Sunday, August 31, 2008

3 Things Money Can't Buy

Dr. Frank Lucido's Bully Pulpit: Everyone's Entitled to My Opinion

"Three things money can't buy":

First you may have heard the joke/riddle:
There are 2 things money can't buy:
True love.......and home-grown tomatoes.

There may be a third thing...

On August 25, 2008, California Attorney General Jerry Brown issued:
“Guidelines for the Security and Non-Diversion of Marijuana Grown for Medical Use”
While apparently giving more protection to individual patients and caregiver/collectives, especially the less profitable and presumably more altruistic, it does promote a touch of "forced socialism."

(Americans for Safe Access comments on these guidelines at:

As I say in my July 2007 newsletter
“BLESSED ARE THE CAREGIVERS for the risk they take to help suffering patients.”

But it seems like small collectives/caregivers will be safer;
And bigger dispensaries, especially those that can be portrayed as greedy, whether true or not, will be more vulnerable.

As I opine in my article “The Victory of Raich”:

“Individual patients, who grow a few plants, are unlikely to be bothered by the Federal government, if one can believe the Solicitor General’s statement to the Supreme Court on November 29, 2004...
...Least protected will be the larger dispensaries/growers, those most visible, and those with the loosest standards or business ethics. Those who can be easily accused of “profiteering,” whether true or not, are perhaps the most vulnerable.”

California's Compassionate Use Act of 1996 is standing the test of time.

But almost 12 years later, safe and legal access still isn't always available for many patients. Patients need more access and less fear. And ultimately, the medicine needs to be more affordable.

It seems these guidelines allow patient collectives to grow and share the fruits of their common labor, and give away their extra to other patients in their groups who need it.

Someday we may be able to say:
There are 3 things money can’t buy.
True love, home-grown tomatoes,
...and “home-grown.”

Frank H. Lucido MD
Family Practice since 1979
Medical Cannabis Consultation
Expert Witness
2300 Durant Avenue
Berkeley Ca 94704
510.848.0958 (by appointment only)

Upcoming blog postings will include:
Dr. Frank Lucido's Code of Ethics Pledge
What is Medical?
Vaporizer Wisdom

Dr. Frank Lucido’s Bully Pulpit”
Bookmark it now, or subscribe to this blog for updates, otherwise you’ll only get my email newsletter once every few months.

Tuesday, August 19, 2008

Society of Cannabis Clinicians meets in L.A. 8/1/08

Dr Frank Lucido's Blog: PotShots from the Bully Pulpit
or: Everyone’s Entitled to My Opinion

The quarterly meeting of the Society of Cannabis Clinicians was held in L.A. on August 1, 2008.

It was the intention of our founder, Dr. Tod Mikuriya, to attract more physicians from Southern California by holding at least one yearly quarterly meeting in Southern California.

I saw a couple of new faces among the physicians, but nowhere near the eight new physicians who showed up in March, 2007 for our first LA meeting.

We had a good educational session with attorney Bruce Margolin discussing two recent state appellate decisions:
People v. Kelly, which overturned the cannabis and plant limits of SB 420
“up to 6 mature or 12 immature plants and up to one-half pound of dried, processed marijuana.”
People v. Windus
in which a judge opined that recommendations do not expire.
(However, the Medical Board still tells physicians they must re-evaluate the patient at least yearly, and that makes medical sense to me, especially if someone wants my medical opinion in a court of law, or better yet, wants to avoid legal issues in the first place. More on these in a future blog.)

Two recurrent problems were noted by me, which I was compelled to comment upon:

1. Dispensary representation for 2nd year in a row at our physicians meeting:
This is inappropriate even for conventional pharmacies,
(See 7/15/08 SF Chronicle op-ed piece:
"Toward purer medicine" by Robert Pearl

The op-ed is about pharmaceutical companies giving physicians gifts, but is even more inappropriate for cannabis dispensaries, since recommending one dispensary over another loses for the physician the full protection of Conant v McCaffrey and Conant v. Walters. I have good friends who runs great dispensaries. And I can’t and won’t refer patients to them for ethical and legal reasons.

As I said in my email newsletter of
July, 2007: "Blessed Are the Caregivers"
An Open Letter to Patients Groups, Dispensaries, Collectives
“I have BAD news, and I have GOOD news:
First, the bad news: I can never refer patients to you.
But the good news is: I can never refer patients to anyone else.
And this will be true of any ethical and legally responsible physician.

As tempting as it is for doctors and dispensaries to cross-refer to increase one’s business, this is illegal, and unethical, and I believe that the vast majority of dispensaries and physicians agree with this.”

I further suggest: Avoid those that DO refer: they are "DEA magnets."

What’s worse, a couple physicians were priding themselves on their association!
Illegal and unethical!

2. Also, one of the new practices was represented by a lay associate whom I had met at the NORML convention is LA last October, 2007. (And the physicians themselves were not present!)
She is a lay person who started a medical clinic. Illegal, as I told her last October.
Now she says she no longer does this, and yet, her "successful" multi-doctor clinic was founded illegally.
In California, lay people CANNOT hire physicians.

As I told the 2 non-physicians: I personally like them both, but their presence was inappropriate.

As I have said: my intention is to make MORE physicians feel comfortable making medical cannabis recommendations, safely and appropriately, not more “corporate medicine.” We have enough newbies fighting for the under 25 y/o patients who have never consulted a physician for their illness. Good luck!
I want to attract that VAST MAJORITY of legitimate patients who fear to make use of the medical cannabis laws of their own state because of the bad press and the bad business ethics of the minority of practitioners.

We have a plethora of new cannabis physician clinics being listed on CaNORML in the past three years since my physician practice standards survey of 2005.
and this year I will continue to expand my survey of physicians. Although I will keep the individual responses confidential (as I have promised the physicians who participate), I will post the qualities I would support and those I will not and will be creating a code of ethics based on my knowledge of the way medicine and medical ethics have traditionally been practiced.

To that end, I have been working with the newly formed AACM (American Academy of Cannabinoid Medicine) to create ethical national standards.
(More about AACM once we have our website up and running: soon…)

My article:
Implementation of the Compassionate Use Act in a Family Medical Practice: Seven Years Clinical Experience written with my colleague Mariavittoria Mangini, PhD, FNP
(published in the Spring, 2007 issue of O’Shaughness’s )
was designed to make MORE physicians feel comfortable making safe and appropriate recommendations.

Unfortunately, some of the chains have stripped it down to a shell of its protective intention, and pretend they are practicing defensible medicine.

I will be publishing my own code of ethics which I will publish soon, and will use the “bully pulpit” to encourage the ethical cannabis community to support when recommending their own friends and relatives to a physician.

In brief: what I have found out for California at least:
-Lay partner in medical clinics
-“Steering” patients for money or other consideration
-Physicians paying for referrals

More on this soon.
The most complete listing of cannabis recommending physicians that I am aware of is California NORML's excellent website:
Unfortunately, this lists ALL the doctors who wish to be listed, even what I call the "low standard" clinics, some of whom I would recommend avoiding if you have a documented serious illness and/or care about your medical-legal health, especially anyone growing their own medicine or acting as a caregiver for a patient.

If after checking for who may be near you, feel free to email me back regarding my opinion on whether that particular doctor or clinic has good standards.
My responses could include:
"I like their practice,"
"I don't know their practice," or
"No comment."

I will be continuing my Survey on Medical Cannabis Practice Standards
Dr. Lucido’s Physician Survey on Medical Cannabis Practice Standards

Stay tuned…

Frank H. Lucido MD
Family Practice since 1979
Medical Cannabis Consultation
Expert Witness
2300 Durant Avenue
Berkeley Ca 94704
510.848.0958 (by appointment only)

Dr. Frank Lucido’s blog:
“Pot Shots from the Bully Pulpit”
Bookmark it now, or subscribe to this blog for updates, otherwise you’ll only get my email newsletter once every few months.

“Hunter, Willie, Tommy, and me…”

Dr Frank Lucido's Blog: PotShots from the Bully Pulpit
or: Everyone’s Entitled to My Opinion

“Hunter, Willie, Tommy, and me…”
Dr. Frank Lucido joins NORML Advisory Board

In early 2006, I was asked to join the Advisory Board of National NORML
(National Organization for the Reform of Marijuana Laws).
NORML was founded in 1970 by the courageous Keith Stroup.

Knowing NORML’s history, I was honored to be asked, and of course I said yes.

Also joining the Advisory Board the same year was Norm Stamper, former chief of police of Seattle, and Advisory Board member of LEAP (Law Enforcement Against Prohibition).

AND, as it turns out, Tommy Chong!

When I logged on to NORML’s website, I saw the list of other Advisory Board members. These included not only many friends and heroes of mine in the medical cannabis movement, like
Lester Grinspoon MD, professor and author;
Valerie Corral, founder of WAMM;
Dale Gieringer, Vice-Chair of NORML, CaNORML state coordinator;
Mitch Earleywine PhD, professor and researcher;
Terence Hallinan Esq, attorney and former DA San Francisco;
and the late John Morgan MD, professor and author;

but also heroes of mine whom I hadn’t yet met, like…Willie Nelson!!

Then I saw the “in Memoriam” section, and realized that HUNTER THOMPSON had been on the Advisory Board, until his death in 2005.
One of my favorite authors!

So, I had to tactfully ask the obvious question below of Keith Stroup, founder and ex-president of NORML, whom I knew to be a good friend of Hunter's...
Enjoy his response...

Frank Lucido

On 10/13/06 6:16 PM, "Frank Lucido MD" wrote:

Hey Keith,
I know that no one could actually REPLACE the late, great, Hunter Thompson, but would it be accurate to say that I, or Norm Stamper, "replaced" him on the Advisory Board?
(or just that it took 2 of us to replace him, and a Tommy Chong to boot...?)
Just wonderin'...



Actually you have JOINED Hunter on the advisory board. We continue to list him as a member of the board (in memoriam, 1973-2005), at least on our letterhead, and so far no one has asked us how a deceased advisory board member can provide advice.

Those are large shoes to fill, and I too would argue, if I were in your position, that I was asked to step in and replace Hunter. It’s an honor, even if not everyone understands.

Hope you are doing well.



Hunter S. Thompson 1937-2005

Frank Lucido, M.D.

Willie Nelson

Tommy Chong

Norm Stamper
“The Drug War has arguably been the single most devastating, dysfunctional social policy since slavery.” - Chief Norm Stamper, Seattle Police Dept. (ret.)

Full listing of NORML Advisory Board members:

Upcoming blog pieces:

What is the range of service, fees, and credibility of cannabis physician? (which attempts to answer the questions: What Is “Medical?” or How Long Does It Take to write a recommendation?)

Civil disobedience vs. civil obedience: What's the difference? When is each appropriate? And for whom?

Three things money can’t buy

Dr. Frank Lucido’s blog:
“Pot Shots from the Bully Pulpit”
Bookmark it now, or subscribe to this blog for updates, otherwise you’ll only get my email newsletter once every few months.