SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE April 28, 1999 6:00 p.m. MEMBERS PRESENT Senator Mike Miller, Chairman Senator Pete Kelly, Vice-Chairman Senator Kim Elton MEMBERS ABSENT Senator Gary Wilken Senator Drue Pearce COMMITTEE CALENDAR SPONSOR SUBSTITUTE FOR SENATE BILL NO. 94 "An Act relating to the medical use of marijuana; and providing for an effective date." -HEARD AND HELD PREVIOUS SENATE COMMITTEE ACTION SB 94 - See HESS minutes dated 3-24-99. WITNESS REGISTER John (Jack) Anderson 1430 W 12th Anchorage, AK 99501 POSITION STATEMENT: Opposed to SB 94 Teresa Lyons Alaska Nurses Association PO Box 477 Ester, AK 99725 POSITION STATEMENT: Opposed to SB 94 Irene Alexakos 1311 Tarn Juneau, AK 99801 POSITION STATEMENT: Opposed to SB 94 Natalie Ringland 50016 Forest Glen Street Kenai, AK 99611 POSITION STATEMENT: Opposed to SB 94 Mark Chryson, Chairman Alaska Independent Party 2140 Wolverine Circle Wasilla, AK 99654 POSITION STATEMENT: Opposed to SB 94 Jim Kentch 2708 W 64th Anchorage, AK 99502 POSITION STATEMENT: Opposed to SB 94 Neal Matson PO Box 80888 Fairbanks, AK 99708 POSITION STATEMENT: Opposed to SB 94 Cathleen Rolph PO Box 2943 Soldotna, AK 99669 POSITION STATEMENT: Opposed to SB 94 Annalee Owens HC 30 Box 5423 Wasilla, AK 99654 POSITION STATEMENT: Opposed to SB 94 Don Dapcevich State Advisory Board on Alcoholism and Drug Abuse Box 021571 Juneau, AK 99802 POSITION STATEMENT: Commented on SB 94 Stephen Mihalik 8009 Huckleberry St. Anchorage, AK 99502 POSITION STATEMENT: Supports SB 94 Bill Kozlowski 713 5th St. Juneau, AK 99801 POSITION STATEMENT: Opposed to SB 94 Kathy Needles 5340 E 26th Anchorage, AK 99502 POSITION STATEMENT: Opposed to SB 94 Roger Hansen PO Box 84951 Fairbanks, AK 99708 POSITION STATEMENT: Opposed to SB 94 Lonnie Temple Box 2914 Kenai, AK 99611 POSITION STATEMENT: Opposed to SB 94 Todd Whitstine HC 04 Box 3477 Palmer, AK 99645 POSITION STATEMENT: Opposed to SB 94 Jeffrey Gottlieb PO Box 91840 Anchorage, AK 99509 POSITION STATEMENT: Opposed to SB 94 Jodi Olmstead PO Box 56853 North Pole, AK 99705 POSITION STATEMENT: Opposed to SB 94 Robert Poggas 9941 Whitefish Circle Anchorage, AK 99515 POSITION STATEMENT: Opposed to SB 94 Charles Rollins PO Box 55616 North Pole, AK 99705 POSITION STATEMENT: Commented on SB 94 Betty Rollins PO Box 55616 North Pole, AK 99705 POSITION STATEMENT: Opposed to SB 94 Ralph Jones 10309 VFW Rd. Eagle River, AK 99577 POSITION STATEMENT: Opposed to SB 94 Cindy Hutchens Rt 1 Box 94-A Kenai, AK 99611 POSITION STATEMENT: Opposed to SB 94 Dirk Nelson PO Box 283 Ester, AK 99725 POSITION STATEMENT: Opposed to SB 94 Kendall Thomas 5350 Little Tree St. Anchorage, AK 99508 POSITION STATEMENT: Opposed to SB 94 Daniel Hancock PO Box 82590 Fairbanks, AK 99708 POSITION STATEMENT: Opposed to SB 94 John Thomas 5350 Little Tree St Anchorage, AK 99508 POSITION STATEMENT: Opposed to SB 94 Keith Klemme 6630 E 10th Ave. Anchorage, AK 99504 POSITION STATEMENT: Opposed to SB 94 Tony Masella 455 3rd Ave. #813 Fairbanks, AK 99701 POSITION STATEMENT: Opposed to SB 94 Deborah Luper PO Box 242032 Anchorage, AK 99524 POSITION STATEMENT: Supports SB 94 Helen Peters 1501 W 11th St. #22 Anchorage, AK 99501 POSITION STATEMENT: Opposed to SB 94 Byron Gray PO Box 544 Anchorage, AK 99510 POSITION STATEMENT: Opposed to SB 94 ACTION NARRATIVE TAPE 99-23, SIDE A Number 001 CHAIRMAN MILLER called the Senate Health, Education and Social Services (HESS) Committee to order at 6:00 p.m. Present were Senators Pete Kelly, Elton, and Chairman Miller. CHAIRMAN MILLER announced that the meeting was scheduled for the specific purpose of taking public testimony on SB 94, and he asked those testifying to limit their testimony to two minutes due to the large number of participants. CHAIRMAN MILLER informed participants that a copy of the amendments proposed by the Administration had been faxed to all Legislative Information Offices that day, and that he intends to adopt those amendments into a new committee substitute which should be prepared by Monday. He asked participants to direct their remarks to the proposed amendments and announced Vice-Chair Kelly would be chairing the remainder of the meeting this evening. The following testimony was taken via teleconference from participants at the Legislative Information Offices around the State. Number 036 MR. JACK ANDERSON, a 60 year resident and past member of the Anchorage Chamber of Commerce, asked committee members to consider that a particular pain pill prescribed to terminally ill patients must be taken every 6 hours, at a cost of $8 each, and does not work. A marijuana injection, taken twice per day, costs 20 cents per injection, and works. He questioned how we can deny our terminally ill friends and family relief from pain. He noted that police go after marijuana users because drug busts on their resumes make them look great. He concluded by saying Alaskans told legislators at the polls what they wanted in no uncertain terms. He believes Senator Leman should be recalled immediately for introducing this legislation. TERESA LYONS, representing the Alaska Nurses Association (ANA), the voice of 7,000 registered nurses throughout Alaska, made the following comments in opposition to SB 94. The ANA is one of several health care professional organizations that endorsed the ballot measure that passed by a margin of 72 percent. The ANA is extremely saddened that SB 94 has been introduced as it appears to be an attempt to legislate professional health care practice which should be left in the hands of professional practitioners. Marijuana is a classified medication, regulated to protect the public. The ANA does not want to increase the legalization of illicit medications but many medications used under prescription are, in fact, available on the street and are used for illicit purposes. The ANA stands opposed to SB 94 and hopes the legislature provides the people of Alaska with access to this particular medication that can be very helpful in reducing nausea and pain. Number 108 IRENE ALEXAKOS testified from Juneau, and discussed her family's experience with her brother's terminal illness. The first sign of her brother's illness came in 1975, four years prior to his death; he died after struggling with cancer at the age of 26. Twenty five years ago physicians knew marijuana would ease the side effects of her brother's chemotherapy treatments. Her brother's neurosurgeon could see no logic in preventing the use of marijuana for therapeutic reasons, when highly toxic drugs could be legally administered. Her conservative parents sought to illegally purchase marijuana to alleviate their son's pain. The emotional pain of watching her brother die eventually killed her father. The fact that her parents' actions were illegal is incongruous and irreconcilable. Initiatives are being passed all around the country because most people know that. Legislatures are reluctant to take up the issue for political reasons so the people are speaking through initiatives. She asked legislators to open their hearts and see that SB 94 will make it harder for patients and folks who need the most help. Number 178 NATALIE RINGLAND, a Kenai resident, stated her opposition to SB 94 via teleconference and encouraged legislators to reject this legislation. She made the following points. First, as a medical patient herself, she has a number of expensive and dangerous prescriptions in her home. Society trusts her not to resell or redistribute her medicines. It would be impossible to prove that she does not sell her prescription drugs, however SB 94 seems to require that for marijuana prescriptions. Second, mandatory registration for the use of medicinal marijuana is unfair. Medical patients do not deserve to be treated like sex offenders. She asked legislators to please give the new law a chance to work before placing restrictions on patients and physicians. Number 206 MARK CHRYSON, Chairman of the Alaska Independent Party (AIP), stated his opposition to SB 94 for the only reason that the medical use of marijuana was passed through an initiative by the people of Alaska, and by law, the Legislature must keep its hands off of that initiative for two years. He urged legislators to reject SB 94. VICE-CHAIR KELLY noted the Alaska Constitution allows the Legislature to make technical changes to initiatives after two years. Number 235 JIM KENTCH, one of the three co-sponsors of the ballot proposition, made several points. First, legislators must listen to the people who are testifying. Second, Ballot Proposition 8 has a better way to reconcile the 1990 ballot initiative which recriminalized marijuana; that is to take medical marijuana out of the criminal system altogether, thereby placing less burden on that system. The initiative will not protect legitimate medical marijuana users from using marijuana in public. He asked how housebound patients will obtain medical marijuana once prescribed. Third, the initiative has not yet been given a chance to work; SB 94 jumped the gun. Fourth, SB 94 tells doctors how to practice medicine by unnecessarily invading the doctor-patient relationship. It requires a doctor to explore other approved medications and treatments that might provide relief. He questioned what "explore" means and whether patients must go through trials and errors when medical marijuana may be the best existing treatment modality. Finally, the physician must conclude, if SB 94 is enacted, that the benefits of medical marijuana outweigh the benefits of other treatments. That conclusion is not required of any other medicine. Number 270 NEAL MATSON, a member of the American Cancer Society, American Kidney Foundation and the President's Advisory Committee of the Alaska Kidney Foundation, made the following comments in his capacity as an ordained priest. SB 94 forcibly juxtaposes a dying patient with the criminal element of our society by not enabling the legal procurement of medical marijuana. He proposed authorizing the release of confiscated marijuana to patients and questioned why a substance will be destroyed that can relieve the suffering of a terminally ill patient. He questioned why payments should be made to out-of-state drug companies for Marinol when Alaskan patients can be supplied with confiscated marijuana at no charge. CATHLEEN ROLPH stated she is testifying in support of friends who benefit from the use of medical marijuana. She is opposed to SB 94; the initiative that passed last fall has not yet been implemented, it is a waste of tax dollars to amend a law that provides compassionate care. She said a person using a medical prescription should not be placed in the same category as a drunk driver. ANNALEE OWENS, representing herself, informed committee members she has a chronic lung disease which requires her to use ineffective medications that cost over $300 per month. She has used marijuana and found it to be the only thing that relieves her pain. She said it makes no sense to her to have to engage in criminal activities to help herself medically. She is terminally ill and under a physician's care, yet the medication that helps her the most is not available to her. She asked legislators to let the initiative stand as is so people like herself have some relief during their last days. Number 327 DON DAPCEVICH, representing the State Advisory Board on Alcoholism and Drug Abuse, said the Advisory Board initially opposed the initiative, however once the initiative passed and Alaskans spoke, it decided to stand behind the implementation of the initiative. The Board also stands behind prosecution of those who illegally use medical marijuana. The Advisory Board encourages the Legislature to pass a law that will allow for the use of medical marijuana by those with a legitimate need, and to prosecute those users who have no legitimate need. STEVE MIHALIK, representing himself, said SB 94 is necessary to tighten language associated with the initiative. He does not argue that compassion is needed for terminally ill people; SB 94 still allows them to use the medication, however others will take advantage of the privilege. He believes marijuana is a gateway drug as his brother used it to relieve the pain of a medical condition, but three years ago he died of a heroin overdose. He urged committee members to pass SB 94 to help control the manipulative minds of drug abusers and to allow people with debilitating conditions to get the medication voters intended them to get. Number 375 BILL KOZLOWSKI, representing himself, testified in opposition to SB 94. He suffers from severe hemophilia and a second disease, which causes internal bleeding resulting in joint deterioration. He has been on many pain medications but because of the severity of his pain, he wanted to die. He felt stuck in the Western narcotic frenzy called medicine which was leading his family into turmoil. That frenzy changed five months ago when he found the one medication that he can use that enables him to have a life and not to be a "junky." Marijuana enables him to get up in the morning, to hold a job, and to be a part of society, which is much more than narcotics could do for him. His concern with SB 94 is the registration requirement. He is the only hemophiliac in the State of Alaska who received blood transfusions in the 1980s and did not contract AIDS. He did contract Hepatitis C through blood transfusions and has felt discriminated against because of his disease. To be required to put his name on a list as a marijuana user is discomforting. He concluded by saying if legislators have faith in the voters to vote them into office, they should have faith in the voters in voting for Ballot Measure 8. Number 418 KATHY NEEDLES testified from Anchorage in favor of Alaskans for Medical Rights, and said those people who voted against the initiative must never have had a medical pain in their lives. She stated liquor is legal, yet it kills, while marijuana is illegal, and it cures. ROGER HANSON testified from Fairbanks and disagreed that marijuana is a gateway drug. His wife worked at a treatment program for heroin addicts; the only common factor among the addicts was that they all started off on milk. He said it is unusual when 70 percent of Alaskans come together on an issue as they did on Ballot Measure 8. He noted many of his colleagues have read SB 94 but none fully understand what it means, yet the bill smacks of the instance during the 1930s when the pharmaceutical companies got just about everything they wanted from Congress. LONNIE TEMPLE testified from Kenai and asked legislators to reject SB 94 and to stop trying to play God with people's lives. He stated if marijuana allows terminally ill people to endure their pain, so be it. He questioned why the elected officials are not listening to the people's vote. TODD WHITSTINE testified from MatSu against SB 94. He questioned why language on page 3, line 25, refers to only one care giver since a patient might have to wait 35 days for a new care giver to be appointed, if need be. He noted that the language on page 5, line 2, will require a patient to become more ill before medical marijuana can be prescribed. He questioned why the language on page 11, lines 4 through 21, was deleted. He believes the language on page 15, lines 9 through 11, will create an undue hardship. He questioned whether a patient will be out of luck if a care giver refuses to prescribe a certain treatment, according to language on page 15, lines 26 through 31. He proposed that the word "may" on page 5, line 24, should be changed to "shall." VICE-CHAIR KELLY noted a lot of the language referred to by Mr. Whitstine was in the initiative and that the problem with initiatives is that most people do not understand the intricacies of the laws they are voting on. Number 490 JEFFREY GOTTLIEB, a physician, stated marijuana is an effective pain prevention medication for a lot of people. Most of his patients who require pain medication are already addicted to opiates and would benefit from the initiative that passed. SB 94 interferes with the patient-doctor relationship; he opposes it and would like marijuana to be classified as a drug that can be prescribed by physicians. He believes patients with other conditions not included in the initiative could benefit from medical marijuana. He noted the chemical structure of marijuana and antidepressants is very similar and that marijuana was mentioned in medical textbooks 2,000 years ago. He stated he does not believe the people, nor the Legislature, should be voting on medical treatments, and that the American Medical Association has taken a position in which it is not opposed to the medical use of marijuana. JODI OLMSTEAD stated she thinks the Legislature has done a really poor job of listening to constituents. She noted the Clinton Administration is in favor of new findings of positive uses of marijuana; she asked legislators to review those findings. She stated her daughter had leukemia 25 years ago, and the same drugs used then are being used today. She stated the people who want to get medical marijuana are going to get it; the Legislature will not stop them. Number 554 ROBERT POGGAS testified from Anchorage and asked legislators to enact the initiative that the people voted on. CHARLES ROLLINS testified from Fairbanks and informed legislators that doctors in California who prescribe marijuana are being investigated by the California Medical Board and that a $10 million lawsuit has been filed. He asked that the bill differentiate between fertile and sterile seeds. BETTY ROLLINS stated she is a 65 year old grandmother who cannot be classified as a person who is attempting to legalize drugs by supporting the use of medical marijuana. She said the initiative was horrible; SB 94 is horribly ridiculous. She noted the initiative called for a register. She expressed concern that SB 94 interferes with the doctor-patient relationship. She said a lot of people are dying and need medication to relieve their pain, and whether medical marijuana is legal or not, they will get it. She asked whether we want to send those people to jail. TAPE 99-23, SIDE B RALPH JONES, a lifelong resident of Anchorage, stated he was diagnosed with liver cancer over one year ago. He went to the Sloan Kettering Cancer Institute where he had a tumor removed from his liver. After the surgery he weighed 125 pounds. He was given every kind of medication imaginable afterward, in an attempt to help him to eat and gain weight. One year after the operation he had gained no weight. In January he began taking medical marijuana and has gained 25 pounds since. He questioned how the Legislature can change an initiative within two years of its passage and he expressed concern that the people of the State no longer have any say in what goes on. CINDY HUTCHENS, a Kenai resident, said she has gastroperisis (ph), a nerve disorder of the intestines. She is frequently hospitalized for dehydration and malnutrition. She has used marijuana for the past five years and it has helped her more than any other drug. Marijuana minimizes her nausea and stimulates her appetite. She no longer sees marijuana as a gateway drug; she sees it as a medicine. She asked legislators to support the voters. Number 534 DIRK NELSON, a licensed clinical social worker and family therapist, made the following comments. He has studied marijuana pharmacology since 1971. Last month the American Academy of Sciences declared the gateway drug theory to be a hoax. He questioned why over 98 percent of government studies never face peer review, and those that do fail miserably. Lie after lie has been discovered in research used by the Drug Enforcement Agency (DEA); credible labs have been unable to duplicate the test results. In all of his years as a therapist, he has never encountered a case involving crisis resulting solely from marijuana use, however, at the mental health centers he has worked at, copies of the Physician's Desk Reference were typically given to clients disclosing side effects of various psychotropics. Most psychotropics come with two to four pages of small print about their serious and severe side effects; the use of these drugs goes unquestioned despite the crises they are capable of generating. It is his opinion that the reason is that psychotropics are not associated with "those darn evil hippies." In summary, SB 94 violates the doctor-patient privilege and the Raven decision. KENDALL THOMAS made the following comments on behalf of the Alaska Hepatitis C Coalition. The Coalition was gratified to see the passage of Ballot Measure 8, which was carefully written to allow a licensed physician to exercise his/her professional opinion to recommend medical marijuana as a treatment to patients who would benefit from it. SB 94 will significantly limit the physician's ability to recommend to patients suffering from a chronic disease, other than AIDS, glaucoma and cancer, medical marijuana. Some of the patients who attend her local Hepatitis C support group or call the help line say that medical marijuana has had a positive impact on the quality of their lives. It is used for those suffering from anorexia, nausea, and joint and muscle pain. Many prefer to take marijuana over other prescribed high-toxicity medications which tax an already compromised liver. SB 94 will force these patients to choose between a therapy they find beneficial and breaking the law. The Coalition urges legislators to vote against SB 94 and allow the current law to remain as is. Number 492 DANIEL HANCOCK testified from Fairbanks and said he supports the medical use of marijuana and is opposed to SB 94 for the same reasons expressed by other participants. JOHN THOMAS, a 25 year Anchorage resident, said he opposes SB 94 and made three points. First, it is clear that the voters of the State believe that marijuana can be effective when other drugs cannot. Second, many other drugs are addictive and very dangerous if misused, such as narcotic painkillers. Third, patients currently abuse the system to obtain drugs. He said he sees no reason to treat marijuana so differently since narcotic drugs are much more dangerous. RICHARD WELCH testified from Fairbanks, and informed committee members he has HIV and Hepatitis C and suffers from chronic pain and weight [indiscernible] syndrome. Marijuana has been the only medication that has benefitted him in alleviating his pain. Some of the other medications prescribed for him have made him more ill. He believes SB 94 is a waste of money and time. KEITH KLEMME testified in opposition to SB 94 from Anchorage. He believes the sponsor is bringing disgrace upon the Legislature by ignoring the will of the people. He spent 15 years in the military to ensure that the people have the right to vote, and not to be dictated to by a legislator. He expressed concern that the privacy rights of those who signed petitions might be violated. Number 433 TONY MASELLA testified from Fairbanks and said SB 94 makes more difficult an issue already decided by the people. He believes the use of medical marijuana, as opposed to Marinol, will be advantageous to the State because of the cost savings. DEBORAH LUPER, a 38 year resident, mother, and former Fairbanks police officer, stated she supports Senator Leman's efforts to close the loopholes in the initiative. She expressed concern that the youth of Alaska are getting the message that marijuana use is beneficial. She believes police should have access to information to verify that a person can legitimately use medical marijuana. She recommends that proponents of the legal use of medical marijuana work with the sponsor to close the loopholes in the initiative, otherwise, in two years, the initiative may be found to be unworkable. HELEN PETERS, a registered nurse in Anchorage, stated she has worked with many terminally ill patients over the past 30 years. Some of those patients found that marijuana was the only thing that helped them gain weight and tolerate their pain. In the past few days she spoke to about one dozen doctors and nurses that she works with and without exception, they all agree that marijuana use should not be legalized for all but that a doctor should be able to prescribe it. BYRON GRAY testified from Anchorage in opposition to SB 94 because any further restriction to the people's demand to allow for the use of medical marijuana can only result in the arrest of sick people and doctors which is foolish, insane, and pathetic. The Legislature should not mandate medical prescriptions and diagnoses. There being no further testimony on SB 94, VICE-CHAIRMAN KELLY announced the bill will be taken up by the Senate HESS Committee next Monday. He adjourned the meeting at 7:12 p.m.