Today I had to appear in court for a patient of mine who was arrested in San Diego for intent to sell marijuana.  He and another patient set up a grow on their property with 180 plants.   They were both legal patients.  Today was a preliminary hearing in front of a judge to determine if their was probable cause that a crime was committed to proceed to trial.   The burden of proof for the prosecution is very minimal.

My role was to testify on behalf of my patient that he was in fact a legal patient, had the right to grow marijuana for consumption and was growing a reasonable amount of medicine.   After stating my credentials my patients attorney attempted to ask me: “In your opinion, what is a reasonable amount for a patient to possess for personal consumption?”

Here was the problem: Prior to asking me that question the district attorney who was prosecuting the case on behalf of the people asked me the following questions: My answers are in bold.

1. Did you receive any specific medical training to prescribe or recommend cannabis? No there is no specific training that physicians are required to go through to be able to recommend cannabis.  Any doctor can recommend marijuana to a patient.

2. Have you taken any additional CME (continuing medical education) courses which makes you an expert in marijuana?  No I have not.  (i actually forgot that i did in fact once take an online CME course about the affects of cannabis on the body)

3. Are there any studies that you know of that specifically recommends how much medicine a patient should use? There are plenty of studies to include ones conducted at the UCSD Medical Cannabis Research Center which describe patients benefiting from the use of cannabis but I can not recall without having them in front of me whether or not specific amounts of cannabis were recommended.    (It is not legal for a doctor to tell a patient how much marijuana to use… per my patients attorney)

4. Do you personally have any experience using marijuana for medicinal purposes? No I do not.

5. Do you tell patients how much marijuana to consume? No as a doctor I tell my patients that can use whatever amount of marijuana that is required to relieve their symptoms. Some patients require more or less than others.

So the problem became when my patients attorney asked me “What I thought would be a reasonable amount for a patient to posses?”  The D.A. quickly argued “Objection, No foundation.”  Meaning I can’t really cant answer the question because it would just be an opinion not based on any expertise or clinical studies or personal use.  He argues I have no personal experience and that  there are no studies that I was aware of saying patients need “X” amount of marijuana to treat chronic pain.  The judge agreed and did not allow my patients attorney to ask me the question.

I personally am not aware if there are any studies that discuss using a set amount of marijuana for any particular illness.  As physicians we really can not discuss a recommended dose because there is no guidance from the medical community.

The truth is there is not any recommended dosing schedule for marijuana.  What I would have answered is that marijuana is unique in that patients can not go the the local drug store and pick up their medicine.   Medicine in dispensaries is often expensive and for many patients the best course of action is to grow as much medicine as possible so they can be assured that they have enough medicine to treat their symptoms.   With many dispensaries being closed it would behoove a patient to have enough marijuana on hand so that they did not have to rely on getting it from an outside source.   This patient would have had enough medicine to last a few years and could have saved a lot of money by not having to go through a collective.

The defense brought in an expert to testify that having 180 plants for two people is reasonable given the yield for new growers (which these patients were).  They could anticipate losing about half their plants because of their inexperience and if they made edibles they could certainly use the rest for personal consumption…. especially if you take into account that there is no real time limit to use all of it.  They could have harvested once and had medicine for 1-3 years.

Here  was another MAJOR PROBLEM for the defense. One of the patients, after the police read them their miranda rights, answered a bunch of questions at the time their residence was raided.   One of which was “what are you intending to do with all of these plants?” To which she allegedly replied “We are going to use some for personal use and also SELL some to our collective.”   She should NEVER have said anything… because she made that one comment made it hard to argue that it was all for personal consumption…. which they very well could have.  The moral of that story is TO NEVER SAY ANYTHING EVER TO LAW ENFORCEMENT UNTIL YOU SPEAK WITH AN ATTORNEY! YOU HAVE THE RIGHT TO REMAIN SILENT.

I do not know what the outcome of this preliminary hearing was as I left after my testimony.   But this issue that came up during my testimony is most likely a hurdle that many attorneys are going to have to jump over if they are trying to defend a specific number of plants that a patient was growing.   Given that the State supreme court ruled that it is unconstitutional for the court to tell a patient what is reasonable… situations like this are doing to be more common moving forward.    If Prop 19 passes it will only make things MORE CONFUSING!