group for medical-marijuana patients.
But RIPAC doesn’t give out doctors’ names to people who come to the group.
“That would hurt us. Most doctors don’t want to be identified as marijuana docs,” says the organization’s executive director, Joanne Leppanen. “So it’s a very serious problem right now. We can’t give out a list of doctors without their permission.”
If a patient comes looking for a referral, “we tell them to ‘Go to the doctors who’ve managed your pain in the past.’ But many doctors are not comfortable with cannabis.”
The 2010 change in the law that now makes it illegal — punishable by up to 180 days in prison and a $1,000 fine — for any government official to disclose marijuana doctors’ names was supported by some of the state’s most passionate open-government advocates: Sen. Rhoda E. Perry, D-Providence; Rep. Edith Ajello, D-Providence; and the Rhode Island Affiliate of the American Civil Liberties Union.
“The original intent of the law [that took effect in 2006] was that physicians would receive the same degree of confidentiality as they would when prescribing any other kind of medicine for any other type of patients,” Perry explained in a recent interview.
But not every lawyer who read the law felt the confidentiality provisions were all that clear.
Early last spring, when a reporter for The Providence Journal asked the Health Department for the names of all physicians who’d certified patients for medical marijuana — and the number of patients each had certified — Bruce McIntyre, a veteran legal counsel for the department, decided that while the law clearly made patient and caregiver names confidential, it did not do the same for names of the doctors. So last March, the department released the names of the 355 doctors who’d at that point signed certifications. The reporter began calling some of the doctors. A front-page story was published. Listed in the story were the names of 21 doctors who’d certified at least 10 of their patients.
An uproar ensued. Doctors started calling the Medical Society, the Health Department and Perry to complain. The ACLU, the Medical Society, the Rhode Island State Nurses Association and RIPAC wrote a joint letter to Dr. David Gifford, then-director of the Health Department, excoriating the department’s release of the doctors’ names.
“Our organizations are writing to express our deep distress and concern over your department’s recent significant breach of confidentiality under the state’s medical-marijuana law,” the letter began. “There can be little question about the impropriety of the department’s actions … it is indisputable that the list of names the department released came directly from the ‘supporting information submitted by qualified patients,’ information that is designated ‘confidential’ in no uncertain terms.”
But in reply, McIntyre said the “protected list” only applied to patients and their caregivers. If there was an interest in protecting the confidentiality of physicians as well, the law needed to be amended and the Health Department would support the change, he wrote.
An amendment to the law was quickly drafted and in rapid-fire fashion passed both chambers and became law last June — without then-Gov. Donald Carcieri’s signature. It makes clear that any information about specific medical-marijuana patients, their doctors and caregivers were exempt from disclosure under the state’s public records act.
“It had a really chilling effect,” Perry said of publication of the physicians’ names.
One doctor whose name was published because he’d certified 100 patients isn’t approving anyone for the program anymore. He’s put up a large sign in his office announcing this to his patients.
Annemarie Beardsworth, spokeswoman for the Health Department, said some doctors were upset at the publication of their names “because they do not want to be viewed as ‘pot docs.’ I think some are also aware that there are some very opposing opinions about the medical-marijuana program. I think if you look at the entire patient population, there are probably some patients in your practice opposed to medical marijuana.” Doctors, Beardsworth said, don’t want to perhaps “risk losing those patients” who are opposed to medical marijuana.
Dr. Todd E. Handel, a Pawtucket physiatrist who specializes in pain intervention, says he’s been practicing for 12 years and that there is a stigma attached to certifying patients for medical marijuana. About 5 percent of the patients he sees ask him to approve them for the program but he says he signs off on only about 2 percent. He says he’s not “a pot doc” but a real doctor, and real doctors “don’t want to have a practice that involves just writing for medical marijuana. All of us fear we’re going to have the type of practice you see on TV where every 15 minutes, patients are coming in just to have a medical-marijuana certificate.”
Handel said there are other reasons physicians were upset over the publication of their names: fear that the federal government would take action against their licenses or their medical-malpractice insurance would be canceled if an insurer found out they were certifying patients to use marijuana. “It’s difficult to assess patient risk” for medical-marijuana because unlike other controlled substances, you don’t prescribe dosage or have any way of monitoring patient use or misuse of the drug, Handel said in an interview. He says he’s made it clear to RIPAC that he doesn’t want any referrals.
Rhode Island is among several states that make the doctors’ names secret. But in California, doctors who approve patients for medical marijuana are falling over each other advertising their services –– in storefronts, fliers and over the Internet.
Condition Number Pct.
Agitation related to Alzheimer’s disease 3 0%
Seizures, including epilepsy 31 1%
AIDS or treatment 37 1%
Glaucoma or treatment 39 1%
Positive status for HIV or treatment 97 2%
Cachexia or wasting syndrome 112 3%
Hepatitis C or treatment 210 5%
Cancer or treatment 218 5%
Severe nausea 262 7%
Severe and persistent muscle spasms 720 18%
Severe, debilitating, chronic pain 902 22%
Other 1,392 35%
Total conditions cited 4,023 100%
Note: Some conditions overlap
Source: RI Department of Health as of 3/18/2011
01:00 AM EST on Wednesday, February 16, 2011
By Philip Marcelo
Journal State House Bureau
PROVIDENCE –– A Providence lawmaker has again submitted a bill that would phase out the practice of using individually licensed suppliers, known as caregivers, to grow or keep marijuana for patients, as well as close what he says are significant loopholes in the state’s medical-marijuana laws.
The proposal, which state Rep. John M. Carnevale, D-Providence, submitted on Tuesday, would require that, effective Jan. 1, 2013, the growing and selling of medical marijuana would be allowed only in state-sanctioned dispensaries known as compassion centers.
The state Department of Health is in the process of selecting the group that will open the state’s first such center.
Under the current medical-marijuana law, a patient legally allowed to use marijuana can either grow the plant at home (up to a maximum of 12 mature plants) or he or she can designate a “caregiver,” an individual who is licensed to grow marijuana in larger quantities (up to 24 mature marijuana plants). A caregiver can only provide marijuana for up to five registered medical-marijuana patients.
Carnevale says his bill, which he first submitted last year, would address the abuse and crime that have plagued communities since the enactment of the Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act in 2006.
Last year, Carnevale, along with fellow retired Providence police officer and former state Rep. Joseph Almeida, submitted the bill close on the heels of a Providence Journal story about Orlando Martino, a Providence man with a record of drug arrests who, at the time, was seeking to have drug-possession charges dismissed based on his approval, months after his arrest, for a medical-marijuana card.
Martino pleaded no contest in June 2010 to a single felony count of possession of marijuana and was sentenced to two years, of which 3 months would be served in the Adult Correctional Institutions in Cranston, and 21 months suspended.
Carnevale argues that in the months since, medical-marijuana-related crimes — from armed break-ins to house fires related to growing marijuana indoors to caregivers and patients illegally growing and selling marijuana for profit — have increased.
“We can’t control what happens in individual homes,” he said Monday. “What it has created is a dangerous situation for the law-abiding citizens in our neighborhoods.”
Like last year’s version, Carnevale’s bill would also amend the law between now and when the caregivers would be eliminated from the medical-marijuana pipeline.
One such proposal would bar the state from registering anyone with a capital offense or felony drug conviction as a caregiver. Another would repeal the law that currently allows registered patients and caregivers to share marijuana with other registered patients or caregivers, as long as no money is exchanged.
“If we’re treating it like a medicine, why are we letting people swap it back and forth? Do we let patients swap Vicodin?” he said.
Other significant changes include having the state police, rather than the Health Department, conduct regular inspections and records reviews at compassion centers. The bill, which has been referred to the House Judiciary Committee, would also allow for a majority, rather than all, of the principal officers and board members of a compassion center to be Rhode Island residents.
“We are a ministry helping sick people,” said Johansson in a phone interview. “We were helping sick people. We were helping people in need in the community.”
The federal authorities have a different take on Johansson. They believe that he is a drug dealer who kept a shotgun in his church where he was allegedly growing more than 180 marijuana plants.
Last month, federal prosecutors charged Johansson and his girlfriend, Lydia Brindamour, with conspiring to manufacture more than 100 marijuana plants and manufacturing more than 100 marijuana plants. If convicted of the charges, Johansson and Brindamour face from 5 to 40 years in prison and $2 million in fines.
The criminal charges could put a serious damper in Johansson’s plans to open one of the state’s first marijuana dispensaries, also known as compassion centers. His proposal is one of 18 that the Health Department has accepted for review. At a public hearing this week, West Warwick’s legal counsel, Albert DiFiore, was highly critical of Johansson and his proposal. He said that it would be a “fiasco” for the state to grant a license to a man who is facing significant jail time and has yet to specify where he might run his marijuana dispensary.
In his application, Johansson suggested that he might open his business, Prospect Ministries Inc., near the Rhode Island Mall or off Kennedy Plaza in downtown Providence.
Despite his recent problems, Johansson has no plans to withdraw his application to open a marijuana dispensary. The Health Department is expected to announce its selections next month.
“My hat is already in the ring,” he said. “It’s up to the [health] board right now, but I don’t think that we have any chance at all.”
On Sept. 14, a team of West Warwick narcotics police officers executed a warrant at 6 a.m. on Johansson’s church at 724 Providence St., in West Warwick, in search of marijuana, drug paraphernalia, documents, records and proceeds from the unlawful sale and possession of drugs.
During the search, the police allegedly found 183 marijuana plants of “varying sizes in pots and trays located in several first-level grow rooms.” They also seized over two pounds of marijuana, $565, an electronic scale and apparatus used to cultivate marijuana indoors, the police said.
The officers in the drug raid also found two cards indicating that Johansson was a licensed caregiver, or supplier, in the state medical-marijuana program. The card allows him to grow up to 24 mature marijuana plants for up to five patients registered with the program.
The police said Brindamour told them that the Health Department had approved two cards for her, but she had yet to receive them.
Johansson and Brindamour were arraigned on the felony drug charges in state court.
Three months later, Johansson submitted his application to operate a marijuana dispensary with the Health Department. In his cover letter, he freely spoke about the police raid and his arrest on drug charges.
“After being pushed face down naked on the floor and handcuffed, I tried to explain plant counts to them and describe the legality of our grow,” he wrote. “They decided to arrest and charge us with two felonies. While we were locked up for over 24 hours, they killed all our plants in violation of state law. The amount of medicine lost and its effects on our patients has been excruciating. The physical, psychological and emotional effects have been devastating to us.”
Johansson said that the shotgun, a .12-gauge, was not loaded. He said that he has used it for hunting and skeet shooting. He also said that he strictly provided the marijuana for patients, not street sales. He estimated that the drugs provided pain relief for “well over 100 people” in the West Warwick area.
“Basically, we assisted people and got them off pharmaceuticals,” he said. “We got them off medicine that was killing them. There was so much demand in the community.”
According to Johansson’s application, he received a certificate of ordination, in May 2009, from the World Christianship Ministries, based in Fresno, Calif. He had previously worked in construction and real estate.
Following the arrests, prosecutors in the office of U.S. Attorney Peter F. Neronha took a closer look at the case. As a rule, federal authorities are not interested in prosecuting cases involving fewer than 100 marijuana plants, but once the amount crosses that threshold, the government often weighs in.
Two months ago, Neronha’s office prosecuted a Providence man, Mark McNaught, caught with more than 100 plants in his apartment. He was sentenced to five years in prison. They also have a case against another man, Shayne R. Costa, who was arrested last fall for growing more than 100 plants on his property in Tiverton.
It’s the second time he has been prosecuted for the same crime.
On Jan. 26, a criminal complaint was filed against Johansson and Brindamour in U.S. District Court in Providence. They were released on unsecured bond and their cases will now be presented to a grand jury.
Johansson said that he is ready to fight the charges in federal court. He said that if it goes to trial, he will have about 15 of his patients take the stand and testify about how his marijuana gave them pain relief.
Under state law, a criminal conviction would not prohibit Johansson from operating a dispensary as long as the Health Department determined that the conviction was related to the medical use of marijuana.
“There is no way they are going to convict me,” he predicted. “[My patients’] lives have been saved. I don’t want to go to trial, I want to be left alone. This is a plant — God’s gift.”
By W. Zachary Malinowski
Journal Staff Writer