Oklahoma voters will consider medical marijuana in a state question on June 26. The following package of articles was written for the Enid News & Eagle in advance of that vote. The first article shares the stories of two families who have illegally brought medical marijuana to Oklahoma to treat loved ones, and why they were willing to go to those lengths and take the risk of imprisonment.
Desperation drives families to skirt law for medical marijuana
ENID, Okla. — As doctors, pundits and policymakers debate State Question 788, some Oklahomans already have taken the question of medical marijuana into their own hands by illegally bringing medical cannabis into the state for loved ones suffering from terminal or chronic illnesses.
Two Oklahomans shared their stories with the News & Eagle on condition of anonymity, out of fear of possible legal consequences for bringing medical marijuana into the state.
Taking risks for the care of a child
For one parent, bringing marijuana across state lines was unthinkable, until their young child was diagnosed with cancer. The child was given a 60 percent chance of survival with traditional oncology treatments.
The parent said they proceeded with all doctors’ recommendations, and the child began a long course of surgery and radiation treatments, followed by chemotherapy. But, if there was anything else that could be done, the parent said they wanted to pursue it.
“At that time we were still like, ‘What in the hell just happened?’ and ‘What are we going to do?’ We just wanted to see what else we could do to help,” the parent said.
Online research and talking to parents in states with legal medical marijuana revealed a wealth of testimonies about the effectiveness of cannabis to improve appetite and ease pain for children undergoing radiation and chemotherapy, and possibly to shrink tumors.
“Those testimonies were enough for me,” the parent said, “just to make my child feel better, at the very least, with the possibility of prolonging … life and improving quality of life.”
The parent eventually connected with a person who had a legal medical marijuana card in another state who was willing to help. Sympathetic doctors and nurses from that state also came forward and helped the parent outline dosage levels and a treatment plan for the child.
But, there were risks. Carrying marijuana across state lines still is a felony — incurring the possible penalty of time in prison.
The parent said they weighed that possibility and determined to proceed anyway.
“It made me a little nervous, but it really made me more cautious, because I already had my mind made up,” the parent said. “There was no doubt in my mind I was going to do it. I would walk through hellfire and back for my child.
“I’d always been asked what I’d do if I got [caught with the medical marijuana] and my answer is always the same: I would tell them exactly what I was doing, and if they took me to jail I hope they could sleep at night, knowing they took medicine away from my child,” the parent said. “What parent wouldn’t go to the ends of the earth for their kid?”
The parent began giving the child an oil mixture of cannabidiol (CBD), a legal extract from the marijuana plant, and tetrahydrocannabinol (THC), the principal psychoactive compound in cannabis, illegal for use in Oklahoma. The parent said the child’s doctors didn’t know about the medical marijuana treatments — at least not explicitly.
Dosages and the balance between CBD and THC were adjusted gradually, based on recommendations from medical staff in the other state, the parent said.
“It’s not like you’re getting your child, or whoever you’re treating, stoned,” the parent said. “You’re starting at a very low dose and working your way up to a target dose where it could start helping.”
The parent said there’s no way of knowing for sure how much difference the THC and CBD mixture made for their child. But, the parent said, their child maintained an appetite and progressed more rapidly in recovery than other kids with similar diagnoses in a support group for the same type of cancer.
“We could see a lot of things that other kids were going through, that our child wasn’t,” the parent said.
Other children in the group had trouble eating, suffered balance and stability problems and some were confined to wheelchairs.
The child was able to stay in school throughout the oncology treatments — while also taking the medical cannabis — and aside from tiring quickly, the worst conditions were from the radiation and chemotherapy.
The child now is in remission, and has resumed all the normal activities of a healthy child.
“Anybody who knows our child and saw what … [we] went through, and knows what I did for …, truly believes it has helped,” the parent said.
A loving goodbye
While the parent feels certain medical marijuana helped their child recover, another area resident has seen medical marijuana help two parents in the terminal stages of cancer, as they fought to spend their last days with family, coherent and with dignity.
The adult caregiver was introduced to medical marijuana when their mother was diagnosed with terminal cancer, that had spread throughout her body.
The mother was prescribed painkillers, but still suffered pain in her leg so severe she begged her husband to cut off the limb.
In desperation, the father loaded her in the family motor home and drove her to Colorado, where medical marijuana was legal.
After starting a course of medical cannabis, the adult caregiver said their mother was able to stop taking all other pain medication. The parents were even able to complete a long-planned trip to Canada in the motor home before the mother died, the adult said.
That experience immediately came to mind when the caregiver’s father also was diagnosed with cancer. By the time the cancer was found, it already had spread to his liver, lungs, colon and brain.
“When we found out he had cancer, he was already terminal,” the adult caregiver said.
Within several months the doctors said the father’s organs were shutting down, and they recommended hospice care.
The doctors prescribed a course of opioid painkillers, including oxycodone and fentanyl, taken a combination of six times a day under the supervision of family members.
“That’s an extraordinary amount of opioids, and we were given all of those drugs without any education about them,” the caregiver said. “He had all these opioids, and he had a compromised liver and uneducated caregivers.”
After receiving “round-the-clock” opioids for several days, the father was incoherent, the adult said.
“It was like having a complete drug addict with you,” the adult caregiver said. “He was running into walls, he didn’t know who he was — it was bad.”
Only later did the caregiver calculate how much pain medicine the father was taking. The Centers for Disease Control and Prevention offers a free app that calculates the milligram morphine equivalent (MME) for prescription opioid pain medicine.
A 2004-2009 CDC study found patients who died of opioid overdose were prescribed an average of 98 MME per day.
The adult said when they entered all of the prescription pain medication in the CDC calculator, the father was prescribed 210 MME per day.
Even with that level of opioids in his system — and the risk of overdosing — the father still was “screaming in pain,” the caregiver said.
That’s when the caregiver made arrangements to bring medical marijuana from a state where it’s legal.
After taking several doses of THC and CBD oil, the father was able to stop taking all of the opioid pain medication, the adult caregiver said.
“Within two weeks of no pain killers and just the medical marijuana, he went from being green [in his skin color] and having no idea what was going on, to being able to talk to us,” the adult caregiver said.
The father, who had been unable to function under the influence of the opioids, was able with the help of medical marijuana to spend about a month with his children and grandchildren, including dinners and family outings.
It was a loving goodbye that the adult said wouldn’t have been possible under the influence of the opioids.
“It gave my kids an opportunity to say goodbye to their Pa Pa,” the adult said. “It gave him clarity at the end. It gave him quality of life that the pharmaceuticals did not give him. He was able to go out with his grandkids and eat, and just live.”
The adult said many people are unsure of what medical marijuana can do, or think it’s only for recreational use. Oklahomans would be sure of its positive uses, the adult said, if they could see it work for someone like it did in their situation.
“All you have to do is see one person go through this, and it’s unreal,” the adult said. “He laughed again, and we were able to talk about Mom, and he was there. It’s the difference between having someone with you who’s completely drunk, and someone who is sober — someone who’s really there with you.”
Giving families a choice
Both the parent of the young child and the adult caregiver said they didn’t take breaking the law lightly. And, they don’t want other families to have to make that choice.
“It’s not that I don’t respect the law, because I do,” the parent said. “But when it’s up to life or death for a little one, you do what you have to do. For doing something any other parent would do, risking jail time or probation — whatever the cost is, they shouldn’t have to worry about that.”
The adult caregiver of the terminally ill father agreed.
“We were OK with the consequences if we got caught, because we were giving it to a sick man,” the adult said. “Dad was sick and he needed it.”
The adult caregiver said until medical marijuana is legally available in Oklahoma, other families will have to make the choice between following the law and providing relief and care for loved ones.
“When you have someone who’s terminally ill, you’ll do what you have to do, because their last days are on you,” the adult said. “Will they be in a drunken stupor, or will they be there with you and be able to talk to you and say goodbye? I don’t want families to have to try and find someone who will sell them a bag of weed when there are states that have done the research and have safe, effective medical marijuana.”
Groups at odds over medical marijuana
Voters will decide June 26 whether or not Oklahoma will join a growing number of states and nations that have legalized the use of marijuana for medical purposes.
If State Question 788 passes it will allow for the growing, processing and distribution of marijuana for medicinal purposes. But, as the vote nears, the state’s two largest doctors’ associations remain opposed to the measure.
SQ788: The basics
SQ788 would establish a process, through the Oklahoma State Department of Health, for patients to obtain a medical marijuana license from an Oklahoma board certified physician.
The measure provides for minors to receive a medical marijuana license with the consent of their parent or guardian and the signatures of two physicians.
Unlike most other states that have legalized medical marijuana, SQ788 does not specify certain medical diagnoses that would qualify for a medical marijuana license.
Instead, the measure leaves the necessity for the license to the discretion of the doctor, “according to the accepted standards a reasonable and prudent physician would follow when recommending or approving any medication.”
License holders would be allowed to possess up to three ounces of marijuana on their person and eight ounces in their residence, as well as six mature and six seedling marijuana plants, one ounce of concentrated marijuana and up to 72 ounces of edible marijuana. Licenses would be good for two years.
The measure also outlines procedures for licensing of dispensaries, processors and commercial growers and levies a tax of seven percent on medical marijuana to cover the cost of licensing and oversight.
Any excess tax revenue would be dispersed, 75 percent to common education and 25 percent to drug and alcohol rehabilitation programs.
For the full text of SQ788, visit the Oklahoma Secretary of State website at sos.ok.gov/documents/questions/788.pdf.
CBD and THC: A drug in two parts
While CBD is sold in Oklahoma as a supplement, the National Institutes of Health in a 2017 report stated CBD has “high potential for therapeutic use,” including relief from epilepsy, anxiety, psychotic disorders, inflammatory disorders and the ability to protect the nervous system.
Tammy Martin, owner of CBD Boutique at 122 N. Oakwood, opened her shop after experiencing firsthand the positive effects of CBD.
Several years ago Martin was diagnosed with an immune system disorder that caused her body to attack her organs and muscle tissue and to stretch her skin, and also with celiac disease, a digestive disorder.
Doctors prescribed opioid pain medications for the side effects of her ailments, and before long Martin said she was “taking way more than I should have been.”
What started as pain management turned into addiction.
“I knew I had no life with all the narcotics I was on,” Martin said. “I told my husband one day, ‘This has to stop, because eventually I’m just going to die.’”
That determination led Martin to pursue CBD oil from Colorado, and to eventually open her shop.
She said the CBD oil helped her get off all her prescription pain medicine, and much of the medication for her immune disorders — all with the consultation of her doctors.
Martin said she opened her shop to connect others with CBD oil. But, she often sees clients she believes would benefit from another component of marijuana: tetrahydrocannabinol (THC).
THC is the psychoactive component of marijuana, and is illegal in Oklahoma.
But, in states with medical marijuana laws, THC is used along with CBD for a wide variety of ailments, including the side effects of cancer treatment, pain management, post-traumatic stress disorder, Parkinson’s disease, epilepsy, arthritis, Alzheimer’s and other chronic diseases.
Martin said she’s not interested in medical marijuana for herself, because CBD is managing her symptoms. But, she would like to see it available for those with ailments that don’t respond to CBD alone.
‘Out of the loop’ — Doctors’ groups opposing SQ788
Dr. Jean Hausheer, M.D., president of the Oklahoma State Medical Association (OSMA), said her group is not opposed to the notion of medical marijuana but is opposed to SQ788.
Hausheer said the language of SQ788 doesn’t provide enough regulatory oversight of medical marijuana, and takes doctors “out of the loop” because it doesn’t specify which conditions qualify for a medical marijuana license.
She likened the medical marijuana license process to a “permission slip” that would allow patients to “go to a dispensary, and all they have to say is they want it for any reason or no reason.”
“From a safety standpoint, we have to make sure inspections are taking place, and it’s being monitored,” Hausheer said.
She said SQ788 doesn’t provide for that level of oversight in its current version, and “there’s no accountability.”
Oklahoma Osteopathic Association (OOA) deferred its comments to Dr. Dale Derby, an osteopathic doctor, OOA member and Republican state Representative from Owasso.
Derby also said the SQ788 language is too “open-ended.”
“The reason I’m opposed to it is, this particular bill is just not a good bill for medical marijuana,” Derby said. “It does not define the medical conditions it should be used for.”
Derby said the requirement for a board certified physician to sign the license also is too broad, and would open the process to practitioners like podiatrists, chiropractors, optometrists and veterinarians.
“There is no reason for this bill, especially for medical marijuana,” Derby said. “This is essentially a front to bring recreational marijuana into Oklahoma.”
Proponents say SQ788 opposition based on misconceptions
Chip Paul, chairman of Oklahomans for Health, the major proponent group for SQ788, said concerns from OSMA and OOA about what kind of doctors could recommend medical marijuana or sign a license are based on misconceptions.
“What we said was any Oklahoma board certified physician,” Paul said. “We didn’t necessarily intend that to be people like veterinarians or chiropractors, but we give them the ability under the language of that law to write a license.”
Paul said opponents of SQ788 have latched onto veterinarians falling under the broad definition of “board certified physician” to claim vets would be prescribing medical marijuana to people.
That’s an unfounded claim, Paul said, because vets can’t prescribe, recommend or license medication for humans, regardless of whether or not SQ788 passes.
“In no way, shape or form could a veterinarian prescribe or recommend medical marijuana for a human,” Paul said.
He said chiropractors — likewise a source of SQ788 opposition by OSMA and OOA — couldn’t sign medical marijuana licenses because chiropractors’ current licensing in Oklahoma doesn’t allow them to prescribe medication.
“There’s a lot of assumptions that people won’t read the state question,” Paul said, “and the ‘No’ side are taking great liberties with this.”
Paul said the contention that SQ788 puts doctors “out of the loop” by not providing a set list of conditions for medical marijuana use likewise is spurious.
“It does the exact opposite of that,” Paul said. “We do not regulate around medical conditions. We regulate through physicians’ opinions, and that puts them in direct control.”
Paul said by leaving determination of need for medical marijuana up to the physician, rather than a set list of ailments, SQ788 gives doctors more ethical and legal “skin in the game.”
That “skin in the game” helps ensure medical marijuana remains licensed by physicians for medical purposes — not recreational use, Paul said.
“We think the proper way to regulate this is with the physicians,” Paul said. “Let’s put them on the hook, both legally and ethically.”
Supporters of SQ788 also counter the OSMA complaint that SQ788 is too vague.
“One of the issues in a state question is you typically don’t spell out hundreds of pages of regulations for an industry,” said Bud Scott, executive director of New Health Solutions Oklahoma (NHSO), a trade association representing the medical cannabis industry in Oklahoma.
Scott said the standard in states that have legalized medical cannabis has been for the principle to be approved by the state question, then for the implementation and regulation to be sorted out through legislation and administrative action.
“Nowhere in the nation where there is legal medical cannabis has it been all spelled out in the state question,” Scott said. “It’s kind of a scapegoat to say this isn’t all spelled out, because it’s going to be spelled out. It’s easy to come back and address any issues through legislation and through agencies and rule makers, and we fully anticipate that’s what will happen.”
Scott said NHSO remains committed to working with OSMA, OOA and other interested parties to craft implementation of medical marijuana, if and when SQ788 passes.
“We still stand ready and willing to address any issues, and we believe the people of Oklahoma deserve this option — an option that is available in 30 states and the District of Columbia,” Scott said. “We think we’re on the right side of history here.”
The personal perspective
While opposing sides of SQ788 wait to see what kind of history will be made on June 26, families are waiting to see if medical marijuana will be an option for their loved ones’ treatment.
Martin, owner of the CBD shop, has a personal stake in SQ788.
Her father was diagnosed several years ago with Parkinson’s disease. Since then, he’s gone from owning his own business to living in a nursing home, often unable to feed or bathe himself.
Several other states list Parkinson’s as an ailment authorized for treatment by medical marijuana. Martin said she’s seen enough positive reports from those states to justify cannabis to relieve her father’s Parkinson’s symptoms.
“He’s just gone way downhill,” Martin said, “and all the research I’ve seen on it online has shown it would work, and and it does help.”
If nothing else, she said medical marijuana with THC would improve her father’s quality of life and comfort, and she hopes SQ788 will pass so she and her father will have that chance.
Linda and Merle Isaak also are proponents of SQ788, not for themselves, but for the sake of their young granddaughter.
The granddaughter, who they declined to name, previously resided in Washington, D.C., where she could have had legal access to medical marijuana, if it became necessary, to treat severe seizures that she might develop due to a rare genetic disorder.
The granddaughter and her parents recently moved back to Oklahoma to be near family, to provide additional caregivers. But, the move also required leaving behind access to legal medical marijuana, meaning medical cannabis currently isn’t a treatment option if the seizures develop.
“We’re just hoping our state will have it so we will have access to it, for her sake,” Linda said.
Merle said families that need medical marijuana will find a way to obtain it. How they obtain it, and its safety and effectiveness, are the real questions in SQ788, he said.
“If you need it in Oklahoma you’re going to have to go to a drug dealer or a doctor,” Merle said. “Which would you prefer?”
Medical marijuana: An idea long and widely in use
If Oklahomans pass State Question 788 on June 26 they will open the door to medical marijuana in the state.
But, passing SQ788 won’t put Oklahoma in new territory for the use of marijuana for medical purposes.
According to the National Institutes of Health (NIH), people have used cannabis, also called marijuana, “for a variety of health conditions for at least 3,000 years,” with another NIH report citing as many as 5,000 years.
In a 2017 article, the NIH stated “cannabis was widely utilized as a patent medicine during the 19th and early 20th centuries” in the United States, and was first listed as a pharmaceutical drug in the U.S. in 1850.
Marijuana use wasn’t federally regulated in the U.S. until 1937, according to the NIH article.
The NIH pointed out that today, the U.S. Food and Drug Administration (FDA) hasn’t certified marijuana “safe or effective for treating any health problems.”
Marijuana still is listed as a Schedule 1 narcotic by the federal government, which makes it illegal at the national level and in interstate commerce and limits research in this country into the plant’s medicinal properties.
But, despite the federal laws on marijuana, 30 states, the District of Columbia, Puerto Rico and Guam all have passed laws allowing medical marijuana.
California became the first state to legalize medical marijuana in 1996. Since then, Oregon, Washington, Nevada, Colorado, Vermont and Maine have legalized adult use, or recreational, marijuana in addition to medical cannabis.
In the southwest, Arizona, New Mexico and Arkansas all have passed measures authorizing medical marijuana.
Oklahoma currently is one of 17 states that permit the sale of cannabidiol (CBD) oil and products, derived from a non-psychoactive component of marijuana, but not products with a significant concentration of tetrahydrocannabinol (THC), the psychoactive component of marijuana also widely used for pain management and treatment of chronic illnesses.
More than 25 nations currently have legalized medical marijuana, including Canada, Mexico, Italy, Israel, Germany, Australia and the Scandinavian nations.
According to a March article in The Telegraph, the United Kingdom now is the world’s largest exporter of medical marijuana, despite its use still being banned there.
Israel, Canada and the Netherlands all have government-sponsored cannabis research programs. Israel leads the world in clinical trials of medical marijuana, according to an April 11, 2017 U.S. News & World Report article, which cited 110 clinical trials underway in Israel at that time.
According to the U.S.-based business consulting firm Grand View Research, medical marijuana is projected to grow to a $55.8 billion global industry by 2025.