Reputable cannabis clinicians and righteous activists want the Medical Board of California to close down the “recommendation mills” that provide 18, 19, and 20-year-olds with access to dispensaries where they can buy megadoses of THC. I mentioned their little campaign to John Fleer, a lawyer who specialized in med board cases. Some 20 years ago, when Dr. Tod Mikuriya was charged with violating the medical profession’s “standard of care,” Fleer had been assigned by Tod’s malpractice-insurance carrier to defend him. The prosecution was preposterous and the defense formidable, but the fix was in.
Fleer, 71, has reduced his case load but is still defending doctors. “I haven’t seen a cannabis case in years,” he said. “The board has been totally focused on the pain specialists –the opioid prescribers. Going after the mills is fine,” he added, “but the Enforcement Division thinks it’s all evil, so they go after the diligent doctors, too.”
The wheel of the law turns, said Uncle Ho, and it sure has turned with respect to opioids. One of Tod’s closest friends and allies, Dr. Frank Fisher, was a humane, conscientious pain specialist based in Redding who was charged with murder (and Medi-Cal fraud) in 1999 after patients for whom he had prescribed OxyContin died. Fisher was exonerated after five years of court fights. A charter member of the Society of Cannabis Clinicians, he decried “the undertreatment of pain” in O’Shaughnessy’s Spring 2006 issue:
“Chronic pain is the largest single cause of disability in America, exceeding both heart disease and cancer. Tens of millions are afflicted, and those who suffer from the severest form of the disease are the least likely to find satisfactory treatment. This is the case because when the disease has progressed to this stage, treatment with opioid analgesics, which are categorically safe —and for pain sufferers, non-addictive— is usually the only therapeutic modality bearing the potential to bring the disease under control.
“Paradoxically, while the streets are awash in illicit analgesic medications, pain sufferers are the only group within society who can’t adequately access these substances.
“The undertreatment of chronic pain is a public-health disaster for which there is a workable solution close at hand. The whole mess is a consequence of prohibition law in the form of the Controlled Substances Act, and is driven by the collapse of medical ethics within the discipline of academic pain medicine.”
We also published a sermon of sorts delivered at a conference by Joe Talley, MD. a North Carolina family practitioner whose willingness to prescribe opioids turned his office, over the years, into a “clinic of last resort” for thousands of pain patients. In 2002 Talley was raided by the DEA and had his license suspended. He was facing criminal charges stemming from patients selling or overdosing on drugs he had prescribed when he gave this talk:
“Even those of us who last saw the inside of the church as a 12-year-old forcibly deposited there will probably remember the parable of the wheat and the tares. The one where farmers woke up to find their wheatfield all grown up with weeds that some wise guy had sown. They asked the boss whether they should pull up the weeds, and he said, ‘No, you can’t tell the wheat from the tares at this point. If you go after the tares, you are bound to sacrifice a lot of good grain with it. So treat the wheat field with the same TLC you always did. The good grain is your priority. The tares we will deal with later.’
“For many people, that parable simply promises them that their enemies (all designated tares) will someday get theirs. For a few, maybe it worries them that they might someday turn out to be tares themselves! But the real point for today, the minister pointed out, was that all the trauma, bloodshed, discrimination, and other horror stories done in the name of religion today, everything from bloody religious wars down to squabbles about gays in the congregation, comes from Christians (not to mention Muslims!) doing what the servants in the field wanted to do –go after the tares now.
“But that won’t work –we can’t tell who are tares and who are wheat– and it is not what our faith teaches us to do. Someday I will be facing 12 men and women tried and true from the mountains of North Carolina (all there because they were too dumb to know how to get out of jury duty). They will live in little houses on the hillside, with American flags flying on their porch, and perhaps a sign saying ‘America! Love It or Leave It!’ They will be haunted by the usual demons –communists, gays, liberals, foreigners, drugs (excepting alcohol and tobacco, of course), abortionists, and their rebellious teenage kids!
“They will almost all be professing Christians. They may not spend much of their time in a careful study of their faith, but they will remember, vaguely at least, the parable of the wheat and the tares. At my trial, on direct exam I would want my attorney to say: ‘Dr. Talley, you admit you must have at some time or other given opioids to people who in fact didn’t need them, or at least that many of them, for pain relief. Why did you do that?’
“I would answer, ‘Because there was no way to be sure. There was no accurate way to foil the drug abusers and dealers without denying mercy to people tortured by pain.’
“‘All of us will remember the parable in Matthew, about the wheat and the tares. The government wants me to do what the Master’s servants wanted to do –to separate them out when there was no way to separate them out. To ignore the needs of the grain just to make sure the tares don’t get away with anything. There is no way to justify that scientifically or morally.
“‘Just as in the case of the wheat and tares, time will tell who is who, but there is no way to tell when the guy sitting across from me in my office appears to be suffering. There are things to do to try to narrow it down, and I did those things. But in the end, there is no way to be sure. And to deny 10 people mercy just to frustrate one drug abuser is just plain wrong.’
“In most of the trials I have followed so far, the jury has not had it hammered home to them convincingly that you cannot tell the wheat from the tares. The government has successfully advanced the scam that we really could have if we had just tried, rather than being criminally indifferent.... Anyhow, now let us all now bow for the benediction.”
• Kyrie Irving has come up with a clever way to become persona non grata in Brooklyn, where he plays for the dismal Nets. Last week Irving tweeted a link to a site peddling a documentary called “Hebrews to Negroes: Wake up Black America” that Rolling Stone deemed anti-semitic. Why didn’t NY Times sportswriter Shaunter Lowe check out “Hebrews to Negroes” for himself before filing a 14-inch story about Irving pushing it? Lowe notes that in September Irving shared a video by the rightwing conspiracy theorist Alex Jones. The Times piece quotes Kareem Abdul-Jabbar’s wise words: “Kyrie Irving would be dismissed as a comical buffoon if it weren’t for the influence over young people who look up to athletes.”
Maybe the Russkies would trade Britney Griner for Kyrie Irving and an arms dealer to be named later. It couldn’t hurt to ask.
• The New York Times front page has been dominated all year by the war in Ukraine. The Times’s political line echoes the State Department’s, an enthusiastic “Let’s you and him fight!” A headline October 10 was revealing. The editors in New York thought Ukrainians were feeling joy because somebody had blown up the very important bridge linking Crimea to mainland Russia.