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",'. STATE OF WASHINGTON DEPARTMENT OF CORRECTIONS P.o. Box 411 00 • Olympia, Washington 98504-1100 . November 26, 2008 . Spokane Valley, W A 99212 D~arMr_ . . We received the request from CBRMedical, Inc., on November 19, 2008, to appeal our denial of your request to use Marijuana medicinally while you are under the jurisdiction or supervision of the Department of Corrections: .. . In the interest of public safety and protection of the community at large, I am denying your request to use Marijuana for medicinal purposes during the period oftime that you are under supervision. I would encourage you to continue to program in a positive manner, following the direction of your assigned CCO and your conditions of supervision. .. n Sincer~ly> ! ..' Dame sistanl Secretary Community Corrections Division KD:md cc: Jon Oglesby, Community Corrections Officer Field File "Working Together for SAFE Communities" t'; ,ecycled paper PDU-6655-3 000161 )
Stern, Marc F. 'Dir Hlth Svc' (~OC) \02: ~ . To: Cc: Subject: . :-'\l . Daniels, Karen R. (DOC) 810~ .. Mr. ____- Medicinal Use of Marijuana Appeal I have reviewed Mr._ appeal of the Department's decision to not authori~e his use of medical marijuana. My review included: -The original request form 380.200, undated by the author, with a one page attachment from Dr. Johnson; -.~.n email from Dr. Hammond to you indicating that M~. lid not meet medical criteria for medicinal· marijuana (MM) use' -A 1'6 page fax - presumably an appeal - dated 11/19/2008, including: . a cover page (indicating.that the fax doc\1ment contains 6, not 16 pages), . a clinic note, dated 11/0212008 a clinic note with no date a 3 page print out entitled "Scoliosis Back Pain" . an 8 page print out entitled "Effects of Smoke Marijuana in Experimentally Induced Asthma" another request form 380.200, also undated by the author .. According to the documentation of th~~1 request, Dr. Hammond determined that Mr. Jseof MM did not meet DOC criteria apparently because Mr: ~id not suffer from designated complications, of two DOC-identified diseases. From a purely procedural standpoint, the appeal is flawed. First, the appeal request itself, contained on DOC 380.200 is incomplete. T[1e required fields, including prescriber signature, date, an¢ prescriber licence number and type are missing. The printed name is illegible, but appears to be similar to the physician name on the attached two clinic notes. Second, the second clinic note, indicating that Mr._sqffers from a$thma and chronic intractable back pain, is undated, So these might have been his diagnoses last week or 20 years ago and no longer active. Third, I question the authenticity of the first clinic note date 11/02/2008. Unlike every other practitioner note I've ever read, and, notably, unlike the other clinic note in this packet, it's written in the third person. From a clinical standpoint J offer the following opinions: Fir~t, with regard to Mr._ diagnoses requiring. treatment with MM, the undated clinic note indicates that Mr. _ . suffers from "Asthma (spasticity disorder)." No such disease exists. In the remainder of my report I am going to assume that there was an error io the report and Mr._suffers from asthma.' . Second, the appeal Indicates that tHe reason for MM is that neither Mr. back pain nor asthma are alleviated by standard therapies. I have difficulty believing that no other analgesics and no other asthma medications has worked. Further, there is insufficient clinical information in the appeal to support either claim. As background for the·next few item!" the Department requested from Mr. prescriber 'information published in . peer-reviewed scientific journals explaining the medical evidence for the use of MM in for Mr._for anything other than the two deSignated diseases. . The third opinion, then, is that with regard to Mt._diagnosis of back pain no such scientific material was provided. the only information that was provided was a print out on scoliosis-related back pain. The print out is is the text of a . question and answer session with a doctor who invented a spine brace, obtained at a website (www.scoliosisbackpain.com).This is not a scientific publication nor is it peer reviewed. From an evidence based medicine standgoint which is how our grofe..s.§ion trie..s_tQ...lIJ.a.ls~tgp.o_cLc.linlc.aLd.e.cis.i.oJ,l.s.,jll:tasJittle..to_o.o~v.alu.o:::.e ____ _ Fourth, even if this publication had scientific value, it is not relevant to this patient. The rint out is on the topic of scoliosiS; the information we received from Mr. doctor did not indicate Mr. has sc~liosis. Fifth, with regard to the (presumed) diagnosis of asthma, Mr,_physician did provide an scientific article from a peer-reviewed journal regarding the salutary effects of smoking marijuana on asthma. However, there are serious shortcomings of this article. First of all, it was a study on only 8 subjects. Second, it tested the effect of a single time smoking marijuana on asthma. It is well known that chronic smoking (of anything) makes asthma worse, and this is even noted in the article itself. Third, the study was done in 1975. There have been tremendous strides in the care of asthma in the last 33 years that don't involve marijuana. Lastly, the.article about smoked marijuana is not relevant to or helpful in Mr . ••• case since the Department would only allow Mr._to use oral, not smoked marijuana. . . 1 PDU-6655-3 000162
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I I , Smith, Sherri K. (DOC) From:
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February 17, 2009 STATE OF WASHINGT
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Documentation of Medical Authorizat
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