Kelly Paige, manager of the state Health Division's medical marijuana program, says lack of income is one of the biggest challenges to making the program successful.

"The costs are a barrier for low-income people," said Paige, who is reviewing the budget as the program nears its one-year anniversary. "A lot of the people who are extremely ill fall into that category."

Oregon's medical marijuana law, passed in November 1998, allows people who suffer from cancer, glaucoma, HIV and other physical ailments to register with the Health Division to use marijuana. No insurance companies cover the expenses of medical marijuana use.

The law prohibits buying and selling marijuana, so patients have to grow their own or get it for free. Start-up costs for an indoor marijuana garden -- plants, lamps, electricity and fertilizer -- can range from $700 to $1,000, Paige said.

The medical-marijuana law also requires patients to have a doctor complete a form that says marijuana might mitigate their symptoms. The patient then mails the form, an application and a $150 check to the Health Division. After reviewing the application, the Health Division issues a card exempting the patient from state laws that prohibit possessing and growing marijuana.

One of many people who have had trouble coping with the costs is John Malaer, who is paralyzed from the waist down and has been confined to a wheelchair since breaking his back two years ago. He gets by on $520 a month in disability payments and $86 in food stamps.

"It's not economically feasible for the people who need it to take advantage of it," Malaer said. "It's almost more of a hassle than it's worth."

Of the five states and the District of Columbia that allow seriously ill people to smoke marijuana, only Oregon and Alaska charge fees for an identification card. Alaska's fee is $25.

When Oregon advocates were lobbying for the statewide initiative, they expected a similarly priced fee, Paige said.

But the Health Division's medical marijuana program gets no general fund money, and its $75,000 budget is funded solely by the registration fees. More than 400 of an expected 500 cards have been issued, which pay for Paige's salary, printing and postage costs and legal costs.

Insurance companies won't pay for marijuana because it is not approved by the Federal Drug Administration. Many insurers and the Oregon Health Plan do cover Marinol, a synthetic version of THC, the key chemical component in marijuana. Doctors also generally prefer prescribing Marinol, because the capsules -- which cost about $2,000 a month -- come in physician-approved doses rather than patient-rolled joints.

But proponents of medical marijuana say patients who smoke marijuana get the benefits of dozens of other agents, or canabanoids, not found in Marinol.

While patients complain of the costs, the medical establishment isn't in favor of subsidizing them.

"It's not being looked at, not being evaluated, not being considered," said Jim Gersbach, a spokesman for Kaiser Permanente. "It would be outside the purview of the health plan to pay for a state registration fee. And marijuana is not treated as a pharmaceutical, so it doesn't come under pharmaceutical benefits."

Portland, Ore. (AP)
Published: March 21, 2000
©2000 Oregon Live LLC
Copyright 2000 Associated Press

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