Oregon Pain Management Commission

[Stoney Girl]

Pain Management Commission Meeting:
July 10, 2008
1:00 p.m. - 4:30 p.m.

Barbara Roberts Human Services Building
500 Summer St. NE, Salem; Room #252

Reasonable accommodations will be provided as needed for individuals requesting assistive hearing devices, sign language interpreters or large-print materials. Individuals needing these types of accommodations may call DHS at 503-945-7009 at least 48 hours in advance of the meeting.

The Pain Management Commission works to improve the services and treatment of pain through education, research and policy. The Commission represents concerns of patients in Oregon on issues of pain management to the Governor and Legislative Assembly.

The public is welcome to attend any regularly scheduled meeting. However, public comment is permitted only when designated as a planned agenda item. If you wish to be scheduled for public comment during a scheduled meeting, please contact Jennifer Wagner at 503-945-7009 to get on the agenda.

Public comment is routinely limited to five minutes per individual or group representative, and a total of no more than 30 minutes of meeting business.


Oregon Pain Management Commission
Mission

The mission of the Commission is to improve pain management in the State of Oregon through education, development of pain management recommendations, development of a multi-discipline pain management practice program for providers, research, policy analysis and model projects. The Commission shall represent the concerns of patients in Oregon on issues of pain management to the Governor and the Legislative Assembly. The Commission shall develop a pain management education program curriculum and update it biennially. The Commission shall provide health professional regulatory boards and other health boards, committees or task forces with the curriculum and work with health professional regulatory boards and other health boards, committees or task forces to develop approved pain management education programs as required.



I am on the agenda for the OPCM meeting next week. I am working on a report to the Commission about how many patients in Oregon qualify for the OMMP, how it can safely treat pain, and the need for safe legal access to medical marijuana. I intend to submit Voter Power's Dispensary to them and ask them to forward it to the legislature with a recommendation to pass it, as the Advisory Council on Medical Marijuana has already done. Any information about how marijuana treats pain would be greatly appreciated. Thank you.

 

[FreakNature]

There are a lot of testimonies on this site. A recent thread was started by kabar...a really inspirational story.

Doctors, prices, and my first experience ;)

The very best of wishes to you as you go before the commission. Thanks for putting a voice to the thoughts of thousands and thousands of people hiding in the closet.

 

[Stoney Girl]

We had 6 OGF'ers at this meeting. They had the public testimony at the beginning of the meeting. I had to go first. I told them this:

In 2005 Voter Power began conducting public meetings open to OMMP cardholders around the State to find out what changes to the OMMP would be most beneficial to their healthcare outcomes. They spent over 2 years gathering input.

We found that many of the patients we spoke with had drastically reduced their healthcare costs by turning to the OMMP. But because there has been no research or even data collection of outcomes for OMMP patients, there is no way to convey this information in a meaningful way. This program has been in place for 10 years now, and we feel that the State has a responsibility to do a risk/benefit as well as a cost/benefit analysis of participation in the OMMP.

We found that too many patients are not getting enough medicine. We found that the primary opposition to a dispensary initiative was the fear that profiteers would make medicine unaffordable for the poor and the fear that it would bring federal interference like we see in California to Oregon. We found, much like the Oregon Health Fund Board has found from their meetings, that people want healthcare to be non-profit, and they feel that medicine should be affordable and provided to those who can't afford it.

We found that many patients are no longer allowed to produce as much medicine as they need. Throughout the State we were told that access to legal medical marijuana is needed so that they would not be forced to fulfill their needs on the black market. The State created this need. The State has an obligation to create a safe legal supply instead of further subsidizing the black market.

We are concerned that pain management patients are facing unreasonable barriers to proper treatment of their pain by SB1085's arbitrary and capricious limits that remove a doctor's discretion from medical care and instead impose LEO's designation of appropriate medical care. We find this to be in direct contradiction of the Assisted Suicide Ruling handed down by the Supreme Court of the United States of America, which found that members of the justice department do not have the medical training to determine the appropriate use of medicine.

To meet the 3 primary needs, 1. data collection/research into health outcomes of OMMP participants and 2. Safe, legal access to medical grade marijuana for OMMP cardholders and 3. affordable cannabis medications available to low-income patients, Voter Power worked with the public outreach meetings, the Drug Policy Forum for Oregon, Oregon Green Free's cardholder-only online forum, Willamette Valley NORML, and even those who opposed the initiative to draft legislation that meets all three needs and is fully self-funded.

The initiative would allow licensed producers to produce and sell marijuana to licensed non-profit dispensaries, who would sell medical cannabis products to licensed OMMP participants. Research would be funded by licensure fees. The dispensaries would give 10% of their profits to the State to distribute to low-income patients who are on OMMP to take care of the program for low-income patients. Absolutely NO taxpayer funding would be involved.

Oregon Pain Commission Doc 2

Dispensaries: Positives
Approved by ACMM
The Advisory Committee on Medical Marijuana has thoroughly reviewed this proposal and voted to forward it to the legislature. It has also been approved by the Secretary of State to begin petitioning as soon as they confirm the ballot title.

Cost Containment, Chronic Disease Management
As previously mentioned, many of our clients drastically reduce their healthcare costs by the use of medical marijuana. This is important because the 10% of Oregonians who generate 69% of Oregon's healthcare costs are the kind of patients that make up 85% of our case-load at Voter Power. If we can reduce costs for those patients, it leaves a lot more of the current budget for the rest of Oregon.

Reduced Prescription Drugs
Nearly all of our patients have reduced their prescription drugs by joining the OMMP. Reducing pharmaceutical drugs reduces the potential for negative drug interactions, currently a leading cause of death nationally.


Public Health Prevention and Wellness

Marijuana has been shown to slow or prevent Alzheimer's and Osteoporosis, two conditions that will soon inundate the healthcare system.

Private Non-Profit

We found that people are demanding that the greed be taken out of healthcare. But they don't necessarily trust the State to take care of them without bungling the effort.

Sorry, I'm not trying to be mean. It's just that you're not really qualified to grow medical marijuana. And every government run medical marijuana dispensing program has been a complete disaster. And it's not like you want to do it either: we are aware that the State would prefer not to handle marijuana in any way if it can be avoided. We'd prefer to have the State regulate private growers and dispensers than have actual State employees growing marijuana for medical consumption. So, really, this solves the problem neatly.


Reduced Home Gardens

Having safe legal access to professionally grown medical cannabis products will reduce the number of patients trying to grow at home on their own.

This will reduce patients' risk of home invasion.One sad aspect of medical marijuana is that security is something that must be considered. This is already a huge problem for individual patients, caregivers and growers. So far, three OMMA patients have been shot by thieves, one patient is charged with murder for shooting a thief, dozens have been assaulted, and there have been hundreds of rip offs. etc.

Dispensaries will be better able to deal with these issues than individuals. Dispensaries must have a security plan as part of their application under the proposal. Dispensaries will deal with security just as banks, jewelry stores and other high value retail stores do.

Development of Multi-Discipline Pain Management Practice Program

The Oregon medical marijuana community has been developing non-smoked cannabis-based medicines for the last 10 years and more. These include, but are not limited to: activated cannabis capsules, cannabis butter, cannabis enhanced chocolates and candies, topical treatments like lotions and massage oils, cannabis-enhanced alcohol tinctures and glycerin elixirs and vaporizers. Safe legal availability of these products will make patients more likely to utilize non-smoked methods if ingestion.

Self-Funded/ Pay-go

Right now OMMP is funded by patient registration fees, and has a surplus of $375,000. The program is entirely self-supporting and has generated surpluses as high as $900,000 in the past on patient licensure alone.

This is a regressive tax where the poor pay the same as the rich. If our initiative passes, patient registration fees can be dramatically reduced or eliminated and be replaced by a tax paid by those that can afford it.




The program we have now is evolving. There are now 20,000 patients and the number is growing rapidly. The more patients there are the less likely they can all grow their own. Some of us have spent ten years trying to make the current law work. It never will. I have matched hundreds of patients with growers, taught grow classes, given away hundreds of pounds of free medicine, helped dozens of patient support groups form, and been very active in getting the rules improved for patients. The result: a very inadequate supply of medicine for patients.

Taking money out of the equation does not eliminate greed, it eliminates the medicine. In this case, the reality is that most patients never register or even try because medical marijuana is not easily accessible. Hundreds of patients register but rarely have any medicine. Thousands more have medicine but must accept the quality that they get because it is their only choice. They have no choice!

We have listened very carefully to the concerns people have about greed and have incorporated mechanisms into this proposal to make the system we propose as patient friendly as possible. Dispensaries must be nonprofits, a competitive producer/dispensary system will lower prices, and we create a DHS program to assist needy patients.

Marijuana is a safe effective medicine. It should be as easily available as the much more dangerous pharmaceutical medicines. Patients should be able to choose which medicines they take. They should be able to choose medical marijuana. If they want to produce their own, they should be able to, but they shouldn't be forced into it like they are now.

Our proposal is structured specifically to help poor patients. But it also recognizes that some patients are not poor. We create a system where those that can afford to will subsidize the medicine of the most vulnerable.


I hope you will carefully consider these points and help us with this proposal.

Thank you,

 

[Stoney Girl]

Another patient brought up the issue of having his doctor fire him for testing positive for marijuana. This is an important issue for all of us with pain that requires pain medications in addition to cannabinoids. The Emerald Steel decision means that they can no longer deny us services based on a positive urine tests without being liable for stiff federal fines and loss of federal funding. I made them aware of the ruling and what it means and gave them the opinion of The State's ADA consultant of record on the matter.

The doctor who runs the Medford VA claims that He has unuasually high rates of marijuana use in his pain management clinics, and I explained that traditionally, Oregon has had higher rates of marijuana usage than the national average based on SAMHSA surveys going back to 1970 and DASC reports going back to 1988. He responded that marijuana users exhibit abberant behavior and have addictive issues. I was not allowed to respond to his reefer madness issues.

 

[Stoney Girl]

The next meeting of the OPMC is September 11. They only allow 5 minutes of testimony at a time. So we need a team to address them.

These folks need an in-depth education about non-smoked methods of ingestion, how they work, and why they should be a part of every multidiscipline pain managment program.

They also need an indepth education about abuse of the program (or lack thereof).We need to illustrate how many people qualify for the program, how many are on the program, and how many have abused the program based on actual evidence (like arrest records and statistics of patients with qualifying conditions).

They also need an in-depth education on the addictiveness (or lack of) of marijuana vs. opiates. NIDA's graph illustrating marijuana's addictiveness as compared to nicotine, caffeine, alcohol, cocaine,and heroin would be helpful.

Any studies or statements from noted doctors refuting reefer madness would also be helpful. One Commission member (who apparently runs the pain management for the VA in Medford) actually said that marijuana users exhibit abberant behavior and that addiction is a major problem in pain management. (I was not allowed to respond to that statement).

We need to explain the Emerald Steel decision to them and explain the implications better than I was able to at this meeting.This is an opportunity to head off SB465 at the pass. You can be sure that Dan Harmon won't be taking the summer off.

We need someone to explain to them that the dispensary could pay for their pain survey, or at least part of it, and it would just be allocated funds from a DHS-run program paying for it instead of a pharmaceutical company.