������Ƶ

Hawaii adopted a fairly progressive stance with medical marijuana back in 2000 through a legislative initiative.

Lawmakers legalized the use of marijuana for several medical diagnoses: cancer, HIV/AIDS, glaucoma, chronic severe pain, seizures, chronic headaches and migraines, painful neuropathies, fibromyalgia, multiple sclerosis, and inflammatory bowel disorders.

Not included were insomnia, anxiety, attention deficit hyperactivity disorder and depression.

With authorization from a certified doctor for the approved medical conditions, it’s been legal to possess a small amount of marijuana for personal use.

But how would you legally get it? Well, you’d have to grow your own, or designate a “caregiver” to do so.

Unlike other states that legalized medical marijuana and then established procedures for procuring it through dispensaries, Hawaii has taken only the first step.

People who obtain a blue card — a type of medical marijuana license — can grow up to seven (three mature, four immature) plants in their home for their own consumption. The possession of 3 ounces of processed marijuana is allowed, and in January that rises to 4 ounces.

Alternatively, one can designate a “caregiver” to grow the plants, as long as that plant provides the marijuana for the patient holding the blue card.

This may be an option for some, but for patients who are suffering from a terminal illness, time is of the essence, and waiting for a plant to grow is not an option.

Neither is being arrested for purchasing marijuana on the street, regardless of holding��blue card status or not.

The process can be improved, and change is in the works.

What if we were to treat the use of marijuana like we do other prescription medications, like codeine, and make it available at a pharmacy?

Currently, a Medical Marijuana Dispensary System Task Force is charged with making a recommendation on how to obtain marijuana for those certified.

Starting in January, the whole system will be controlled by the Department of Health. For better or worse, only primary care doctors will be allowed to provide the recommendation for the use of medical marijuana for individuals, along with a rigorous process of certification along with the need for yearly renewals.

Many doctors, myself included, are completely unaware of the rules and regulations of the process of certifying patients to use this medicinal substance. But we had better be quick studies, because change is in the wind, and it’s coming in four weeks.

Having the Department of Health take charge of the process might provide the incentive needed to find a way for those holding cards to acquire medical marijuana without having to grow it themselves.

But paperwork and the requirement that only primary care doctors are given the authority to recommend medical marijuana just makes it harder for those who need it most. Many primary care doctors don’t treat the conditions that qualify, and the board certified pain management doctors seem to be left out of the loop.

What happens if a primary care doctor doesn’t feel comfortable prescribing medical marijuana in the first place?

Where will patients go if they need to obtain the certification? Will they be switching doctors just to get marijuana?

And, of course, none of this solves the problem of where to get it legally.

Many doctors, myself included, are completely unaware of the rules and regulations of the process of certifying patients to use this medicinal substance.

In most medical marijuana states, dispensaries have been set up to deliver the goods so that people suffering chronic pain are not left to their own devices.

What if we were to treat the use of marijuana like we do other prescription medications, like codeine, and make it available at a pharmacy?

The marijuana plant could be cultivated in a monitored setting, and provided to pharmacies securely. All doses would be accurately measured, the amount tightly regulated. The process by which other medications are carefully monitored, like oxycodone, morphine, and hydrocodone, is already familiar to almost all primary care doctors.

Standardizing the delivery without forcing patients to resort to illegal means of obtaining marijuana would be a place to start. Pharmacies are very familiar with how to handle, dispense, and secure highly controlled substances.

Even if certain pharmacies refused to participate, having at least one on each island that could control the prescription and distribution of medical marijuana would be a step up from what we have now.

The system could essentially pay for itself. That’s not including the revenue already allocated to the special fund from the applications and renewals.

Hawaii set a precedent by being one of the first states to legalize medical marijuana.

If the Department of Health really wants to help those designated as able to legally use it, then the process needs to be simple, streamlined and efficient.

Anything less is a disservice to the people that need help the most.