Heather De Mian does not smoke marijuana to fit in with the cool crowd or get high on weekends. She uses marijuana to control her nausea and pain.
“I can’t even get high,” she said. “I have been on opiate (painkiller) since I was 10 years old.”
De Mian, 34, has vascular Ehlers-Danlos syndrome. The disease causes her intense pain and makes it hard for her to keep down food or oral medication. She takes Marinol and Zofran to help control her nausea. Marinol is a synthetic version of the active ingredient of marijuana, which is called tetrahydrocannabinol. She uses Zofran to avoid vomiting her Marinol pills.
Monday’s Supreme Court ruling that federal bans on marijuana supersede local laws doesn’t overturn Columbia’s loosened regulations but does affirm the right of higher authorities to prosecute users like De Mian if they choose.
De Mian receives a Social Security check but is not able to work. Medicaid pays for her prescription drugs, and she receives her marijuana for free from friends, she said.
Medical marijuana helps De Mian cope with symptoms associated with her disease. Marijuana soothes her nausea, but she also uses it to control her pain.
“I should have the right to kill my pain,” she said. “Without cannabinoids, they aren’t giving me much of a choice.”
With the passing of Proposition 1 last November, De Mian and other patients were allowed to legally possess marijuana for medical use. The new city ordinance allows for severely ill adults to possess less than 35 grams of marijuana for medical use with the recommendation of a doctor. However, according to state and federal laws, it is illegal to possess pot.
Dr. Michael Acuff, an assistant professor in MU’s Department of Physical Medicine and Rehabilitation, said he has some patients who could benefit from the use of regulated medical marijuana.
Marijuana can help to reduce pain, calm nausea, soothe muscle spasms and stimulate appetite, he said.
“These (benefits) are complicated by the fact that people are going to use it for recreational use too,” he said.
Marinol has some of the beneficial effects of marijuana, but not all, he said.
“My patients tell me that Marinol is not as good as smoking a joint,” Acuff said.
Not all doctors agree that medical marijuana is beneficial.
Dr. Kevin Dellsperger, chairman of the department of internal medicine at MU, said he did not think the proposition was a good idea. Although marijuana can change a patient’s perception of pain and can control nausea, intense misuse and an inability to control the substance are problems with medical marijuana, he said.
“I don’t think (doctors) should be writing recommendations for it, or they risk their license,” Dellsperger said. “Most physicians don’t want to cross the (Drug Enforcement Agency).”
The Missouri State Medical Association opposes the use of medical marijuana, Executive Vice President C.C. Swarens said.
“There are better medications than cannabis to help patients,” he said.
Medical marijuana has health risks for the patients who use it, Swarens said. In Missouri, the only way to obtain marijuana is illegally, so it cannot be regulated, and patients do not know what they are getting.
“The smoke is more dangerous than cigarette smoke,” Swarens said. “(Marijuana smokers) are getting a higher dose of smoke.”
A study conducted by the University of California-Los Angeles demonstrates that marijuana smoke contains four times more tar than cigarettes.
De Mian wants Missouri state law to change so patients can legally obtain their marijuana. She understands that there are problems with marijuana that patients buy off the street.
“Most of what is on the street is not potent enough for most medical users,” she said. “You would have to smoke joint after joint after joint to keep your stomach down.”
Dan Viets, a Columbia lawyer who represented the Columbia Alliance for Patients and Education, which backed Proposition 1, said that the current Columbia ordinance has limitations and that patients need to be able to grow their own marijuana or be able to obtain it legally.
“It doesn’t make sense to tell a patient they have to go out in the street and find a drug dealer to get their medication,” he said. “Congress needs to take action. It could easily stop the so-called Justice Department from prosecuting medical marijuana patients.”
Rose Wibbenmeyer, Columbia city prosecutor, said the effectiveness of the medical marijuana ordinance is limited.
“It creates a false perception that this can be very helpful, when it is very limited,” she said.
The medical marijuana ordinance reduces punishment and provides a possible defense if the case is tried in municipal court.
The ordinance only applies if the person is caught in possession, and is caught by the Columbia Police Department, she said. If the person is arrested while committing another felony, such as purchasing marijuana, the case will go to state court and the ordinance will not apply.
When the office gets marijuana possession offenses, they “put the file in a drawer. If there are no other problems (offenses by the person), we wait for the statute of limitations,” Wibbenmeyer said.
De Mian is not satisfied with the city ordinance. She wants to see the availability of medical marijuana expanded.
“Most people are under the impression that it gives us access to marijuana. We have a right of possession, period,” she said. “The right to cultivate has to be an absolute right.”