Report on the February 8, 2001, Arkansas Legislature House Public Health Committee hearing of House Bill HB 1303, modeled after the Arkansas Medical Marijuana Act,  sponsored by State Representative Jim Lendall.

Report submitted by Denele Campbell, ARDPArk Executive Director: 

Representative Jim Lendall (D-Mabelvale) gave a brief review of the bill's provisions and an explanation of why the bill is important. Then he gave the microphone to the first witness, Betty Jean Wicker. 

Let me back up here and explain that yesterday, in preparation for this hearing, I drove to Little Rock and took one patient, Jean Cooper, with me. I had previously contacted Ms. Wicker and make arrangements for her to be brought to Little Rock. I booked her, her brother, Ms. Cooper, and myself into a hotel for the night. Also joining us at the hotel and for dinner was Dr. Dana Copp and his wife Mary Ann.

This crew gathered at 9 am Thursday at the Capitol legislative hearing room to wait for the committee to convene. Soon we were joined by other supporters, Gene Remley and Patrick Egan of our Little Rock  group, and Rita Sklar with the Arkansas ACLU. John Markes of Conway also soon arrived with the help of his friend. Greg Cooley also arrived in a wheelchair, escorted by Eric Camp of the Arkansas AIDS Drug Assistance Program Working Group. 

The room filled with people and media. It was very intense. By the time our testimony got underway, we were overheated and stressed. 

Let me just say right now how impressed I was by the testimony given by all our people. Everyone was composed, compelling, and to the point. I could tell the committee was very favorably moved. 

Ms. Wicker was dragged by a horse when she was 17, and as a result of her injuries, developed what the doctors first thought was a "nervous condition." She shakes uncontrollably from head to foot. Soon doctors decided she had developed cerebral palsy as a result of the injuries, and put her on 21 pills per day. Sometime afterwards, she discovered that marijuana controlled the shaking better than the pills, but continued to take both. 

After confiding in her doctor that she was using marijuana, the doctor confirmed that it would help her and said that even if she quit taking the pills, she should continue to use the marijuana or she would be in a wheelchair in a year's time. 

Ms. Wicker explained to the committee that she had been successfully controlling her condition with marijuana until last year, when she was arrested for possession. As a condition of her parole, she is urine tested for marijuana. 

During the last year, Ms. Wicker has suffered nine seizures and her shaking has become so bad that she has recently been taking up to three morphine pills per day. She is now taking two types of tranquilizers. 

The committee questioned her briefly, asking whether she had ever tried using the prescription form of THC, Marinol. She said she had not, and this resulted in some discussion as to why a physician would recommend marijuana when a legal "safer" form was available. Ms. Wicker replied that at the time the doctor had recommended it in 1993, there was a federal program in place which allowed patients to use marijuana if their doctors helped them apply. 

This was met with disbelief by some. Ms. Wicker did not know the details of the federal program, nor did Rep. Lendall. But Ms. Wicker did an admirable job of telling her story in a brief and yet very strong manner. 

Next to speak was the only person who signed up as an opposing witness, Ken Fithen of the Arkansas Faith and Ethics Council, Sherwood. He did a fairly thorough job of dragging out every bad thing anybody ever said about marijuana - brain damage, addiction, gateway effect, etc etc. He cited several studies and argued that this was not an appropriate medicine. 

Jean Cooper, a 65-year-old grandmother,  spoke next, describing how an early childhood bout with polio had resulted in a recent diagnosis of post-polio syndrome, which caused severe joint pain, muscle rigidity, and symptoms similar to fibromyalgia.  

She had discovered marijuana while living in California and found that it was very effective in providing relief. She had gradually decreased dosage of prescription drugs which had dangerous side effects.  

However, upon returning to Arkansas to care for her father after his stroke, she has been unable to legally obtain marijuana. She is again taking powerful prescription drugs and not finding effective relief. 

Next to speak was Dr. Dana Copp, who explained his background in international public health before going on to lay out an excellent reasoned argument as to why doctors and patients are the ones who should be in charge of whether marijuana is used as medicine. He stated, in part: 

"Unlike cocaine, methamphetamine, or heroin, the active agent in marijuana is NOT an addicting substance, any more than a cheeseburger, fries and Coca Cola are an addiction. There are addictive personalities, people who abuse chocolates, anything that brings pleasure. But these are not true addictions. 

"Marijuana has a genuine beneficial medical effect on glaucoma and several debilitative diseases. It is a useful drug in the practice of any physician.  

"I have never witnessed antisocial behavior as a result of using marijuana, a statement I cannot make about the use of alcohol. People do NOT commit crimes because they are "high" on marijuana. 

"There is a great deal of mythology which has grown up around marijuana ...  The bill you are considering, HB 1303, is not some effort to open the floodgates of drug abuse in the state. This legislation would not "legalize" marijuana. 

"It proposes to allow licensed physicians to prescribe a very useful and inexpensive agent for their patients with particular conditions under a controlled system managed by the Department of Health. It is an act of compassion for folks who are suffering and should be, as the contemporary lexicon puts it, a "no brainer." 

Committee members had many questions for Dr. Copp, such as "Why not just prescribe Marinol?" and "Why should the legislative process be responsible for approving a medicine? Isn't this what the FDA is supposed to do?" and "What about the conflict with federal law?"  

Dr. Copp did a great job of handling these questions. At some points, Rep. Lendall also responded to some of these questions.  

Then the chair recognized Dr. Fay Boozman, who had been in attendance since the hearing began. Dr. Boozman spoke as a provider of information, not pro or con on the bill. He gave a brief explanation of marijuana's unproven status, compared to "real" medicine which had been researched, tested, and approved by the FDA. He commented on the concern he had that the health department would become required to "police" this provision. 

A discussion ensued on some of the points of the bill. It became apparent that most of the legislators had not previously read the bill. [It was equally apparent throughout the hearing that the legislators had not read any of the materials provided to them in a briefing packet, which I had given to Rep. Lendall. I also provided packets to the media.] 

[These packets had been intended to provide an advance overview of the subject and included copies of Comparison of Marinol and Marijuana, a bulleted list of the main points from the Executive Summary of the March 1999 Institute of Medicine Study, a copy of the Endorsements list, a summary sheet showing basic points covered by the law and a review of what other states have done as well as court decisions in favor of the laws, and a copy of our Patient Stories booklet.] 

One concern stated as legislators read through the bill was that there would have to be appropriations made to fund the cost the Health Department might incur implementing this bill. 

In fact, this bill differs from our proposed law (as contained in our petitions) in that it does not assess an application fee. A patient applying for a registration card to allow legal use of marijuana for medical purposes would - under our law - have to pay a fee which would offset the Health Department cost for processing applications, issuing registration cards, and maintaining records of registered persons. 

It is true that HB 1303, as written, has no provisions of funding that would pay for its implementation.  

Another concern involved the point raised by Dr. Boozman, that the proper place for medical decisions lay with researchers, scientists, and the FDA.  

Rep. Jan Judy (D-Fayetteville) then asked who would want to undertake study on marijuana as medicine. She asked how much a typical drug study might cost. Dr. Boozman gave the figure of $10 million. Rep. Judy made the point that drug companies would have little incentive to "study" marijuana officially, since they would never be able to recoup their investment. People would simply grow their own. 

Another concern stated by legislators was that they felt uncomfortable in a role of making medical decisions.  

After continuing discussion, a motion was made to limit remaining discussion to two minutes per side, after the session had continued for about one hour. The motion was approved by a voice vote, but it was a close vote. The chair said the motion carried. There was some discussion. Then another motion was made to allow ten minutes per side, and this motion also passed by a strong vote, and superceded the two minute vote. 

Dr. Boozman answered questions for ten minutes, although technically he was not speaking against the bill. He stated that some allowance could be made wherein people might be included in a research program and get marijuana that way, which in essence conceded the point that marijuana had some value. 

The ten minutes remaining for HB 1303 supporters came last. Greg Cooley was wheeled to the microphone and said he had prepared a whole speech, but because of the time limitation, he would just state that he had tried Marinol and found that he was "stoned" for 6 to 8 hours. With marijuana, he could control the dosage effectively and take only enough to stimulate his appetite. 

Rita Sklar quickly pointed out that the reason more research had not been done was that the federal government had not permitted such studies. She cited previous research done by the government, including President Nixon's National Commission on Marihuana and Drug Abuse (1972), which stated, "There is little proven danger of physical or psychological harm from the experimental or intermittent use of natural preparations of cannabis." 

She also cited the 1982 report from the National Academy of Sciences, that "over the last forty years marijuana has been accused of causing an array of anti-social effects including ... provoking crime and violence .. leading to heroin addiction ... and destroying the American work ethic in young people. [These] beliefs ... have not been substantiated by scientific evidence." 

She also mentioned the main points of the 1999 Institute of Medicine Report. She thanked the committee for hearing testimony in support of the bill and pointed out that even a few years ago, such a hearing would not have been held. She said this was an important step forward. 

Then I took the microphone and briefly explained how, two years ago, I learned of my friend's fight with breast cancer. She had shown me a note the doctor gave her that she could show to the police if she got caught with marijuana, which he had suggested might help her get through chemotherapy. 

I told the committee how outraged I had been watching my friend cope with this deadly disease and have to worry about being arrested for using a substance that helped her.  

I told the committee that in our group's work, I get calls every week from people whose lives, whose health, depend on using marijuana. I told them how frustrated, how outraged, these people are in having to be illegal with this medicine. 

I said how terrible it was that time was short in this hearing that these patients who had come here to talk, come here at great expense both physically and financially, had ended up with so little time to state their case. 

Then I made specific points to refute previous testimony, as follows:  

• that the National Institutes of Health studies cited by Mr. Fithen were outdated and superceded by the 1999 Institute of Medicine study, which concluded that "for some patients, there is no alternative to smoked marijuana." 

• that arguments against the use of medical marijuana cited many potential negative side effects of marijuana but failed to consider the negative side effects of other medications  

• that if marijuana has no medical benefit, why does Marinol have any benefit, since Marinol is a derivative of marijuana 

We were running out of time and I yielded the last two minutes to John Markes, remarking to the committee that marijuana was the only thing keeping John alive. 

John talked about being a Navy veteran and struggling with a mysterious digestive ailment that caused him to continue losing weight. Finally, the Veterans Administration had given up on him and a doctor, speaking on the side, suggested John try marijuana.  

John had never considered trying an illegal drug and waited nearly two more months before his continued weight loss and distress caused him to try it. He said he was amazed at the immediate relief. [John's full story is available, as is Ms. Wicker's, under "Testimonials" on our website and in our Patient Stories booklet.] 

With only seconds of time left, John returned the microphone to Rep. Lendall who urged members of the committee to understand the immediate need behind the bill and to support it. 

Rep. Tracy Steele, committee chair, thanked Rep. Lendall for an "excellent" presentation of testimony and asked what was the committee's wish. Rep. Jan Judy offered a "Do Pass" motion, and the committee voted by voice. Only three voices said "yes" and the rest said "no." 

Rep. Steele said the bill failed, but added that he thought an interim study would be appropriate for this question. 

Rep. Lendall and Rep. Judy voted for the bill. We do not know who the third voice was. 

I thanked Rep. Judy after the committee adjourned for her vote, and she stated that "it was the right thing to do." 

After adjournment, Rep. Bill Pritchard (D-Elkins) said he supported the idea but there were too many unanswered questions. He was very interested in speaking with our people and explained that a friend of his had used marijuana while undergoing chemotherapy.

Rep. Cecile Bledsoe (R-Rogers) left the meeting shortly after testimony began and did not return. Two or three representatives left for various periods of time and seemed disinterested. However, several of the representatives seemed intent on learning more and Rep. Shawn Womack (R-Mountain Home) repeatedly asked about Marinol and seemed to not believe that it was not interchangeable with  marijuana.

Rep. Bill Scrimshire asked many questions too about Marinol, and seemed unwilling to accept that marijuana had any legitimate uses. 

Dr. Boozman lingered after the meeting, talking with our people and being sympathetic to the patients. He said that he hoped "reasonable" people could come together to develop some ideas that would let us address the problems of these people. He seemed sincerely concerned that the patients who spoke could find some way to get marijuana. He was interested in vaporizers that would release active marijuana ingredients without patients inhaling smoke.

I suggested to Dr. Boozman that we should sit down together informally and talk about this issue, perhaps with Dr. Copp, who was standing in on this conversation, and Dr. Dick Nugent, who is on the staff at the health department and whom I've debated, along with Kyle Russell, on AETN's half hour "Marijuana as Medicine." 

I believe that there will be discussion with Dr. Boozman that will lead somewhere constructive. However, I am concerned that any program administered through the Department of Health will be very restrictive. Patients would have to have direct support by a physician who was willing to go on record in advocating the patient's use of marijuana. The program would no doubt be limited to using marijuana produced on the federal farm in Mississippi, which is notoriously low quality marijuana requiring patients to use up to ten joints per day to achieve dosage levels. 

Of course, in any future discussion I will make every effort to move Dr. Boozman beyond these problems in a sincere effort to set up a program through the Health Department that would allow certain patients to be research subjects in a medical marijuana program. 

I don't accept this alternative as a substitute for our proposed medical marijuana law, where patients would be able to produce their own medicine and use it as they see fit. I have more faith in people's judgment about what works for them than does Dr. Boozman or others in governmental positions. 

I believe the choice of using marijuana for medical purposes must be left to patients in order to be inexpensive, effective, and fair in the American tradition of personal self determination. I believe this is the will of those who support our organization, and I will continue to work to get enough petition signatures to place this measure on the November 2002 ballot. 

In the meantime, I just can't say how impressed I've been by our people -- not only those who went to Little Rock to testify -- but also by those who have written letters, emails, or made phone calls to their elected representatives.  Now more than ever we must each take time to talk with our representatives. Once the legislative session ends in March, we must visit with our representatives, sit down and get familiar with them, and make them familiar with us and this issue.  

When this bill comes up for interim study, we will have more time for discussion and hopefully I and others will be able to move legislators even closer to supporting the bill.  

This is how laws are changed in this state, by building personal relationships with our representatives and continuing to work through the process. With the right preparation during the interim period, we should be able to move the bill out of the House committee. Then it will be up to the full House of Representatives to vote on it, and that's where your work with your local rep will pay off.  

And of course then it will have to go through the Senate, too, so don't overlook your state senator as you plan your local get-acquainted meetings.  

We'll be working with you to help make these meetings productive, so don't hesitate to contact us.  And of course we must continue to gather signatures. 

I believe we are moving forward. This was a powerful day. We should all be very proud of ourselves.