October 24, 2004 - Dr. Tod Mikuriya believes the state is out to get him for prescribing medical pot. Critics say it's not that simple.

( Berkeley, CA ) Mikuriya has recommended pot more than ten thousand times.

Dr. Tod Mikuriya is a true believer. He views his medical practice as a platform from which to help re-establish the medicinal status marijuana enjoyed before the reefer madness of the late 1930s.

"It had been available to clinicians for one hundred years until it was taken off the market in 1938," the wide-eyed Mikuriya said in a recent interview. "I'm fighting to restore cannabis."

But Mikuriya isn't just burnishing the drug's reputation; he's actively recommending it to dozens of patients each week, and using it himself. Dr. Tod, as he is known by his patients, has recommended cannabis more than ten thousand times since California voters approved Proposition 215 in 1996. That makes him one of the state's leading advocates of medical marijuana.

Mikuriya claims that because of his prominent role in the medical pot scene, investigators from the California Medical Board conspired to take away his medical license. The doctor and his lawyers say that the board's enforcement action directly contradicted the passage in Proposition 215 that states:

"Notwithstanding any other provision of law, no physician in this state shall be punished, or denied any right or privilege, for having recommended marijuana to a patient for medical purposes."

But the state attorneys who prosecuted Mikuriya counter that the case against Dr. Tod did not really concern marijuana, but whether he had applied the appropriate standards of patient care.

The key question in the case boils down to how rigorous an examination doctors must perform when recommending marijuana to a patient. State investigators have said they began investigating Mikuriya because they thought he was recommending pot with little more than drive-by consultations. And once their investigation was done, they said they had a stash of proof that Dr. Tod had repeatedly failed to thoroughly examine patients before advising them to toke up.

The 71-year-old Berkeley resident has long been an outspoken proponent of medipot. In 1967, he was a consulting psychiatrist in charge of marijuana research at the National Institute of Mental Health Center for Narcotics and Drug Abuse Studies. He has written numerous articles on the effects of cannabis, worked with San Francisco medical pot guru Dennis Peron, and founded the California Cannabis Research Medical Group.

"It never ceases to amaze me the broad range of ailments that are helped by cannabis -- chronic conditions, physical or psychological," he said.

All this advocacy has given Mikuriya a certain notoriety. In late 1996, he was singled out by federal drug czar Barry McCaffrey during a national TV appearance announcing that doctors risked losing their federal licenses to prescribe drugs if they recommended marijuana following passage of Prop. 215.

The doctor believes that sometime after that warning, state law enforcement officials who sided with McCaffrey actively commenced a witch hunt against him. What better way for opponents to eviscerate California's groundbreaking medical marijuana law, he asked, than to make life miserable for the small handful of doctors who most often suggest pot to their patients? Mikuriya refers to some of these antagonists as "the forces of darkness."

Records show that state investigators began focusing on Mikuriya sometime in the late 1990s. They suspected that he had recommended pot a little too casually in the case of a 58-year-old Napa County quadriplegic with advanced multiple sclerosis. Mikuriya later testified that the bedridden patient whom he saw for five minutes in November 1998 was already using pot and that his conservator said he was benefiting from it.

To build a case against Mikuriya, medical board investigators began working with law enforcement officials from around the state. Cops and prosecutors from rural counties appeared most eager to help, producing the names of about fifty people who had been arrested or investigated for marijuana use and had obtained pot after receiving a recommendation from Mikuriya. Just two came from the Bay Area -- both from Napa County. By contrast, nine came from El Dorado County, ten from Tehama County, and eleven from Nevada County.

Medical board investigators wrote to each of the patients, asking them to release their private medical records. The vast majority did not respond. Working in concert with the California Attorney General's Office, investigators then subpoenaed Mikuriya to release the records of 47 patients.

Mikuriya and his lawyers fought the subpoenas in court, but ultimately accepted a deal in which they released the records under the threat of medical license suspension, according to court documents.

Investigators combed through the 47 patient records and identified sixteen cases in which they believed Mikuriya had inadequately examined his patients. The medical board and attorney general then added one final case: that of a Sonoma County Narcotics Task Force agent who said that Mikuriya recommended pot to him during an undercover operation.

Prosecutors and investigators then brought in a San Francisco psychologist to study the seventeen cases as an expert witness. In making her determinations, Laura Duskin relied on a 1997 "policy statement" from the medical board that said California doctors who recommend marijuana should use the same patient-examination standards as doctors who prescribe any drug or procedure. Use of the strict state standard doomed Mikuriya. Duskin found him grossly negligent in all seventeen cases.

The doctor's attorneys later argued that he should not be held to the terms of the policy statement because it was not an official regulation. Mikuriya also noted that he considers himself a consultant, not a primary physician. His attorney, Susan Lea, argued that more-thorough examinations would force Mikuriya to raise his fees for patients who cannot afford it.

Lea noted that none of Mikuriya's patients complained or claimed they had been harmed by his advice, and that Duskin did not interview any of them. She further observed that Duskin had never once recommended pot to a medical patient. "Obviously, we're not dealing with people who respect Prop. 215," Lea said.

The two deputy attorneys general who prosecuted Mikuriya, Lawrence Mercer and Jane Zack Simon, did not return phone calls seeking comment for this story. But in court documents and previous statements to reporters, they contended that there was no conspiracy against Mikuriya.

The administrative law judge who oversaw the case bought the state's argument that the real issue was whether Mikuriya applied the appropriate standards of care. In his April 19 decision, Judge Jonathan Lew was unconvinced by testimony from Dr. Philip Denney, an expert witness for Mikuriya, that Dr. Tod's exams were sufficient under Prop. 215. In fact, Lew used Denney's testimony against Mikuriya, noting that Denney said he conducted thorough examinations of his own patients whenever he recommended marijuana to them.

Lew revoked Mikuriya's medical license, but stayed the order and put him on five years' probation. During this time, Mikuriya will be monitored by another doctor, who will periodically review his patient records. Lew also fined Mikuriya $75,000 to help pay for the medical board's investigation and prosecution. Board spokeswoman Candis Cohen said its current executive director, Dave Thornton, was "very satisfied" with the outcome of the case.

Shortly after Lew's ruling, Mikuriya opened a small new medical office above the El Cerrito Trader Joe's. Medical marijuana consultations remain his primary practice. He said he sees about forty patients a week, and intends to follow the state medical board's policy statement regarding the standards appropriate for recommending medical marijuana. Mikuriya also acknowledged using his chosen medicine himself, saying another doctor recommended it to him to help treat his mild depression.

Mikuriya is appealing Lew's decision on several grounds. One challenges the legality of the patient subpoenas. In a case involving another medical marijuana practitioner, Dr. David Bearman, the Second District Court of Appeals in Los Angeles shot down a request by the medical board and the state attorney general's office to subpoena patient medical records. The court said established precedent does not allow the board to "delve into an area of reasonably expected privacy simply because it wants assurance the law is not violated or a doctor is not negligent in treatment of his or her patient." Mercer and Simon of the attorney general's office argued that it is too late for Mikuriya to challenge the subpoenas.

At the same time, Mikuriya's defense team also is arguing that Lew neglected to reveal what they allege is a possible bias. Lew sits on the advisory board of a Christian group, Powerhouse Ministries, that equates marijuana addiction with slavery on its Web site.

"The challenge is not about the judge's actual bias, but his failure to disclose a highly relevant fact that would have allowed petitioner to probe the possibility of that bias," Mikuriya's lawyers wrote in his appeal in Sacramento County Superior Court. Prosecutors Mercer and Simon called the suggestion that Lew's involvement in Powerhouse Ministries constitutes an appearance of bias "absurd and offensive."

Meanwhile, the medical board acknowledged the ongoing confusion surrounding proper standards of care by promulgating another advisory statement after Lew issued his decision. The new statement essentially repeats the 1997 statement. But like the earlier advisory, the new policy is not an official regulation.

Mikuriya Case Update

By now Administrative Law Judge Jonathan Lew has presumably filed his "Proposed Decision" advising the Medical Board whether or not to punish Tod Mikuriya, MD ‹and if so, by what measures. At a lengthy hearing this fall, the Attorney General, representing the Board, charged that Mikuriya had violated the prevailing standard of care in approving cannabis use by 17 patients (one an undercover narc). The Board's expert witness had come to this conclusion by reading Mikuriya's patients¹ charts -but she hadn't contacted any of the patients to determine if their treatment at his hands had actually been harmful or beneficial.

Mikuriya defended his methods of determining whether patients were using cannabis appropriately and rightfully. The evidence showed that all his patients -except the narc, of course- had benefited from cannabis use. Nine patients testified that Mikuriya had conducted thorough and empathetic exams. At the very end of the hearing, ALJ Lew asked Mikuriya if he would be willing to modify his procedures in the future, and Mikuriya said "Absolutely." The exchange left him hopeful that a career-ending stand-off might be averted.

The Board has 30 days to review the judge's Proposed Decision. In this period a six-member panel from the Board's Division of Medical Quality votes by mail on whether or not to adopt the Proposed Decision. Four "adopt" votes suffice. If two members vote ³Hold,² the panel will discuss the case behind closed doors at the May Board meeting. (Two ³hold² votes prevail over four ³adopt² votes.) In deciding whether to accept the Proposed Decision, the panel can order and review the transcript of the hearing and take oral and written arguments from Mikuriya and the AG¹s office.

SO, Mikuriya's fate could hang in the balance for a long time. Some generalize that delays are good for the defendant -in this case, the doctor who stands to lose his license- because life goes on in the meanwhile... But the law's delays can also be a mild form of torture (see Hamlet's Top 10 reasons to commit suicide). "Let him twist slowly in the wind" Nixon told his henchmen -Don't let Patrick Gray know his job status. It's been years since Mikuriya felt he could make longterm work plans. If the Medical Board allows him to keep practicing, he says, he sees himself sharing an East Bay office with other cannabis specialists, gladly adhering to whatever clear-cut, sensible guidelines the Board has established for them.

Denney Opens Orange County Office

On Feb. 9, Philip A. Denney, MD, started seeing patients at a "cannabis evaluation practice" in Lake Forest, a city at the intersection of Freeways 5 and 405 in Orange County. If the demand is as great as Denney anticipates, he hopes to interest other physicians in the new specialty, which he defines as "determining whether a patient has a serious medical condition that could be treated safely and beneficially with cannabis."

Denney has already recruited Robert E. Sullivan, MD, a former associate in a Sacramento practice, to join him in Orange County.

An estimated 60,000 patients have gotten physician approvals to use cannabis In the more-than-seven years since it became legal. "That represents a very small set of the population that could be helped by cannabis if knowledgeable doctors were available throughout the state," says Denney.

Twelve doctors specializing in cannabis evaluations have issued approximately half the approvals to date, and all but one of those doctors are in Northern California.

For most of his 27-year career Denney was a family practitioner. In the late 1990s, having become aware that doctors who approved cannabis in treating conditions other than AIDS or cancer were few and far between, he began studying the available medical literature and corresponding with specialists in the area. In January, 1999, Denney opened an office in Loomis, East of Sacramento, specializing in cannabis evaluations.

"It was obvious when we had our practice in Loomis," says Denney (the 'we' refers to his wife Latitia, who manages his office), "and people kept showing up from all 58 counties, that there was a tremendous need and demand throughout the state." A related need, according to Denney, is for a Continuing Medical Education course that would bring California doctors up to speed on a subject they learned nothing about in Med School.

By the fall of 2002 Denney had approved cannabis use by some 8,000 patients and decided he would take early retirement. He transferred his practice (to William Turnipseed, MD) and devoted himself to reading, gardening, spending time with his family, and doing all the projects that needed doing on his hilltop spread in rural Greenwood. But he didn't entirely withdraw from the fray -he helped defend colleagues under attack by the Medical Board of California, and he kept abreast of the medical literature and cannabis-related political developments.

In May 2003 Denney appeared before the Board to protest the investigation of nine doctors specializing in cannabis consultations. "When you mention that nine investigations is a small number, you must consider the effect of those investigations on the rest of the physicians in California," Denney reminded the Board. "The sanction of even one physician will have a dramatic impact on the practices of all others." (Denney himself has never been investigated by the Board, a fact he attributes to the rigor with which he takes histories, reviews records, and conducts physical exams.)

Denney also served as an expert witness in defense of Tod Mikuriya, MD -one of the cannabis specialists whom the Medical Board's Enforcement Division had chosen to prosecute. Denney reviewed the relevant files and testified that Mikuriya had elicited enough information in each case to justify approval of continued cannabis use. Mikuriya's practice should not be evaluated by the same standards as a conventional practice. "Patients come to a medical cannabis consultant seeking the answer to one specific question: 'Do I have a medical condition for which cannabis might be a useful treatment?'" Denney faulted the Board for not issuing guidelines relevant to such situations.

A key factor in Denney's decision to resume practicing medicine was the October 2003 decision by the U.S. Supreme Court to let stand the ruling in the Conant v. Walters case: federal authorities are permanently enjoined from threatening or punishing California doctors who approve cannabis use by their patients. "The Conant ruling," says Denney, "was tremendously reassuring."

Denney says that "more than 95%" of the patients to whom he has issued approvals had been self-medicating with cannabis before consulting him. The conditions with which they present, he estimates, are: chronic pain (50%); neurologic (20%); psychiatric, including ADHD and as a "harm reduction" substitute for alcohol (15%); gastro-intestinal (10%); other (5%).

None of Denney's patients have reported serious adverse reactions or drug interactions. "Cannabis has been used medicinally for thousands of years," Denney says, "and has a remarkably benign side-effect profile."

For more information, or to arrange an appointment, contact the office of Drs. Denney and Sullivan at 949-855-8845.

PS. Denney and Sullivan are announcing their presence through an ad in the Orange County Weekly (whose commercial mainstays are tacky Botox and plastic surgery ads). The first D&S ad ran on Feb. 5 -an expanded business card with a small boldface headline: "Medical Cannabis Evaluations." By the end of opening day there had been three or four calls from young men who thought the ad was offering employment as taste testers. Where there's youth, there's hope!

UPDATE: Mikuriya Hearing Resumes Sept. 24

The Medical Board of California's prosecution of Tod Mikuriya, MD, began Sept. 3 with the testimony of an expert witness, Kaiser psychiatrist Laura Duskin. The scene was a fluorescent hearing room at the state office building in Oakland, presided over by Administrative Law Judge Jonathan Lew, a trim, soft-spoken man with a businesslike air.

In some of the 16 cases, according to Duskin, Mikuriya had failed to conduct an adequate exam, specify a treatment plan, or arrange proper follow-up. Duskin said she could adduce all this from the files because, "From day one in medical school they teach us, 'If you didn't write it down, it didn't happen.'" She quoted this literally false dictum as if it were some sanctified truth, as if the paperwork really is more important than the actual interaction between doctor and patient.

The prosecution called only one other witness, Steve Gossett, a deputy sheriff who heads Sonoma County's marijuana investigations unit and is known as a zealous drug warrior. Gossett testified that he had visited Mikuriya at an office in Oakland in January '03 and obtained a letter of approval by claiming to suffer from stress, insomnia, and shoulder pain that had kept him from holding a job for several years. The stress, Gossett said he'd told Mikuriya, was exacerbated by a pending marijuana possession case (54 grams).

Bill Simpich: When this case began, the AG's office claimed that Tod had no right to recommend marijuana to one patient [W.H.] who had MS and was virtually a quadripelegic, had an ashtray full of roaches and his request was seconded by his conservator.

This position was so ridiculous, that the hardcore anti-215 crowd in the AG's office was forced to round up all the reports filed by DAs and cops that were "sore losers" in 215 cases and sought the records of the victorious patients... They subsequently realized that they might actually lose all 16 cases against these 16 patients. So, in a frantic last attempt, they have brought in Sonoma County sheriff Steve Gossett to try to claim that Tod is wrapped up in a fraudulent scheme to enable unqualified patients to obtain marijuana.

On Friday, Sept. 5 the defense called its expert, Philip Denney, MD, an experienced family practitioner from Loomis, CA. Denney said he'd reviewed the 17 relevant files and determined that Mikuriya had, in each case, elicited enough information to justify approval of continued cannabis use. (All the patients, including Gossett, told Mikuriya that they had been self-medicating prior to seeking his approval.)

Denney defined Mikuriya's as a "medical cannabis consultation practice" in which "patients are seeking the answer to one specific question: 'Do I have a medical condition for which cannabis might be a useful treatment?'" He faulted the Board for not issuing guidelines relevant to such practices.

To refute the state Medical Board's Accusation against Tod Mikuriya, MD, the defense has called to the witness stand nine of the patients who allegedly received substandard care from him. Each patient described Mikuriya as a thorough, empathetic, and helpful consultant who never passed himself off as a primary care provider. Each confirmed that s/he had been self-medicating with cannabis before seeking Mikuriya's approval to do so.

The prosecution's expert, Laura Duskin, MD, had claimed that reading Mikuriya's files enabled her to detect "extreme departures from the standard of care" in his treatment of 16 patients. She felt no need to get input from the patients themselves. "We're taught from day one in medical school that if you didn't write it down, it didn't happen," Duskin testified in all seriousness. But it became obvious, as the patients recalled their encounters with Mikuriya, that a great deal had happened between them that Duskin failed to discern.

€ First to testify was D.K., a middle-aged woman from Humboldt County who walked and spoke slowly and with obvious effort. At 21 she'd suffered a stroke brought on by the combination of smoking cigarettes and taking birth-control pills. ("The pill" was originally approved by the FDA in a dosage many orders of magnitude greater than required for efficacy. A safer formulation was introduced quickly in the U.S., less quickly in South America.)

D.K.'s enunciation may not have been crisp, but what she had to say was eloquent. "None of you have ever had a cerebral hemorrhage. I'm always the wrong one, the one who doesn't get the joke... I get feeling like I'm up against a wall. A couple of puffs and I can come back to myself, I can grip reality again." D.K. said she first consulted Mikuriya in June, 1998. "He had been recommended to me as a compassionate doctor... I was totally honest with him. I had discovered for myself that marijuana helped more than anything. And I don't need more and more -the same amount works!"

Prior to the next swearing in, Administrative Law Judge Jonathan Lew commented that he'd never had a case in which patients's names had been kept from him. Simon said, "We often have cases where patients names aren't used -but of course they never testify." Which shows how far removed from reality the Medical Board's procedures have become. Why shouldn't patients be testifying about mistreatment by physicians? The Mikuriya case is highly unusual in that no patients contend they were victimized. Quite the contrary -the alleged victims are coming forward to say "Thank you, doctor."

€ D.H., another middle-aged woman who didn't look as if life had been a bed of roses, testified that she'd found on her own that cannabis provided relief for severe itching and stress headaches "so bad I can't even function." Tests couldn't determine the causes of her problems. Other doctors had given her "medicines that didn't help. They put me out and deprived me of feeling in control." She'd brought Mikuriya records from her previous doctors and told him that when she smoked cannabis, "the itching is less and I don't go to sleep with headaches." Mikuriya gave her an approval for cannabis and taught her a method of rolling the shoulders to reduce headache-inducing tension. She said she couldn't see him again "money-wise."

Duskin had found an "extreme departure from the standard of care" every time Mikuriya issued an approval letter stating that a patient was under his "supervision and care" for the given condition(s). The phrasing implies an ongoing relationship instead of a one-time consultation -a semantic error, at worst, in the real world. Mikuriya said he'd lifted the phrase verbatim from a California Medical Association advisory letter sent to doctors after Prop 215 changed the law.

If this matter was being heard in the Court of Common Sense, the judge would direct the doctor to re-word his letter of approval; advise the Medical Board to stop pursuing complaints from law enforcers that don't involve harm to patients; and spare California taxpayers any further expense on such an absurd prosecution. But Common Sense is just the name of some old leaflet, and the legal string must be played out, however long it takes, however much it costs. Mikuriya's testimony resumes on Sept. 24 in the hearing room of ALJ Jonathan Lew, 1515 Clay St., Oakland, California. The subject will be Mikuriya's encounter with an undercover Sonoma County narc named Steve Gossett, who received an approval based on false claims of sleep, stress, and shoulder problems.

Then comes Mikuriya's cross-examination by Mercer and Simon - the very same prosecutors who were sicced on Dennis Peron by former Attorney General Dan Lungren. "Why did Bill Lockyer assign those two to prosecute Dr. Mikuriya?" is a FAQ among spectators at the hearing. It appears that he's trying to mollify a rightwing faction within his office... When Terence Hallinan was elected District Attorney of San Francisco in '96, he could change the culture of the office overnight because SFDA employees serve "at the pleasure of" the DA, and TH could and did fire 14 rightwing stalwarts. Lockyer, elected in '98, was stuck with the career Assistant AGs because they have civil service protection. But he didn't have to allow them to prosecute California's foremost proponent of cannabis therapeutics; and he certainly didn't have to assign the job to two Lungrenite dead-enders.

Maybe Gray Davis will save the day. The Medical Board members are his appointees, and it's they who will ultimately act on Judge Lew's "recommended decision." They can follow it or depart in either direction -punishment or leniency... But they have a problem analogous to Lockyer's. Whereas the Med Board's appointed members come and go, the staff consists mainly of career law enforcers - more than 100 Investigators under Enforcement Division chief Joan Jerszak- who have social and political connections to the prison guards, the narcotics officers, the sheriffs, the police chiefs, the police officers, the DAs, and others who think the War on Drugs has been good for business.



AVA 8/27/03

Tod Mikuriya, MD, has rejected a final settlement offer from the Medical Board of California. The deal would have meant four years probation; taking classes on ethics, record-keeping, and other areas in which the Berkeley psychiatrist is supposedly deficient; and a $10,000 fine. The Board claims that its investigation of Mikuriya has cost more than $100,000 -an amount for which he now could be found liable.

So, starting on Sept. 3, the courtroom of Administrative Law Judge Jonathan Lew in Oakland's State Building (1515 Clay St.) will be the scene of a file-by-file review of Mikuriya's handling of 17 cases.

Just as the federal government used unwilling jurors to convict Ed Rosenthal in his infamous cultivation case, the state of California is using unwilling patients to prosecute Mikuriya for "unprofessional conduct." Not one of the 17 patients who allegedly received sub-standard care has filed or expressed a complaint against Mikuriya. Not one has reported adverse effects from the treatment he approved. In fact, almost all the patients in whose name the Board is bringing this case express gratitude and describe Mikuriya as an attentive, empathetic interviewer. All had been self-medicating with cannabis before consulting him. Many report that Mikuriya was the first and only doctor with whom they could discuss the fact that they'd been using marijuana to cope with various problems.

There is an Alice-in-Wonderland quality to the Mikuriya prosecution. A psychiatrist who elicits from his patients the most honest medical history they've ever given stands to lose his license for conducting inadequate exams!

Although all the complaints come from law enforcers who resented Mikuriya's support for marijuana users, the Medical Board insists that their case has nothing to do with marijuana -as if Mikuriya would now stand accused if he were a well known proponent of, say, Ritalin!

Mikuriya is charged with violating a "standard of care" that the Medical Board has never defined with respect to doctors who approve their patients' cannabis use. To add to the irony, for years Mikuriya has been urging the Board to adopt specific standards with respect to cannabis approvals, while the Board insists that such approvals are equivalent to prescriptions for "dangerous drugs."

Some of the patients who have been asked to testify on Mikuriya's behalf will need rides to Oakland from farflung towns when the defense begins (possibly as soon as Friday, Sept. 5). If you're interested in transporting a friendly witness, please call Mikuriya's assistant, John Trapp, at 510-548-1188.

This week Trapp released a list of the complainants, as gleaned from documents filed in the case:

  • Sacramento County Deputy District Attorney Del Oros: Patient 1
  • Nevada County Sheriff's Sgt Steve Mason [listed as Commander of the Narcotics Task Force] Patients 2, 9, 14
  • Humboldt County Sheriff's Sgt Steve Knight patients 3, 6
  • El Dorado County Narcotics Det. Bob Ashworth, Patients 4, 7, 8
    Sacramento County Sheriff's Det Jeff McCannon, Patient 5
  • District Attorney's Office Tehama Patients 11, 12
  • Tehama County Det. Sgt Dave Hencraft Patients 13, 15
  • Anonymous (newspaper clip sent to MBC Investigator Tom Campbell] 10
  • Napa County District Attorney's Office 16
  • Sonoma Narcotics Task Force 17

All documents relevant to the case (except patients' records, of course) can be found on Mikuriya.com, including the final settlement offer from the Medical Board that Mikuriya rejected.

This just in from Dale Schafer, husband of Dr. Marian Fry: "Mollie was served with a three-count accusation from the Attorney General 8/22. It is alleged that she did not do a thorough enough exam and did not have enough records before she recommended cannabis. She is the next target. We will do our best to fight this. I thought Bill Lockyer was on our side..." Simultaneously, the AG's office has decided not to pursue the Medical Board's flimsy case against Dr. Frank Lucido (another example of the patient thriving). The AG seems to be playing bad cop/good cop with the medical marijuana movement.

Says Schafer: "What we want from Lockyer is a general amnesty for doctors who were recommending cannabis based on its safety profile and in the absence of explicit do's and don'ts from the Medical Board. If the Board establishes practice standards and doctors violate them, sanctions would be appropriate. But to do it ex post facto is extremely unfair."

Calif. Doctor Faces Sanctions Over Pot

By TOSHI MAEDA The Associated Press Sunday, July 13, 2003; 12:46 PM

OAKLAND, Calif. - In a state where doctors are allowed to suggest marijuana for medical purposes, a medical panel is trying to suspend or revoke the license of a physician who has written 7,500 marijuana recommendations for his patients.

Dr. Tod H. Mikuriya, 69, is accused of writing those recommendations without conducting sufficient medical exams and of improperly maintaining medical records.

The case has nothing to do with marijuana itself, says the Medical Board of California, which licenses physicians.

But Mikuriya, of Berkeley, and his supporters view the accusation as a political attempt to hush the vocal psychiatrist, who has been at the forefront of medical marijuana advocacy for decades and has written extensively on the topic.

The accusations are having "a chilling effect to other doctors," said Frank Lucido, another Berkeley physician, who is under investigation for recommending marijuana to a 16-year-old patient.

Mikuriya's lawyers have asked an administrative law judge to dismiss the accusations against him, citing Proposition 215, the 1996 voter-approved measure allowing California doctors to recommend marijuana to sick patients. Judge Jonathan Lew heard arguments Friday and is expected to rule in three weeks.

"Dr. Mikuriya is the biggest fish, the most visible advocate who has been writing on this for 40 years," said John Fleer, one of Mikuriya's attorneys.

The accusation comes as the Bush administration is stepping up its efforts to crack down on doctors who approve marijuana. Doctors are allowed to recommend marijuana in Alaska, Arizona, California, Colorado, Hawaii, Maine, Nevada, Oregon and Washington.

Last week, the Bush administration asked the U.S. Supreme Court to let federal authorities punish doctors who recommend pot to their patients. The move was in response to a San Francisco-based 9th U.S. Circuit Court of Appeals ruling in October that physicians had a constitutional right to speak candidly with their patients about marijuana without fear of government sanctions.

Mikuriya is among nearly a dozen California physicians under investigation by the medical board in connection with medical marijuana recommendations. Some of the doctors have written more recommendations than he has. One already is on suspension in connection with medical marijuana practices.

The charges against Mikuriya are about "a doctor practicing without doing what a good doctor has to do," state Deputy Attorney General Lawrence Mercer, who represents the medical board, told the judge Friday.

"The standard requires physical exam, medical history, mental status exam, follow-ups to ensure that medication or treatment is working," said Hallye Jordan, a spokeswoman for Attorney General Bill Lockyer. "We believe that Dr. Mikuriya did not provide that responsible, standard care."

Mikuriya disputes the allegations.

"They say I didn't see them, I didn't examine them. That's absolutely untrue," Mikuriya said, arguing he spends at least 15 minutes with each patient before recommending marijuana.

Mindy Devereax, 51, said her life has dramatically changed since she met Mikuriya three years ago and started using marijuana medicinally.

"Within 15 minutes, he understood, recognized and diagnosed my problems," said the Albany resident who is recovering from a brain injury and has suffered from chronic pain and depression since a car accident.

"I cannot tolerate this much pain," she said. "He is the only one who saved my life."

--- On the Net:
Mikuriya: http://www.mikuriya.com/
Medical Board: http://www.medbd.ca.gov/
© 2003 The Associated Press

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