Letters for March 24 

Readers sound off on our profile of Dr. Assad, Berkeley Daily Planet reporter Richard Brenneman, and Burmese refugees.

"Oakland Pot Doc Is Defrocked," Feature, 3/10

Hardly Muckraking

It was muckraking when the North Coast Journal reported the sexual charges against Hany Assad in 2007, while he was still practicing. But it was beating a dead horse and merely salacious when the East Bay Express resurrected the story months after Assad's license was pulled.

I'm writing because my name was invoked in a paragraph consisting of five false sentences:

"Ever since Proposition 215 passed in 1996, there's been a boom in clinics run by doctors that only prescribe pot." Your inapt use of the verb "prescribe" is trivial compared to your distortion of the political situation after the passage of Prop. 215. As of November, 1996, there was only one pro-cannabis MD, Tod Mikuriya, flying up and down the state conducting ad hoc clinics. Slowly and cautiously over the ensuing years, a few other doctors let it be known that they recognized cannabis as safe and effective medicine. Drs. Frank Lucido, David Bearman and Stephen Banister were among the first and patients flocked to them for approvals. All three got investigated by the state medical board and Banister was put on probation. In the next wave Drs. Eidelman, Hergenrather, Fry, Denney, O'Connell, Barth came out as pro-cannabis. As of 2003, nine of the 15 doctors issuing large numbers of approvals had been investigated by the med board — a costly, frightening ordeal that sufficed to keep doctors of average courage from doing so. 

"According to Fred Gardner, a leading member of the cannabis clinician community ... there's an estimated 600,000 to 700,000 people with pot recommendations from a doctor, amid a field of perhaps 4 million California pot smokers." I'm not a clinician, I'm a writer and I never made either estimate. You can (not) look it up.

"Anywhere from fifty to a few hundred doctors in the state do all the prescribing."  The first half of that sentence is one of the facts your reporter should have tried to nail down, the second half is provably wrong. Thousands of mainstream California doctors have authorized cannabis use by their patients. When I surveyed California doctors in 2006 for the O'Shaughnessy's 10-year report, I concluded, "Approximately 160,000 patients have been authorized to use cannabis by some 30 MDs involved in the survey. In Oregon, where a 1998 voter initiative created a medical-marijuana program that tracks participants, an equivalent number of cannabis specialists have issued 45% of the approvals. By extrapolation we put the number of Californians who have become legal cannabis users since Prop. 215 passed at around 350,000." In other words, slightly more than half the authorized patients were approved by their "regular" doctors and other specialists such as oncologists. 

"No one counts them." The Patient ID Center keeps track of doctors who issue approvals that gets processed by their Oakland and LA offices. The number exceeded 2,100 as of a few months ago. 

"They set up high-volume practices where they exclusively determine if marijuana would be an effective treatment for customer maladies." Not all cannabis specialists run high-volume practices. In any case, volume reflects demand. Demand has been pent-up because most doctors, having learned nothing about cannabis in medical school, remain reluctant to recommend it, while others are simply too scared of running afoul of the medical board. As for "exclusively," who other than the doctor and patient should be involved in the treatment decision? The local police? The reality is, some pro-cannabis doctors are conscientious, painstaking, ethical and respectful; and some are cursory, venal and sleazy. As in every field, there's a spectrum of skill. I'd put Phil Denney at the high end of his and David Downs at the low end of his.

Fred Gardner

David Downs Responds

I misattributed the "600,000 to 700,000" figure to Mr. Gardner and I should have attributed it to Dr. Denney. Apologies.

It doesn't change the fact that there are now literally "countless" doctors running high-volume practices up and down the state capable of making millions of dollars off cannabis recommendations. They did not exist before 215, so I characterize this as a boom.

Indeed, Fred Gardner is not a clinician, he is the editor of a medical cannabis journal O'Shaughnessy's, long-time member of the Society of Cannabis Clinicians, and a long-time activist. This led me to correctly characterize him as "a leading member" of that community.

Former SCC president Dr. P.A. Denney provided me with the estimate of 50 high-volume doctors, while the Los Angeles Times' Steve Lopez in 2009 provided the estimate of a few hundred. There is no official count. While any doctor can recommend cannabis (I interviewed a respected doc at UC Davis who had issued one in her decades-long career), a select few are responsible for the majority of recommendations.

According to the California Medical Board, no officials count the number of recommendations, or doctors who issue them, as it is a private matter between doctors and patients. The Patient ID Center does keep track of some doctors, but no one counts them all. While there may be 2,100 doctors who at one time have issued a recommendation tracked by the Patient ID Center, a select few like Assad do much of the high-volume work, essentially running script mills. In Venice Beach, clowns dance along the boardwalk with big signs encouraging people to come in off the street for a doctor's recommendation and cannabis purchase from such high-volume clinics.

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