3/16/01

Washington State House of Representatives
HB 5176 Hearing Committee
House Room C - JLOB Building
Olympia, WA

Dear State Representatives:

This letter is a reiteration of my supportive testimony before the Washington State Senate Hearing Panel for SB 5176 on February 12th, 2001. I am a double board-certified psychiatrist licensed to practice medicine in the State of Washington with 18.5 AMA credits in continuing education in medical marijuana studies. In addition, I have collaborated on a comprehensive review of medical marijuana research in a book published last year. Four years of clinical experience with medical marijuana users in Washington State adds practical experience to my established credentials of expertise in this area.

Patients, physicians, and law enforcement authorities should all welcome the passage of HB 5176. We support this attempt by the Washington State Legislature to clarify RCW 69.51A.030 by empowering the Washington State Department of Health to authorize implementation of rules to clarify the meaning of a "60 day supply." By determining these rules, patients, physicians, and law enforcers will all have a much-needed legal foundation, including reference to the current standard of care in the use of marijuana as medicine.

Since 1976, the United States government has delivered between 6 and 9 pounds per year of smokable marijuana to a handful of patients under the Compassionate Use Investigational New Drug Program. Although that program has been closed to new applicants since 1992, seven recipients still remain alive and continue to receive a minimum of 292 grams per month of marijuana for their personal medical use. These facts are recorded in numerous publications, and I have personally consulted with four of those federally recognized medical necessity patients who have each confirmed this information.

Further information has been acquired through my professional review of the medical records of several hundred medical marijuana users and through my personal consultation with dozens of qualified patients under my care. The current standard of medical care established by the federal government and replicated by cities such as Oakland, California is reasonable as it compares with my clinical experience among medical marijuana users. In dispensing pain medications, physicians depend on the patient's own reports in determining dosage. The medical term PRN, meaning "as needed" is plain. Some patients require a much greater dosage of any given pain medication to relieve their personal symptoms, and in many cases, those dosages fluctuate during the course of treatment. While not all medical marijuana patients require the amounts delivered under the Compassionate Use Investigational New Drug Program, there are many who do use medical marijuana in the range of 6 to 9 pounds per year. This range of care established by the United States government provides the Washington State Department of Health with a sound basis for setting a reasonable standard allowed by law.

I expect most physicians, patients, and police will applaud clarification of this issue in the laws of Washington State, and we thank this honored Committee and the sponsors of 5176 for this Hearing.

Sincerely,



Francis A. Podrebarac, MD