For example, it remains to be seen how the dismissal (or resignation-rescission-rejection, depending on what story you read) of John Thiele, former director of the Maine Medical Use of Marijuana Program, will affect operations overall. Thiele's departure in November came as a surprise to many in the medical marijuana community.

"He was pretty much the one who got the medical marijuana program to where it is now," says Paul McCarrier, legislative liaison for the Medical Marijuana Caregivers of Maine, a statewide trade association.

"John was very open to the concerns of patients, caregivers, and dispensary operators," Melnick adds. "He had a lot of trust from the community."

"It was a mistake taking him out of there," echoes Ron Norton, founder of the Maine Green Cross, which works to help patients set up a home-growing system and gain access to low-cost, high-quality medicine. "Being 'patient-friendly'" — the pejorative accusation rumored to have been leveled against Thiele — "is a prerequisite for the job he was in." The Phoenix was unable to reach Thiele before going to press.

Both McCarrier and Melnick say that since Thiele left, there have been reports of delayed communication between the Division of Licensing and Regulatory Services (the division of the state Department of Health and Human Services that oversees the pot program) and law-enforcement officials seeking clarification on patient or caregiver status. They worry that such holdups further complicate a delicate system, and they note that when dealing with medical pot users, doctors, and police officers who are already skittish, it's best to operate as a well-oiled machine.

When asked about the alleged lag-time, DHHS communications director John Martins said the division was unaware of any such delays. "In fact," Martins wrote in an email to the Phoenix, "features in DLRS' new phone system has helped increase the timeliness of responses to both law enforcement and medical professionals."

Local pot reformers are also focused on expanding the list of "qualifying conditions" that must be present for a legitimate medical marijuana recommendation in Maine. Currently, that list includes: cancer, glaucoma, Crohn's disease, HIV-positive status, hepatitis C, Alzheimer's, any a chronic or debilitating disease or medical condition or its treatment that produces cachexia (a/k/a "wasting syndrome"), severe nausea, seizures, or severe and persistent muscle spasms.

Advocates are particularly interested in seeing certain psychological diagnoses, including depression and post-traumatic stress disorder, added to the list. There is a process to petition the government to add conditions, but it is untested.

"I have a lot of patients who would benefit from cannabis and who do benefit from cannabis but can't use it legally right now," says Dustin Sulak, a Hallowell physician and probably the state's foremost pot-doc. "What I'd like to see is for certification to be left up to the physician."

Of course, that would require more physicians to proactively educate themselves about cannabis use, a practice that isn't as common as Sulak would like.

"Some doctors have cannabis-phobia," he says. "Every week we've got a handful of patients calling and asking, 'Do you know a primary care physician that will take me?'" Sulak and the other doctors in his practice both take patients and make referrals. "We have a list of PCPs around the state who understand the benefits of cannabis," he says.

The Maine Board of Licensure in Medicine rules state that "Clinicians should not fear disciplinary action from the Boards for ordering, prescribing, dispensing or administering controlled substances . . . for a legitimate medical purpose and in the course of professional practice."

Still, University of Southern Maine professor Wendy Chapkis, who is the co-author of Dying to Get High: Marijuana as Medicine (New York University Press, 2008), notes that "a lot of doctors are still very anxious about going on the record recommending cannabis to their patients," she says.

Yet another flaw in the state's medical marijuana program is that patients and caregivers are technically not permitted to possess more than two and a half ounces of weed at any time. If a patient grows more than the permitted amount, he or she is not allowed to store it for future use.

"The way the law is written, the patient is forced to throw it away," Norton says. "Of course they all keep it and they live in fear that they're criminals."

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Related: Smoke Local, Pot patients could be out in the cold, Green light for Maine’s biggest dispensary company, More more >
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