US Drug Enforcement Administration investigators have visited the homes and offices of Massachusetts physicians involved with medical marijuana dispensaries and delivered an ultimatum: sever all ties to marijuana companies, or relinquish federal licenses to prescribe certain medications, according to several physicians and their attorneys.
The stark choice is necessary, the doctors said they were told, because of friction between federal law, which bans any use of marijuana, and state law, which voters changed in 2012 to allow medical use of the drug.
The DEA’s action has left some doctors, whose livelihoods depend on being able to offer patients pain medications and other drugs, with little option but to resign from the marijuana companies, where some held prominent positions.
The Globe this week identified at least three doctors contacted by DEA investigators, although there may be more.
“Here are your options,” Dr. Samuel Mazza said he was told by Gregory Kelly, a DEA investigator from the agency’s New England Division office. “You either give up your [DEA] license or give up your position on the board . . . or you challenge it in court.”
Mazza, chief executive of Debilitating Medical Conditions Treatment Centers, which won preliminary state approval to open a dispensary in Holyoke, said the DEA investigator’s visit came shortly after state regulators announced the first 20 applicants approved for provisional licenses for medical marijuana dispensaries.
Mazza said he returned from vacation in February to find a DEA business card on the door to his home and several messages on his answering machine urging him to contact the agency immediately.
The quiet DEA crackdown comes even as the US House of Representatives approved a measure last week that would restrict the DEA from raiding medical marijuana operations in states where it is legal. Senate action is pending.
Tensions between federal and state officials have flared as 22 states, including Massachusetts, have legalized medical marijuana, many since 2010.
A spokesman for the DEA in Boston on Wednesday referred calls to agency headquarters in Washington.
A DEA spokeswoman in Washington declined to answer questions Thursday about the doctors’ assertions that they are being asked to choose between their drug prescribing licenses and their ties to dispensaries. The spokeswoman would not say whether the action in Massachusetts is part of a national policy or limited to the state.
Physicians, dentists, and other health care providers who prescribe or administer narcotics and other controlled substances are required to register with the DEA, which tracks use of the drugs and strips federal licenses of those who fraudulently prescribe the medications.
At least two physicians resigned their medical officer positions with planned medical marijuana dispensaries in the past two weeks after visits from the DEA, including Dr. Carl Fulwiler.
The psychiatrist was part of the executive management team of the William Noyes Webster Foundation, which was granted preliminary approval for a dispensary in Dennis, and resigned his position last week, according to a person with direct knowledge of the situation. Fulwiler did not return calls seeking comment.
Another physician who asked that his name not be used for fear of reprisal said two DEA investigators arrived unannounced at his office last month.
“DEA agents can be quite direct when they want to make an impression on you,” the doctor said.
“My terrified secretary asked what to do with them, and I said I’d see them in five minutes after I finished what I was engaged in,” the physician said.
During a polite, 15-minute conversation, one of the officials asked “probing” questions about the dispensary’s proposed operations, while the other furiously took notes, the doctor said.
“The gist was to get me to either relinquish the DEA license, if I insisted on continuing with the dispensary, or give the license up ‘temporarily’ while involved with the dispensary,” he said.
The investigator told the physician that if he gave up his DEA license, he could later apply to have the license reinstated if he no longer was involved with the dispensary. But, the doctor recalled, the investigator said there was no guarantee the license would be restored.
Otherwise, the investigator explained, the doctor could divorce himself from any association with the dispensary.
“I had no choice but to choose the last option,” said the physician, who resigned his position at the dispensary.
Valerio Romano, a Boston attorney who represents several dispensaries, said the DEA’s action may further delay dispensaries from opening.
When state regulators selected companies in January for provisional licenses, they said they expected most would open by this summer. But since then, problems have surfaced, including misrepresentations and conflicts of interest involving several of the companies. State officials have acknowledged they did not check the veracity of the companies’ statements in their applications.
State regulators say they are now conducting extensive background checks of dispensary applicants, and Romano said those checks may be prolonged now that some dispensary companies will be searching for new medical officers to fill positions vacated by physicians who recently resigned.
“In the end, what all of this means is more delay for patients,” Romano said.
Dave Kibbe, a spokesman for the state Department of Public Health, which issues dispensary licenses, said in a statement Thursday that the companies are not required to have medical personnel on their management teams, and that the doctors’ resignations would not cause delays in the state program. But Kibbe said the departures may cause delays for individual dispensaries.
“When registered marijuana dispensaries experience changes in leadership, they are required to notify [the health department],” he said. “Any new [dispensary] personnel must go through a comprehensive background check as part of the department’s standard process.”
Dr. Walter Panis, chief medical officer for Alternative Therapies Group, which was granted preliminary approval by state health officials to open a medical marijuana dispensary in Salem, said he has not been contacted by the DEA, but expressed concern after learning other doctors had been given an ultimatum.
“The dispensaries need good medical information and how else are they going to get it except through physicians that are able to give that information?” said Panis, whose role in the dispensary will be to educate staff about medical marijuana and patient treatment.
Panis, a neurologist, said he needs his DEA license to prescribe certain medications. He said he would consult a lawyer if given an ultimatum by the DEA, but would probably withdraw from the dispensary if forced to make a choice.
“I’d probably resign, but I don’t want to do that,” Panis said. “I wouldn’t want to jeopardize my ability to practice medicine. Practicing medicine is the soul of my life.”
Mazza, the physician associated with the Holyoke dispensary, said that when he returned the DEA’s urgent messages in February, he was put on a speaker phone with three DEA officials.
“You are chairman of an organization that is going to distribute a product that is against federal law,” Mazza said the DEA officials told him.
The DEA investigators were “quite congenial” but adamant, according to Mazza, that he couldn’t keep his DEA license to prescribe controlled substances if he maintained his position at the dispensary.
Even though Mazza has held his DEA license for 40 years, he said it was easier to surrender it than to engage in a legal battle. Mazza, who works part-time for the federal government, performing surgeries at the VA Medical Center in Northampton, said he doesn’t need the DEA license for that job.
Correction: Because of a reporting error, an earlier version of this story had the wrong first name for Dr. Samuel Mazza.