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How a Dying Woman Forced the State's Hand on Medical Marijuana

Last Friday, Linda Horan sat in front of a bank of reporters in the back room of a medical marijuana dispensary in Portland, Maine. She was beaming.

"My god, I’m over the moon – completely over the moon," she said.

It took Horan months to get here. She had to sue the state so she and other patients could buy medical marijuana legally now. The court ruled in fact she could, and next week the state will begin issuing registration ID cards to patients eligible for medical marijuana.

Horan has late-stage lung cancer and she wants to use marijuana to avoid opioids in her final days. In NHPR's latest story in a series called "Dangerous Ends," we lay out the case that finally opened the door to the state's medical marijuana program.

Linda's Last Crusade

Horan's victory against the state came after a very public battle with the state – a battle that began this past Labor Day.

That’s when Horan was given a lifetime achievement award from the AFL-CIO. In the audience was Governor Maggie Hassan. Horan seized a moment.

"Governor," she said while choking back sobs, "I have Stage IV lung cancer with only months to live. I need you to open that dispensary. Please…."

Horan is not afraid of a bruising public fight. She’s a retired Verizon worker and she’s been a labor activist for most of her life. As it turns out, suing the state was just something she had to do before she died.

I had a tumor that was seven centimeters in diameter and probably had been growing for about seven years. So that put me into Stage 4 lung cancer almost immediately. I just skipped right over the first three.

I went to Horan’s home in Alstead a month ago. She was sitting on a couch in a sun-drenched back room, watching her favorite show: Judge Judy. Her house is full knickknacks and tchotchkes.  

Horan says she’s always been healthy – until she got a cold last March.

"The cold went away, but the cough lingered, and lingered, and lingered," Horan said. "And I have an ostrich-approach to my own health."

Horan kept her head in the sand for months. On July 29, she saw her doctor.

"He found that I had a tumor that was seven centimeters in diameter and probably had been growing for about seven years," she said. "So that put me into Stage IV lung cancer almost immediately. I just skipped right over the first three."

Within weeks, Horan found herself winded walking across a room and frequently crippled by a long, rasping cough. She dropped from 112 pounds to 96. She’s 64 years old.

"I think of death as a transition into some other form, so I have no fear and no qualms. And I’m anxious to see what my next adventure is going to be."

But there is one thing Horan fears.

"I am very afraid of having to rely on narcotics and opiates, which I’m told when my decline begins, are my only option except for therapeutic marijuana."

Horan hopes cannabis will keep up her appetite and keep her lucid longer than opioids would.

"The opiate of choice is morphine and fentanyl, the same opiates that are plaguing the state."

"A victim in the War on Drugs"

So let’s go back – since the medical marijuana law passed in 2013, lots of patients have complained about the program’s slow roll out. The state has had to start this industry from scratch and lawmakers never set aside money for it.

So Horan decided to sue the state. Her attorney? Paul Twomey, who was legal counsel to the house when the medical marijuana bill passed. In November, Twomey filed Horan’s lawsuit against the Department of Health and Human Services.

"Well they’re the ones that give out the licenses so that’s who we had to sue," says Twomey. "Now, they were not giving out the licenses on the basis of advice from the Attorney General’s office."

The AG’s office and the governor declined to comment for this story.

They are a law-enforcement agency to begin with and I think that they are making the mistake of looking at this solely through the lens of a law-enforcement agency. I mean, we are talking about a health problem. - Paul Twomey, attorney to Linda Horan and former legal counsel to the N.H. House of Representatives

Horan argued the state has a legal obligation to issue her a medical marijuana ID card immediately. That card would allow her to go to Maine to legally purchase her medication. But the AG’s office refused. In court, the state said it could not issue ID cards until the New Hampshire dispensaries were open.

"They are a law-enforcement agency to begin with," says Twomey, "and I think that they're making the mistake of looking at this solely through the lens of a law-enforcement agency. I mean, we're talking about a health problem."

While Horan went to court, State Representative Renny Cushing (D-Hampton) waged a public relations battle.

"Linda Horan is, in many ways, a causality of the War on Drugs," he said on the house floor in November. "It’s time for the State of New Hampshire to issue medical marijuana cards to patients like Linda and everyone else similarly afflicted."

Cushing argued the legislature had intended for patients to get this medication quickly, and the state had no legal grounds to not issue the ID cards. The court agreed with him. On November 24, for the first time, a U.S. court ordered a state to issue a medical marijuana ID card to a patient.

More patients to come

By the time Horan went to Maine last week, she was down to 90 pounds.

"The doctors tell me to stay off the scale," she told reporters. "But as a curious person I find that hard to do."

In front of Horan there were marijuana cookies, tinctures, capsules and the old-fashioned smokeable stuff too. The dispensary is one of four owned by Wellness Connection, which serves 10,000 patients in Maine. Becky DeKeuster says there’s a reason they send their patients home with lots of options.

"Within the first month of beginning on a medical cannabis regime, they have dialed in what strain works best, what delivery method works best, what dosage is helping them," says DeKeuster."

Credit Jack Rodolico
Linda Horan at a dispensary in Maine, shortly after becoming the first New Hampshire resident to legally purchase medical marijuana.

Maine dispensaries could see other New Hampshire customers soon, now that the state will begin issuing ID cards to all who qualify. One hundred people have applied so far.

Back in Alstead, before the outcome of this case was certain, Horan told me she had started chemotherapy because her doctor said it would giver he more energy.

"I want to be strong enough to see this fight through," Horan said. "And I would not be doing this if it was just for me. But it’s not unusual for me to have a final crusade. In fact it’s good for me."

Linda Horan is no longer getting chemotherapy. And the governor’s staff did eventually reach out to her. They’ve offered to drive to Horan’s home, where she’s already begun to experiment with her new meds.

Before joining NHPR in August 2014, Jack was a freelance writer and radio reporter. His work aired on NPR, BBC, Marketplace and 99% Invisible, and he wrote for the Christian Science Monitor and Northern Woodlands.

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