GAETAN H. BOURGOIN v. TWIN RIVERS PAPER COMPANY, LLC, …

MAINESUPREMEJUDICIALCOURT ReporterofDecisionsDecision: 2018ME77Docket: WCB-16-433Argued: September13,2017Decided: June14,2018Panel: SAUFLEY,C.J.,andALEXANDER,MEAD,GORMAN,JABAR,HJELM,andHUMPHREY,JJ.Majority: SAUFLEY,C.J.,andMEAD,GORMAN,HJELM,andHUMPHREY,JJ.Dissent: JABARandALEXANDER,JJ.Dissent: ALEXANDER,J.

GAETANH.BOURGOINv.

TWINRIVERSPAPERCOMPANY,LLC,etal.HJELM,J.

[¶1] After sustaining a work-related injury, Gaetan H. Bourgoin was

issuedacertificationtousemedicalmarijuanaasaresultofchronicbackpain.

He successfully petitioned the Workers’ Compensation Board for an order

requiringhisformeremployer,TwinRiversPaperCompany,LLC,topayforthe

medicalmarijuana.OnthisappealfromthedecisionoftheAppellateDivision

affirming that award, we are called upon for the first time to consider the

relationship between the federal Controlled Substances Act (CSA) and the

MaineMedicalUseofMarijuanaAct(MMUMA).Weconcludethatinthenarrow

circumstances of this case—where an employer is subject to an order that

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wouldrequireittosubsidizeanemployee’sacquisitionofmedicalmarijuana—

thereisapositiveconflictbetweenfederalandstate law,andasaresult, the

CSA preempts the MMUMA as applied here. See 21 U.S.C.S. § 903 (LEXIS

throughPub.L.No.115-181).WethereforevacatethedecisionoftheAppellate

Division.1

I.BACKGROUND

[¶2] Twin Rivers Paper Company, LLC, and Sedgwick Claims

ManagementServices(collectively,TwinRivers)appealfromadecisionofthe

Workers’CompensationBoardAppellateDivisionaffirmingahearingofficer’s

(Pelletier, HO)2decree that ordered Twin Rivers to pay the cost of medical

marijuanausedbyitsemployee,GaetanH.Bourgoin.

[¶3] Wedrawthe following facts,whicharesupportedby the record,

fromthehearingofficer’sdecree.SeeBaileyv.CityofLewiston,2017ME160,

¶2,168A.3d762.

1TwinRiversalsochallengestheAppellateDivision’sdecisiononseveralalternativegrounds:

(1)that Twin Rivers is a “private health insurer” and therefore is not required to reimburse anemployee formedical marijuana treatment pursuant to 22M.R.S. § 2426(2)(A) (2017); (2) thatmedical marijuana is not a “reasonable and proper” treatment pursuant to theMaineWorkers’CompensationAct,39-AM.R.S.§206(2017);and(3)thatthehearingofficererredbyrejectingthefindingsoftheindependentmedicalexaminer,seeid.§312(7)(2017).BecausetheorderrequiringTwinRiverstopayforBourgoin’smedicalmarijuanaisbarredbytheCSA,weneednotanddonotreachtheseotherreasonswhyTwinRiverscontendstheordershouldbesetaside.

2ThedecreewasenteredonMarch16,2015,beforethechangeintitlefrom“hearingofficer”to“administrativelawjudge.”SeeP.L.2015,ch.297(effectiveOct.15,2015).

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[¶4] Bourgoinworked as a papermachine laborer for Fraser Papers,

whichwassubsequentlyacquiredbyTwinRivers,atapapermillinMadawaska

from 1980 until 1989, when he sustained a work-related back injury. By

agreementoftheemployer,Bourgoinwasplacedontotaldisabilityasaresult

of the injury. On three occasions, Twin Rivers filed a petition seeking a

reduction in Bourgoin’s incapacity, but each petition was denied, and he

remainsontotaldisability.

[¶5] Asaresultofhisworkplace injury,Bourgoinsuffers fromsevere

chronic pain syndrome. Bourgoin consulted with a number of pain

management specialists and attempted a variety of treatments, including

opioidmedications,forhispain.Duetoadversesideeffectsofhiscontinued

use of opioids, and on the recommendation of his primary care physician,

Bourgoin stoppedusingnarcoticmedications. In Januaryof2012,Bourgoin

obtained amedicalmarijuana certification and since then has usedmedical

marijuanatomanagehischronicpain.See22M.R.S.§§2421to2430-B(2017).

[¶6] In February of 2012, Bourgoin filed a “petition for payment of

medicalandrelatedservices”withtheWorkers’CompensationBoardseeking

paymentfromTwinRiversforthecostofthemedicalmarijuana.TwinRivers

opposedthepetitionontheground,amongothers,thatanorderrequiringitto

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payforBourgoin’smedicalmarijuanaisbarredbytheCSAevenifhisuseof

medicalmarijuanawerepermittedbytheMMUMA. Followingahearing,the

hearing officer granted Bourgoin’s petition in a written decision issued in

Marchof2015.TwinRiversappealedtotheAppellateDivision,whichaffirmed

thehearingofficer’sdecisioninAugustof2016.WethengrantedTwinRivers’

petition for appellate review. See 39-AM.R.S. § 322 (2017);M.R. App.P.23

(Tower2016).3

II.DISCUSSION

[¶7]TwinRiversarguesthattheControlledSubstancesAct,21U.S.C.S.

§§801-904(LEXISthroughPub.L.No.115-181),preemptsapplicationofthe

MMUMA as a predicate for an order that would compel Twin Rivers to

reimburseBourgoinfortheuseofmedicalmarijuana.Federalpreemptionisa

questionoflawthatwereviewdenovo.GuardianshipofSmith,2011ME51,

¶10,17A.3d136.

A. PreemptionPrinciples

[¶8]ThepreemptionanalysismustbeginwiththeSupremacyClauseof

theUnitedStatesConstitution,which“unambiguouslyprovidesthatifthereis

3TherestyledMaineRulesofAppellateProceduredonotapplybecause thisappealwas filed

priortoSeptember1,2017.SeeM.R.App.P.1(restyledRules).

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anyconflictbetweenfederalandstatelaw,federallawshallprevail.”Gonzales

v.Raich,545U.S.1,29(2005);seeU.S.Const.art.VI,cl.2(“ThisConstitution,

andtheLawsoftheUnitedStates...shallbethesupremeLawoftheLand.”).

There are two “cornerstones” that guideourpreemptionanalysis: first, “the

ultimate touchstone in every pre-emption case” is Congress’s purpose in

enactingthefederallaw;andsecond,“inallpre-emptioncases,andparticularly

in those in which Congress has legislated in a field which the States have

traditionally occupied,we startwith the assumption that the historic police

powersoftheStateswerenottobesupersededbytheFederal[law]unlessthat

wastheclearandmanifestpurposeofCongress.”Wyethv.Levine,555U.S.555,

565 (2009) (alterations omitted) (citations omitted) (quotation marks

omitted). Implementation of these principles serves to retain the

“constitutionally mandated balance of power” between state and federal

government. Gregoryv.Ashcroft,501U.S.452,458(1991)(quotationmarks

omitted).

[¶9]Federallawcanpreemptstatelawinthreeways:first,byexpress

preemption,where Congress expressly states that federal lawpreempts the

statelaw;second,byfieldpreemption,whereCongressexplicitlyorimplicitly

leaves “noroom” forstate law,orwhere federal law is “sodominant” that it

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“will be assumed to preclude enforcement” of the state law; and third, by

conflictpreemption,wherethestatelaw“actuallyconflictswithfederallaw.”

Hillsborough Cty. v. Automated Med. Labs., Inc., 471 U.S. 707, 713 (1985)

(citations omitted); see also Arizona v. United States, 567 U.S. 387, 398-400

(2012);GuardianshipofSmith,2011ME51,¶10,17A.3d136. Itisthethird

typeofpreemption—conflictpreemption—thatisatissuehere.

[¶10] Conflict preemption arises in two circumstances. The first is

where “compliance with both federal and state [law] is a physical

impossibility,” see Hillsborough Cty., 471 U.S. at 713 (citations omitted)

(quotation marks omitted), because federal and state law “irreconcilabl[y]

conflict”with one another, see Barnett Bank, N.A. v. Nelson, 517 U.S. 25, 31

(1996). Second, conflict preemption occurs where “state law stands as an

obstacle to the accomplishment and execution of the full purposes and

objectivesofCongress.” HillsboroughCty.,471U.S. at713 (quotationmarks

omitted);seealsoArizona,567U.S.at399.

[¶11]Here,Congressexpresslyregulatedtheconsequenceofanyconflict

thatarisesbetweentheCSAandstatelawbyincludingthefollowingprovision

intheCSA:

NoprovisionofthistitleshallbeconstruedasindicatinganintentonthepartoftheCongresstooccupythefieldinwhichthat

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provisionoperates,includingcriminalpenalties,totheexclusionofanyStatelawonthesamesubjectmatterwhichwouldotherwisebewithintheauthorityoftheState,unlessthereisapositiveconflictbetweenthatprovisionofthistitleandthatStatelawsothatthetwocannotconsistentlystandtogether.

21U.S.C.S.§903(emphasisadded).Throughthisstatutoryprovision,Congress

haseliminated fieldpreemption—but ithaspreserved thesupremacyof the

CSAwhereitsprovisionsconflictwithstatelawinawaythatmakescompliance

with the requirements of both impossible. See Freightliner Corp. v. Myrick,

514U.S. 280, 287 (1995);Robards v. CottonMill Assocs., 677 A.2d 540, 544

(Me.1996).Inthisway,Congresshasspecifiedthattheprinciplesofconflict

preemptionaretobeinvokedtodetermineifstatelawsmustyieldtotheCSA.

Consequently, when framed in terms of the conflict preemption rubric, the

dispositivequestionpresentedhere iswhetherTwinRivers isnecessarily in

violationoftheCSAifitweretocomplywiththeBoard’sordertopayforthe

medicalmarijuanathatBourgoinisauthorizedtousepursuanttotheMMUMA.

B. TheControlledSubstancesAct

[¶12]Nearlyhalfacenturyago,theUnitedStatesCongressenactedthe

Comprehensive Drug Abuse Prevention and Control Act of 1970, Pub.

L.No.91-513,84Stat.1236(LEXIS).SubchapterIoftheAct,whichwasTitleII

intheoriginallegislation,constitutestheControlledSubstancesAct,21U.S.C.S.

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§§801-904,whichestablisheslawspertinenttodrugcontrolandenforcement.

See Pub. L.No.91-513, §§ 100-709, 84 Stat. 1236, 1242-1284. The United

StatesSupremeCourthascharacterizedtheCSAas“aclosedregulatorysystem

making it unlawful to manufacture, distribute, dispense, or possess any

controlled substance except in a manner authorized by the CSA.” Raich,

545U.S. at 13; see also 21 U.S.C.S. § 801(1)-(6) (establishing Congressional

“findingsanddeclarations”regardingcontrolledsubstances);UnitedStatesv.

Moore,423U.S.122,134-35 (1975)(discussing the legislativehistoryof the

CSA).

[¶13]TheCSAclassifiessubstancessubjecttothatlegislationintofive

schedules that are differentiated based on three factors: their respective

potential for abuse, the existence—or absence—of their currently accepted

medicaluse,andriskstheyposeevenwhenusedundermedicalsupervision.

See21U.S.C.S§812(a),(b).MarijuanaisclassifiedasaScheduleIdrug,seeid.

§ 812(c)(Sched. I)(c)(10), which is the category of substances that, as

determined by Congress, have a high potential for abuse, do not have a

currently acceptedmedical use for treatment, and pose unacceptable safety

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risksevenundermedicalsupervision,seeid.§812(b)(1)(A)-(C).4Thismeans

that,withoneexceptionthat isnotapplicablehere,see infran.5, federal law

barstheprescribeduseofmarijuana—andofanyotherScheduleIdrug—even

in a state with local laws allowing the medical use of marijuana. See id.

§§812(b)(1)(A)-(C)(listingthe“findings”requiredtoclassifyasubstanceasa

Schedule I drug), 829 (establishingparameters forprescriptionsofschedule

II-Vdrugs);seealsoRaich,545U.S.at14,27;UnitedStatesv.OaklandCannabis

Buyers’Coop.,532U.S.483,494(2001);Mont.CaregiversAss’n,LLCv.United

States, 841F. Supp. 2d 1147, 1149-50 (D. Mont. 2012); Ross v. RagingWire

Telecomms.,Inc.,174P.3d200,204(Cal.2008);Peoplev.Crouse,388P.3d39,

41-42(Colo.2017).

[¶14] Although theCSA requiresperiodicupdatesof the schedulesof

controlled substances by the United States Attorney General, see21 U.S.C.S.

§§811,812(a),marijuanahasremainedaScheduleIdrugeversincetheCSA

wasenactedin1970.SeeRaich,545U.S.at15n.23(discussingthehistoryof

challenges to reclassify marijuana from 1972 through 2001). This is true

notwithstanding efforts by some to reclassify it—including, most recently,

4Substanceslistedintheotherfourschedulesaredeemedtopresentlesserconcernsinrelation

tooneormoreofthethreecriteriausedforcategorizationpurposes.See21U.S.C.S.§812(b)(2)-(5)(LEXISthroughPub.L.No.115-181).

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2016 denials of a challenge filed in 2011, seeDenial of Petition to Initiate

Proceedings to Reschedule Marijuana, 81 Fed. Reg. 53,687, 53,688-53,766

(Aug.12,2016),andin2009,seeDenialofPetitiontoInitiateProceedingsto

RescheduleMarijuana,81Fed.Reg.53,767,53,767-53,845(Aug.12,2016).See

alsoAmericansforSafeAccessv.DrugEnf’tAdmin.,706F.3d438,440-41,452

(D.C.Cir.2013)(affirmingthedenialofapetitiontoreclassifymarijuanaina

lessrestrictiveschedule);Washingtonv.Sessions,17Civ.5625(AKH),2018U.S.

Dist.LEXIS30586,at*5-7(S.D.N.Y.Feb.26,2018)(summarizingtheprocedure

for petitioning for reclassification of a drug, including judicial review of the

determination, and recent attempts at rescheduling the classification of

marijuana);DenialofPetitiontoInitiateProceedingstoRescheduleMarijuana,

76Fed.Reg.40,551,40,551-40,589(July8,2011).

[¶15]BecausemarijuanaisaScheduleIsubstance,theCSAmakesita

crimetoknowinglyor intentionally “manufacture,distribute,ordispense,or

possess with intent to manufacture, distribute, or dispense” marijuana,

21U.S.C.S.§841(a)(1),aswellasto“knowinglyorintentionally. . .possessa

controlled substance,” id.§ 844(a).5 Further, and important to the question

5 These prohibitions are subject to one exception, namely, the use of marijuana in research

projectsapprovedby thegovernment—acircumstancenotpresenthere. See21U.S.C.S.§823(f)(LEXISthroughPub.L.No.115-181);UnitedStatesv.OaklandCannabisBuyers’Coop.,532U.S.483,490 (2001)(“Formarijuana (andotherdrugs thathavebeen classified as ‘schedule I’ controlled

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presented here, a federal prosecution can be directed against a “principal,”

whichisdefinedasanyindividualwho“commitsanoffenseagainsttheUnited

Statesoraids,abets,counsels,commands,inducesorprocuresitscommission,”

18 U.S.C.S. § 2(a) (LEXIS through Pub. L. No. 115-181) (emphasis added).

Section 2 “reflects a centuries-old view of culpability: that a personmay be

substances),thereisbutoneexpressexception,andit isavailableonlyforGovernment-approvedresearchprojects,[section]823(f).”).

We note that section 844(a) of the CSA creates another exception to criminal liability forpossessionof scheduleddrugs, but that exception is inapplicable tomarijuana. Pursuant to thatexception,possessionofacontrolledsubstanceispermittedifit“wasobtaineddirectly,orpursuanttoavalidprescriptionororder,fromapractitioner,whileactinginthecourseof[thatpractitioner’s]professionalpractice.”21U.S.C.S.§844(a)(LEXISthroughPub.L.No.115-181);seealsoid.§802(21)(LEXISthroughPub.L.No.115-181)(defining“practitioner”).Thisexceptiondoesnotextendtothepossessionofmarijuana, however, because, by categorizing it as a Schedule Idrug, Congresshasdeterminedthatmarijuanahas“nocurrentlyacceptedmedicaluseintreatment”andthatthereis“alack of accepted safety for use of the drug or other substance under medical supervision.” Id.§812(b)(1)(B)-(C)(LEXIS throughPub.L.No.115-181);seealsoOaklandCannabisBuyers’Coop.,532U.S.at491(statingthat,asdesignatedintheCSA,“marijuanahas‘nocurrentlyacceptedmedicaluse’ at all” (quoting21U.S.C.S. §812(LEXIS throughPub. L.No. 115-181))); see alsoGonzales v.Oregon,546U.S.243,269(2006)(statingthat“Congress’expressdeterminationthatmarijuanahadnoacceptedmedicaluseforeclosedanyargumentaboutstatutorycoverageofdrugsavailablebyadoctor’sprescription”);Gonzalesv.Raich,545U.S.1,24(2005)(“The[CSA]regulatoryscheme isdesignedtofosterthebeneficialuseofthosemedications[listedinSchedulesIIthroughV],topreventtheirmisuse,andtoprohibitentirelythepossessionoruseofsubstanceslistedinScheduleI,exceptasapartofastrictlycontrolledresearchproject.”);UnitedStatesv.Harvey,794F.Supp.2d1103,1105-07(S.D.Cal.2011)(concludingthat,underCalifornialaw,a“doctor’srecommendation”foruseofmedicalmarijuanaisnota“validprescriptionororder”undersection844(a)oftheCSA),aff’d,659F.3d1272,1274(9thCir.2011)(withan“addition[that][w]hat-everelse‘order’mightmeanunder[section]844(a)ofthe[CSA],itdoesnotincludeamererecommendationfromaphysicianpursuantto the [California] Compassionate Use Act”). Further, the lawful parameters for prescribingcontrolleddrugsorsubstancespursuanttotheCSAdonotextendtoScheduleIdrugsorsubstances.See21U.S.C.S.§829(LEXISthroughPub.L.No.115-181).

Thus, a “written certification” for medical marijuana authorized by the MMUMA, 22 M.R.S.§§2422(16),2423-B(2017),evenwhenissuedbyamedical“practitioner”asdefinedbytheCSA,21U.S.C.S.§802(21),ora“medicalprovider”asdefinedbytheMMUMA,22M.R.S.§2422(4-C)(2017),isnota“validprescriptionororder”thatwouldexempttheresultingmarijuanapossessionfromthepurviewoftheCSA.

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responsibleforacrimehehasnotpersonallycarriedoutifhehelpsanotherto

complete its commission.” Rosemondv.United States, 134S. Ct. 1240,1245

(2014).AstheRosemondCourtrecognized,“almosteverycourtofappealshas

held[that]adefendantcanbeconvictedasanaiderandabettorwithoutproof

that he participated in each and every element of the offense.” Id. at 1246

(quotationmarksomitted)(alterationomitted).Thus,“apersonisliableunder

[section] 2 for aiding and abetting a crime if (and only if) he (1) takes an

affirmativeactinfurtheranceofthatoffense,(2)withtheintentoffacilitating

theoffense’scommission.”Id.at1245.

[¶16]Themensrearequiredforaidingandabettingisan“intent[that]

must go to the specific and entire crime charged,” such as “when a person

actively participates in a criminal venture with full knowledge of the

circumstancesconstitutingthechargedoffense.”Id.at1248-49.Putanother

way, “for purposes of aiding and abetting law, a person who actively

participatesinacriminalschemeknowingitsextentandcharacterintendsthat

scheme’s commission,” and, on that basis, is criminally liable. Id. at 1249

(emphasisadded);seealsoid.at1250(“Thelawdoesnot,norshouldit,care

whether [the defendant] participates with a happy heart or a sense of

foreboding. Either way, [the defendant] has the same culpability, because

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eitherway[thedefendant]hasknowinglyelectedtoaidinthecommissionofa

[crime].”(emphasisadded)).Therefore,wereTwinRiverstocomplywiththe

administrative order by subsidizing Bourgoin’s use ofmedicalmarijuana, it

wouldbeengaginginconductthatmeetsalloftheelementsofcriminalaiding

andabettingasdefinedinsection2(a).6

6Title18U.S.C.S.§2(LEXISthroughPub.L.No.115-181)containstwoseparatebasesonwhich

athirdpartymaybeheldcriminallyliable. Asdiscussedinthetext,section2(a)imposesliabilityuponapersonwhoaidsandabetsanotherperson incommitting thepredicatecrime. Seesupra¶¶15-16.Section2(b),incontrast,criminalizestheconductofanyindividualwho“willfullycausesanacttobedonewhichifdirectlyperformedby[thatperson]oranotherwouldbeanoffenseagainsttheUnitedStates.”(Emphasisadded).

Although,inits2014opinion,theRosemondCourtaddressedthemensrearequirementforaiding

andabettingbycitinggenerallytosection2,thestatutorylanguagethatitquotedandsubstantivelyanalyzedisfoundspecificallyinsection2(a).SeeRosemondv.UnitedStates,134S.Ct.1240,1243-45(2014). Section2(a)doesnot require “willful[]” conductbecause facilitationof theactivitywithknowledgeofitsillegalnatureissufficienttoformabasisforcriminalliability.Seeid.at1248-50;seealso,e.g.,UnitedStatesv.Slatten,865F.3d767,793(D.C.Cir.2017)(“Toestablishaidingandabetting,thegovernmenthadtoprove,beyondareasonabledoubt,that[thedefendant]intentionally‘facilitatedanypartof thecriminalventure,’withenough ‘knowledgeof thecrimeto enable [thedefendant] tomake the relevant legal (and indeed, moral) choice’ to opt out instead.” (quotingRosemond,134S.Ct.at1246,1249)(alterationsomitted));UnitedStatesv.Ford,821F.3d63,69(1stCir.2016)(“Thewords‘aids[and]abets’...allsuggestthatapersonviolatessection2onlyifthepersonhas ‘chosen,with fullknowledge, toparticipate in the illegalscheme.’” (quotingRosemond,134S. Ct. at 1250) (emphasis added));United States v. Encarnación-Ruiz, 787 F.3d 581, 589-91(1stCir.2015)(discussingtheapplicabilityofRosemondtothecrimeofaidingandabettinganotherperson’scriminalconductandstatingthatsection2(a)containsnoexplicitmensrearequirementbutthatcourtshaveimposeda“knowledge”element);UnitedStatesv.Watson,Nos.3:11-CR-079and3:15-CV-044,2016U.S.Dist.LEXIS88180,at*14(S.D.OhioJuly7,2016)(concluding“that[section]2(a)describesan‘inchoate’offense,or,asJusticeKaganwritesinRosemond,itcodifiesthe‘common-law standards for accomplice liability.’ Section 2(b), in contrast, does describe a substantiveoffense.”). Gaugedby the languageofsection2(a)andthese judicialexplanationsofthecriminalexposurecreatedbythatstatute,TwinRiverswouldactincontraventionoftheCSAifitweretofundBourgoin’sacquisitionofmedicalmarijuana.JusticeJabar’sdissentingopinioncitestosection2generallybutdrawsitsanalysisontheelement

ofwillfulnessthatisfoundinsection2(b)andnotinsection2(a),and,onthatbasis,concludesthatTwinRiverswouldfallbeyondthatstatute’sreach.SeeJabar,J.,DissentingOpinion¶¶40-45.This

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[¶17] It also bears noting that aside from the exposure to a federal

conviction itself, the penalties for violation of the CSA can be significant.

Pursuanttotheleastseverepenaltyrangeforaviolationofsection844—and,

consequently,foraidingorabettinganotherperson’sviolationofsection844—

thesentence,atminimum,isamandatoryfineof$1,000,anditmayalsoinclude

asmuchasoneyearofincarceration,withanevengreatersentenceifcertain

aggravatingfactorsarepresent,suchasapriorconvictionforanydrugoffense,

includingoffensesestablishedbytheCSA.See21U.S.C.S.§844(a);seealsoid.

§841(b)(1)(A)(enhancingamandatorysentencebasedonpriorconvictionsof

“felonydrugoffenses”toarangeofatleasttwentyyearsinprisontoalifeterm).

C. TheCSAandMaine’sMedicalMarijuanaLaw

[¶18] Thisdescriptionof the scopeandeffect of federal regulationof

marijuanabringsustothepointwhere theCSAandMainelawintersect. As

relevanttothiscase,theMaineMedicalUseofMarijuanaAct,22M.R.S.§§2421

formulationofliabilityisentirelydifferentfromthatsetoutinsection2(a),addressedinthetext,seesupra¶¶15-16,whichisbasedonconductthataidsandabetsanother’scriminalactivity.Therefore, irrespectiveofwhetherTwinRiver’ssubsidizationofBourgoin’smedicalmarijuana

wouldexposeTwinRiverstoprosecutionpursuanttosection2(b),thatconductwouldnonethelessaidandabetBourgoin’sviolationoftheCSAandrenderTwinRiverscriminallyliablepursuanttosection2(a).

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to2430-B,allowsa“qualifyingpatient”7suchasBourgointopossessalimited

amountofmarijuanaformedicaluse.Id.§§2422(9),2423-A(1)(authorizing

thepossessionofmarijuana).Thewrittencertificationbyamedicalprovider,

whichiseffectiveforoneyear,isbasedontheprofessional’sopinionthatthe

“qualifying patient is likely to receive therapeutic benefit” from themedical

marijuana used “to treat or alleviate the patient’s debilitating medical

condition.”Id.§2423-B.

[¶19]Theseconflictingfederalandstatelaws,andtheirembodimentof

competingpoliciesandunderlyingconclusionsabouttheefficacyofmarijuana

asalegitimatetherapeuticsubstance,framethenarrowissuethatiscentralto

thiscase:giventhisnetworkofstatutes,canTwinRiversberequiredtopayfor

Bourgoin’s acquisition and use ofmarijuana—conduct that is proscribed by

federallawbutallowedbytheStatebecauseaMMUMAcertificationhadbeen

issuedtohim?

[¶20] Compliancewithboth is an impossibility. WereTwinRivers to

complywiththehearingofficer’sorderandknowinglyreimburseBourgoinfor

thecostof themedicalmarijuanaaspermittedby theMMUMA,TwinRivers

7A“qualifyingpatient”is“apersonwhohasbeendiagnosedbyamedicalproviderashavinga

debilitatingmedicalconditionandwhopossessesavalidwrittencertificationregardingmedicaluseofmarijuanainaccordancewithsection2423-B.”22M.R.S.§2422(9)(2017).

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wouldnecessarilyengageinconductmadecriminalbytheCSAbecauseTwin

Riverswouldbe aiding and abettingBourgoin—inhis purchase,possession,

and use of marijuana—by acting with knowledge that it was subsidizing

Bourgoin’spurchaseofmarijuana.See18U.S.C.S.§2(a);21U.S.C.S.§844(a);

Rosemond,134S.Ct.at1248-50;seealso,e.g.,UnitedStatesv.Pinillos-Prieto,

419F.3d61,63-66(1stCir.2005)(describingathird-partyintermediarydrug

transaction that resulted in guilty verdicts for aiding and abetting); United

Statesv.Dingle,114F.3d307,309-12(D.C.Cir.1997)(affirmingthedefendant’s

convictionforaidingandabettingillegaldrugpossession).8Conversely,ifTwin

Rivers compliedwith the CSA bynot reimbursing Bourgoin for the costs of

medicalmarijuana,TwinRiverswouldnecessarilyviolatetheMMUMA-based

orderofthehearingofficer.

[¶21] Several courtshaveheld that a consumer’s state-law-compliant

choice to use medical marijuana does not trigger the limited preemption

provisionofsection903.See,e.g.,Reed-Kaliherv.Hoggatt,347P.3d136,141-42

(Ariz.2015);TerBeekv.CityofWyoming,846N.W.2d531,537-38(Mich.2014);

8 Furthermore, although Justice Jabar’s dissenting opinion, see Jabar, J., Dissenting Opinion

¶¶45-46,drawson thehypothetical situationposed inRosemond,where a third-party gunstoreownerknowsbutdoesnotcarehowanillegallysoldgunwillbeused,TwinRiverswouldnotbe“incidentallyfacilitat[ing]acriminalventure”butratherwouldbe“activelyparticipat[ing]init”byknowinglypayingforBourgoin’spurchaseandpossessionofmedicalmarijuana.Rosemond,134S.Ct.at1249n.8.

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Qualified Patients Ass’n v. City of Anaheim, 187 Cal. App.4th 734, 757 (Cal.

Ct.App.2010). This isbecausestate laws,suchastheMMUMA,providesafe

harborfromstateprosecution,butdonot—andcannot—createa“stateright

to commit a federal crime,”meaning that the state law protections have no

bearingonfederalcriminalizationorexposuretofederalprosecutionforthat

conduct. Mont.CaregiversAss’n,LLC,841F.Supp.2dat1150;seealsoRaich,

545U.S.at26-27;Garciav.TractorSupplyCo.,154F.Supp.3d1225,1229-30

(D.N.M.2016);QualifiedPatientsAss’n,187Cal.App.4that757;TerBeek,846

N.W.2dat540.Thiscase,however,doesnotcallforustodeterminewhether

thatlegalanalysiswouldprotecttheMMUMAgenerally.Thecasesofbroader

application,however,helptorevealthecriticalpointthat,inthecasebeforeus,

the Appellate Division, by affirming an order issued by the hearing officer,

wouldrequireTwinRiverstoengageinconductthatconstitutesaviolationof

theCSA.

[¶22]ThepreemptiveeffectoftheCSAonstatemarijuanalawshasbeen

addressed in several cases involving circumstances similar to the one

presentedhere,whereaparty—suchasTwinRivers—wasconfrontedwitha

mandatetoengageinconductthatwouldbeviolativeoftheCSA.Twocourts,

forexample,haveheldthatastatelawauthorizingmedicalmarijuanausedoes

18

notrequireanemployertotreatanemployee’smedicaluseofmarijuanaasa

reasonableworkplace accommodation. SeeGarcia, 154F. Supp.3dat1230;

EmeraldSteelFabricators, Inc.v.BureauofLabor&Indus.,230P.3d518,536

(Or. 2010). In Garcia, an employee asserted that his termination from

employmentbasedonapositive test forcannabismetaboliteswasa formof

unlawful discrimination because he was using medical marijuana for a

disablingmedicalcondition.154F.Supp.3dat1227.Thecourtgrantedthe

employer’smotiontodismissthecomplaintbecause, inthatcontext,theCSA

preemptedNewMexico’smedicalmarijuanalaw.Id.at1229-30.Inpart,the

courtreasonedthat“[t]oaffirmativelyrequire[theemployer]toaccommodate

[theemployee’s]illegaldrugusewouldmandate[theemployer]topermitthe

veryconducttheCSAproscribes.”Id.at1230(emphasisadded).

[¶23] Similarly, the Oregon Supreme Court has held that Oregon’s

medical marijuana law did not require an employer to accommodate an

employee’s use of medical marijuana pursuant to the principle of obstacle

preemption,aformofconflictpreemption,seesupra¶10,andthereforethat

“[t]otheextentthat[thestatemedicalmarijuanalaw]affirmativelyauthorizes

theuseofmedicalmarijuana,federallawpreemptsthatsubsection,leavingit

without effect.” Emerald Steel Fabricators, Inc., 230 P.3d at 529 (quotation

19

marksomitted);seealsoWashburnv.ColumbiaForestProds.,Inc.,134P.3d161,

167-68(Or.2006)(Kistler,J.,concurring)(statingthat“[t]hefactthatthestate

may choose to exemptmedicalmarijuana users from the reach of the state

criminallawdoesnotmeanthatthestatecanaffirmativelyrequireemployers

toaccommodatewhatfederallawspecificallyprohibits”).

[¶24] As these cases demonstrate, a person’s right to use medical

marijuanacannotbeconvertedintoaswordthatwouldrequireanotherparty,

suchasTwinRivers,toengageinconductthatwouldviolatetheCSA.

[¶25]Inathirdcaseofrelevance,althoughpresentingaverydifferent

factual situation, the Supreme Court of Colorado considered whether the

Colorado medical marijuana law—which is now part of that state’s

Constitution,seeColo.Const.art.XVIII,§14—maybeenforcedinawaythat

wouldviolatetheCSA.Crouse,388P.3dat40.TheColoradolawrequiredlaw

enforcementofficerstoreturnseizedmedicalmarijuanaif thepersonwhose

marijuana had been seizedwas later acquitted of the underlying state drug

charge.Id.at40-41.Theofficersdeclinedtocomplywiththatlawbecausethey

claimedthat,bydoingso,theywouldbedistributingmarijuanainviolationof

theCSA. Id.at41. The courtheld that “[b]ecause compliancewithone law

necessarilyrequiresnoncompliancewiththeother,thereisapositiveconflict

20

between [the state constitution] and the CSA such that the two cannot

consistentlystandtogether.”Id.at42(quotationmarksomitted).Analytically,

there is no difference between the circumstances of Crouse and this case:

Compelling an employer to subsidize an employee’s medicalmarijuana will

require the employer to commit a federal crime—aiding or abetting the

distribution and possession of marijuana, see 18 U.S.C.S. § 2(a); 21 U.S.C.S.

§844(a)—justasColoradolawwouldhaverequiredlawenforcementofficers

todistributedrugsinviolationoftheCSA.

[¶26]Inaffirmingthehearingofficer’sdecision,theAppellateDivision9

explicitly relied on the Department of Justice’s 2009 “OgdenMemo,” which

assignedlowprioritytotheprosecutionofmedical-marijuana-basedviolations

offederaldruglaws.DavidW.Ogden,DeputyAtt’yGen.,U.S.Dep’tofJustice,

Memorandum for Selected United States Attorneys: Investigations and

ProsecutionsinStatesAuthorizingtheMedicalUseofMarijuana1-2(Oct.19,

2009); see alsoNoll v. LepageBakeries, Inc.,Me.W.C.B.No. 16-25, ¶¶ 14-15

(App.Div.2016).Anyrelianceonthisinternaldepartmentalpolicy,however,

9Initspreemptionanalysissetoutinthedecisionitissuedinthiscase,theAppellateDivision

incorporatedadiscussionfoundinadecisionissuedthesamedayinadifferentcase,Nollv.LepageBakeries,Inc.,Me.W.C.B.No.16-25,¶¶11-15(App.Div.2016). WethereforeaddresstheBoard’sreasoningasdescribedinthelattercase.

21

isentirelymisplaced.Suchapolicyistransitory,asisirrefutablydemonstrated

byitsrecentrevocationbythecurrentadministration.10

[¶27]Evenmoresignificantly,theOgdenMemoitselfmadeclearthatit

wasdirectedonly to thequestionofenforcement of lawsbutdid nothing to

challenge their existence. David W. Ogden, Deputy Att’y Gen., U.S. Dep’t of

Justice,MemorandumforSelectedUnitedStatesAttorneys:Investigationsand

ProsecutionsinStatesAuthorizingtheMedicalUseofMarijuana1;seeUnited

Statesv.Hicks,722F.Supp.2d829,833-34(E.D.Mich.2010)(addressingthe

DOJ memoranda and concluding that the “[DOJ]’s discretionary decision to

directitsresourceselsewheredoesnotmeanthatthefederalgovernmentnow

lacksthepowertoprosecutethosewhopossessmarijuana”).Infact,theOgden

Memoexpresslystatesthat itmerelyprovided“guidanceregardingresource

10Thatfederalpolicychangeoccurredinearly2018,whentheUnitedStatesAttorneyGeneral

issued a memorandum declaring that “previous nationwide guidance specific to marijuanaenforcementisunnecessaryandisrescinded,effectiveimmediately.”JeffersonB.SessionsIII,Att’yGen., U.S. Dep’t of Justice,Memorandum for All United States Attorneys:Marijuana Enforcement(Jan.4,2018).Thisrescindedprosecutorialpoliciesthathadnotincludedmedicalmarijuanaamongitsenforcementpriorities.SeeJamesM.Cole,DeputyAtt’yGen.,U.S.Dep’tofJustice,MemorandumforAllUnitedStatesAttorneys:GuidanceRegardingMarijuanaEnforcement(Aug.29,2013);JamesM.Cole,DeputyAtt’yGen.,U.S.Dep’tofJustice,MemorandumforUnitedStatesAttorneys:GuidanceRegardingtheOgdenMemoinJurisdictionsSeekingtoAuthorizeMarijuanaforMedicalUse(June29,2011);DavidW.Ogden,DeputyAtt’yGen.,U.S.Dep’tof Justice,MemorandumforSelectedUnitedStatesAttorneys:InvestigationsandProsecutionsinStatesAuthorizingtheMedicalUseofMarijuana1-2(Oct.19,2009)(statingthatthe“pursuitof[theDepartment’s]prioritiesshouldnotfocusfederalresourcesin...Statesonindividualswhoseactionsareinclearandunambiguouscompliancewithexistingstatelawsprovidingforthemedicaluseofmarijuana”).

22

allocation [and]doesnot ‘legalize’marijuanaorprovidea legaldefense to a

violationoffederallaw....Nordoesclearandunambiguouscompliancewith

statelaw...createalegaldefensetoaviolationofthe[CSA].”DavidW.Ogden,

DeputyAtt’yGen.,U.S.Dep’tofJustice,MemorandumforSelectedUnitedStates

Attorneys: InvestigationsandProsecutions inStatesAuthorizing theMedical

Use of Marijuana 2; see also Mont. Caregivers Ass’n, LLC, 841 F.Supp.2d at

1148-49(“Areasonableperson,havingreadtheentiretyoftheOgdenMemo,

couldnotconcludethatthefederalgovernmentwassomehowauthorizingthe

production and consumption of marijuana for medical purposes. Any

suggestiontothecontrarydefiestheplainlanguageoftheMemo.”).Therefore,

evenifthepolicyexpressedintheOgdenMemowerealivetoday,itcouldnot

weakentheconclusionthatthereisapositiveconflictbetweentheCSAandthe

MMUMAasappliedhere.

[¶28]Mostimportantly,however,themagnitudeoftheriskofcriminal

prosecutionisimmaterialinthiscase.Prosecutedornot,thefactremainsthat

TwinRiverswouldbeforcedtocommitafederalcrimeifitcompliedwiththe

directiveoftheWorkers’CompensationBoard.11SeeSkinnerv.Ry.LaborExecs.’

11TheBoardalsoreliedontwodecisionsissuedbytheNewMexicointermediateappealscourt

incases thatraised the typeof issuepresentedhere,namely,whether theNewMexicoWorkers’CompensationActrequiredanemployertoreimburseaneligibleemployeeforthecostofmedicalmarijuanathattheemployeewaspermittedtousepursuanttoNewMexico’smedicalmarijuanaact.

23

Ass’n, 489 U.S. 602, 651 (1989) (Marshall, J., dissenting) (“The absence of

prosecutions to date . . . hardly proves that prosecutors will not avail

themselves[oftheapplicablelaw]inthefuture.”).

III.CONCLUSION

[¶29]ThroughitsenactmentoftheMMUMA,theMaineLegislaturehas

exempted qualifying patients and other specified individuals from state

prosecutionthatotherwisecouldarisefromthemedicaluseofmarijuana.The

Legislature, however, does not have the power to change or restrict the

applicationoffederallawthatpositivelyconflictswithstatelaw.SeeU.S.Const.

art.VI,cl.2. SolongasmarijuanaremainsaScheduleIsubstanceunderthe

CSA,see21U.S.C.S.§812(c)(Sched. I)(c)(10),anemployer that isordered to

compensateanemployee formedicalmarijuanacosts is therebyrequired to

commitafederalcrimedefinedbytheCSA. See18U.S.C.S.§2(a);21U.S.C.S.

§844(a).ThiscreatesapositiveconflictbetweentheCSAandthisapplication

See Lewis v. Am. Gen. Media, 355 P.3d 850 (N.M. Ct. App. 2015); Vialpando v. Ben’s Auto Servs.,331P.3d975 (N.M. Ct. App. 2014). In the earlier of those cases the court declined to reach thequestionoffederalpreemption,concludingineffectthattheemployerhadnotpreservedtheissue.Vialpando,331P.3dat979-80.Inthesecondcase,thecourt,relyinginpartonVialpando—anopinionthat did not reach the merits of the issue—rejected the contention that the CSA trumped anyrequirementthattheemployersubsidizethecostofmedicalmarijuanabecause,thecourtreasoned,theDOJenforcementmemosrenderedtheprospectofprosecutionundertheCSAtobespeculative.Lewis,355P.3dat858-59.Tothelimitedextentthesecasesaddressthemeritsofthepreemptionissue,theanalysisislessthancompelling,andwedeclinetofollowtheirlead.

24

of theMMUMA. See21U.S.C.S. § 903. As invoked against TwinRivers, the

MMUMA requires what federal law forbids, and the authority ostensibly

providedbytheMainelawis“withouteffect.”Mut.Pharm.Co.,Inc.v.Bartlett,

570U.S.472,486-87(2013)(quotationmarksomitted);Robards,677A.2dat

543(quotationmarksomitted).

[¶30]BecausetheCSApreemptstheMMUMAwhentheMMUMAisused

asthebasisforrequiringanemployertoreimburseanemployeeforthecostof

medicalmarijuana,theorderbasedontheMMUMAmustyield.Wetherefore

vacatethedecisionoftheAppellateDivision.

Theentryis:

Judgment vacated. Remanded to theWorkers’Compensation Appellate Division withinstructionstovacatethedecisionofthehearingofficerandremandfordenialofthepetitionforpaymentofmedicalexpensesandservices.

JABAR,J.,withwhomALEXANDER,J.,joins,dissenting.

[¶31] I respectfully dissent because I do not believe that the federal

ControlledSubstancesAct(CSA)preemptstheMaineMedicalUseofMarijuana

Act(MMUMA)inthiscase.

25

A. PreemptionAnalysis

[¶32] The United States Supreme Court has recognized that in “all

pre-emption cases, and particularly in those in which Congress has

legislated...inafieldwhichtheStateshavetraditionallyoccupied,...westart

withtheassumptionthatthehistoricpolicepowersoftheStateswerenottobe

supersededbytheFederalActunlessthatwastheclearandmanifestpurpose

of Congress.” Wyeth v. Levine, 555 U.S. 555, 565 (2009) (quotation marks

omitted).Centraltothisinitialassumptionisthetheoreticalunderpinningthat

ournationwasfoundedupon:“federalism...allow[s]theStatesgreatlatitude

undertheirpolicepowersto legislateastotheprotectionofthelives, limbs,

health,comfort,andquietofallpersons.”Gonzalesv.Oregon,546U.S.243,270

(2006) (quotationmarks omitted). Particularly relevant to this case, “[t]he

structure and operation of the CSA presume and rely upon a functioning

medical profession regulated under the States’ police powers.” Id. And in

Maine,wehavebeenclear:

In caseswhere federal law is said tobar state action in fieldsoftraditional state regulation, such as workers’ compensationlegislation,thereisanassumptionthatthehistoricpolicepowersoftheStateswerenottobesupersededbytheFederalActunlessthatwastheclearandmanifestintent[ofCongress].

26

Ciampi v. Hannaford Bros. Co., 681 A.2d 4, 8 (Me. 1996) (emphasis added)

(quotationmarksomitted). “Thecaseforfederalpre-emptionisparticularly

weakwhereCongresshasindicateditsawarenessoftheoperationofstatelaw

in a field of federal interest, and has nonetheless decided to stand by both

conceptsandtotoleratewhatevertensionthereisbetweenthem.”BonitoBoats,

Inc. v. Thunder Craft Boats, Inc., 489 U.S. 141, 166-67 (1989) (alteration

omitted)(quotationmarksomitted).

[¶33]InordertodeterminewhethertheCSApreemptstheMMUMAhere,

wemustdeterminewhetheritisthe“clear”or“manifest”purposeofCongress

topreemptastateworkers’compensationboardfromorderinganemployerto

reimburseanemployeeforvalidmedicalexpensesrelatedtoproperlycertified

medical marijuana. As the Court states, the CSA contains the following

provisionregardingpreemption:

NoprovisionofthistitleshallbeconstruedasindicatinganintentonthepartoftheCongresstooccupythefieldinwhichthatprovisionoperates,includingcriminalpenalties,totheexclusionofanyStatelawonthesamesubjectmatterwhichwouldotherwisebewithintheauthorityoftheState,unlessthereisapositiveconflictbetweenthatprovisionofthistitleandthatStatelawsothatthetwocannotconsistentlystandtogether.

27

21U.S.C.S.§903(LEXISthroughPub.L.No.115-181)(emphasisadded);Court’s

Opinion¶11.Ourquestionnowbecomeswhethera“positiveconflict”exists

here.

[¶34] Apositiveconflictarises “whencompliancewithbothstateand

federalrequirementsisimpossible.”Robardsv.CottonMillAssocs.,677A.2d540,

544 (Me. 1996) (emphasis added). In the words of Erwin Chemerinsky, a

preeminentscholarofconstitutionallaw,andhisco-authors,

Thephrasepositiveconflict...sothatthetwocannotconsistentlystand together in section 903 has been interpreted as narrowlyrestricting thepreemptivereachof theCSAtocasesofanactualconflictwith federal law such that compliancewith both federalandstateregulationsisaphysicalimpossibility.JusticeScaliahaswritten that the plain language of section 903 states acongressional intent that the CSA preempt only state laws thatrequire someone to engage in anaction specifically forbiddenbythe CSA. As a California appellate court succinctly put it, merespeculationaboutahypotheticalconflict isnotthestuffofwhichpreemptionismade.It is not physically impossible to complywith both the CSA andstate marijuana laws; nothing in the more liberal state lawsrequires anyone to act contrary to the CSA. Only if a state lawrequiredacitizentopossess,manufacture,ordistributemarijuanainviolationof federal lawwould itbe impossible foracitizen tocomplywithbothstateandfederallaw.Similarly,ifastateweretomakestateofficersthemanufacturersordistributorsofmarijuana,itmightwellbeimpossibleforthoseofficialstocomplywithbothstate and federal law. No state marijuana law, however, hasattemptedtorequirestateorlocalofficialstoviolatetheCSAinthismanner.

28

Erwin Chemerinsky et al.,Cooperative Federalism andMarijuanaRegulation,

62UCLA L. Rev. 74, 105-06 (2015) (emphases added) (footnotes omitted)

(quotationmarksomitted).

[¶35]Turningtothesupposedlyconflictinglaws,theMMUMAallowsa

medical provider to “provide a written certification for the medical use of

marijuana”ifa“qualifyingpatientislikelytoreceivetherapeuticbenefit”from

its use “to treat or alleviate the patient’s debilitating medical condition.”

22M.R.S. §2423-B (2017). Pursuant to the CSA, on the other hand, it is

“unlawful for any person knowingly or intentionally . . . to manufacture,

distribute, or dispense, orpossesswith intent tomanufacture, distribute, or

dispense”marijuana.21U.S.C.S.§841(a)(LEXISthroughPub.L.No.115-181).

TheCSAalsomakesitunlawfultoknowinglyorintentionallypossessmarijuana.

Id.§844(a)(LEXISthroughPub.L.No.115-181).

[¶36] Here, there is no positive conflict between the CSA and the

MMUMA because there is no state law that requires the employer—or any

personorentity—topossess,manufacture,ordistributemarijuana. Inother

words,compliancewithboththefederallawandtheWorkers’Compensation

Board(WCB)orderispossible:reimbursementdoesnotrequiretheemployer

tophysicallymanufacture,distribute,dispense,orpossessmarijuana,and,asa

29

result,nophysical impossibilityexistsbetweenthefederal lawandtheWCB

orderinthiscase.AdoptingChemerinsky’sanalysisofsection903oftheCSA,

becausethereisnophysicalimpossibilityhere,andbecauseCongresshasnot

expressed a clear and manifest preemptive intent regarding state workers’

compensation boards and reimbursement for state-law compliant medical

marijuanause,seeCiampi,681A.2dat8,nopositiveconflictexists.

[¶37]TheemployerandtheCourtpointtotheColoradocaseofPeoplev.

Crousetosupporttheargumentthatreimbursementcreatesapositiveconflict.

388P.3d39(Colo.2017);Court’sOpinion¶25.Thatcase,however,servesto

highlighttheexactreasonthatnopositiveconflictexistsinBourgoin’scase.In

Crouse, the Colorado Supreme Court held that there was a positive conflict

between the CSA and its constitution—its state law—that required police

officerstophysicallydistributeseizedmedicalmarijuanatoindividualswhohad

beenchargedandacquittedofthecrimethatledtotheseizure.Id.at40.The

conflict existed because of the actual physical impossibility that existed

between the Colorado state law and the CSA: the officers were—literally—

requiredtophysicallydistributethemarijuana,andtheCSAmakesdistribution

unlawful.Id.at42;21U.S.C.S.§841(a).

30

[¶38]ThiscaseisunlikePeoplev.Crouse.Thereisadifferenceinboth

natureanddegreebetweenfollowingaWCBordertoreimburseaworkerfor

medicaltreatmentauthorizedbyaphysicianandapprovedbytheWCBanda

statelawthatrequirespoliceofficerstophysicallydistributemarijuana.The

keydistinctionisthatthepoliceofficers’actionsinCrousefitwithinanactual,

proscribedactivityspecificallydefinedbytheCSA.SeeCrouse,388P.3dat41.

Because theofficerswouldbe required to “deliver,”meaning engage in “the

actual,constructive,orattemptedtransferofacontrolledsubstance,”therewas

a physical impossibility between the state law and the CSA. See id. at 42

(quotationmarksomitted);seealso21U.S.C.S.§802(8),(11)(LEXISthrough

Pub.L.No.115-181). Here,unlike inCrouse, theemployer’s reimbursement

doesnotfallintoanycategoryofdefinedorproscribedactivityundertheCSA.

Becausetheemployerisnotrequiredtophysicallyengageinactivitythatthe

CSAproscribes,thereisnopositiveconflictinthiscase.

B. AidingandAbetting

[¶39] The Court’s primary legal theory—that because the employer

would be aiding and abetting Bourgoin’s possession, the CSA preempts the

MMUMAhere—isunpersuasivebecausethegovernmentwouldnotbeableto

provethattheemployerwouldbeactingwiththespecificintentnecessaryto

31

establishtherequisitemensreaelementoftheoffenseofaidingandabetting.

See18U.S.C.S.§2(LEXISthroughPub.L.No.115-181). Further,theCourt’s

analysisonaidingandabettingisspeculativebecauseitisnotspecificorcertain

enoughtoshowthatthereisapositiveconflictinthiscasesuchthattheCourt

canconcludethatpreemptionhereisthe“manifest”purposeofCongress.See

Wyeth, 555U.S. at565. Atmost,whether thegovernmentwouldbeable to

provethemensreaelementishypothetical,andhypotheticalsdonotgiverise

topreemption.See,e.g.,ExxonCorp.v.GovernorofMaryland,437U.S.117,131

(1978);seealsoRicev.NormanWilliamsCo.,458U.S.654,659(1982) (“The

existenceofahypotheticalorpotential conflict is insufficient towarrant the

pre-emptionofthestatestatute.Astateregulatoryschemeisnotpreempted

by the federal ... laws simply because in a hypothetical situation a private

party’s compliancewith the statutemight cause him to violate the [federal]

laws.”).

[¶40] A person is punishable as a principal under federal law if that

person “aids, abets, counsels, commands, induces or procures [a crime’s]

commission”or“willfullycausesanacttobedonewhichifdirectlyperformed

by [that person] or anotherwould be an offense against theUnited States.”

18U.S.C.S. §2. In 1938, Judge Learned Hand set forth a definition of the

32

necessarymensreaforallaidingandabettingoffenses,statingthatinorderto

beguiltyofaidingandabetting,itisnecessarythattheallegedaiderorabettor

“participatein[theventure]asinsomethingthathewishestobringabout,that

heseekbyhisactiontomakeitsucceed.”UnitedStatesv.Peoni,100F.2d401,

402(2dCir.1938)(emphasisadded). Aboutadecade later, inNye&Nissen

v.United States, the United States Supreme Court quoted Judge Hand’s

formulation, affirming this theory ofmens rea for the offense of aiding and

abetting.See336U.S.613,618-19(1949).

[¶41]SinceNye&Nissen,federalcourtshavecontinuedtoholdthatthe

accomplicemustwishordesire tobringaboutthesuccessoftheprincipal in

committingtheunderlyingsubstantiveoffenseinordertobepunishableasa

principal.SeeUnitedStatesv.Zafiro,945F.2d881,887(7thCir.1991)(“Tobe

provedguiltyofaidingandabetting,...thedefendant[musthave]desiredthe

illegal activity to succeed.”); United States v. Poston, 902 F.2d 90, 93 (D.C.

Cir.1990) (quoting Judge Hand’s formulation); United States v. Indelicato,

611F.2d376,385(1stCir.1979)(“Tosustainaconvictionontheaidingand

abetting. . .counts,thegovernmenthadtoprovebeyondareasonabledoubt

that appellant willfully associated himself in some way with the criminal

ventureandwillfullyparticipatedinitashewouldinsomethinghewishedto

33

bring about.”); United States v. Newman, 490 F.2d 139, 143 (3d Cir. 1974)

(“[T]hegovernmentmustprovebeyondareasonabledoubtthatthedefendant

participated in a substantive crime with the desire that the crime be

accomplished.”).

[¶42]Inotherwords,thecrimeofaidingandabettingisaspecificintent

crime.SeeUnitedStatesv.Nacotee,159F.3d1073,1076(7thCir.1998)(“Tobe

liableunderanaidingandabettingtheory. . .adefendantmusthavehadthe

specificintenttoaidinthecommissionofthecrimeindoingwhatevershedid

to facilitate its commission.”);Bosco v. Serhant, 836 F.2d 271, 279 (7th Cir.

1987)(“Aidingandabettinginthecriminallawrequiresnotonlyknowledgeof

theprincipal’sobjectivebutadesire tohelphimattain it.”). InZafiro, Judge

Posnerexplainedfurther,

To be proved guilty of aiding and abetting, [it] must beestablished[] that the defendant desired the illegal activity tosucceed.Thepurposeofthisrequirementisalittlemysteriousbutwethinkitistoidentify,andconfinepunishmentto,thoseformsofassistancethepreventionofwhichmakesitmoredifficulttocarryontheillegalactivityassisted.

945F.2dat887.

[¶43]Indistancingitsownanalysisandviewofliabilityforaidingand

abettingfromthatsetforthhere,theCourtdistinguishesbetweenthecriminal

liabilityelementcontainedin,ontheonehand,18U.S.C.S.§2(a)and,onthe

34

other, 18U.S.C.S. § 2(b). Court’s Opinion ¶ 16 n.6. However, the above

discussion—ofthegeneralprinciplesunderlyingaidingandabettingliability—

isnotpremisedonthatdistinction.TheCourt’sdiscussionfailstoadequately

accountfortheoriginofthespecificintentelementthatbothsection2(a)and

2(b)contain.Itisthecommonlaw—notthestatutorylaw—thatgeneratesthe

necessaryspecificintentelementofsectiontwoliabilityforaidingandabetting,

andCongress’sdecisionnot toset forth therequisitementalstate insection

2(a)doesnotmeanthattheelementislacking,orthatitisanythingotherthan

what the common law has said that it is. See, e.g., Staples v. United States,

511U.S.600,605-06(1994)(“Indeed,wehavenotedthatthecommon-lawrule

requiringmensreahasbeenfollowedinregardtostatutorycrimesevenwhere

thestatutorydefinitiondidnotintermsincludeit.”)(quotationmarksomitted).

[¶44]Inthiscontext,thecommonlawestablishestherequisitemensrea

elementforallofsectiontwo.SeeNye&Nissen,336U.S.at618-19(discussing

the intent requirement for offenses of aiding and abetting). Moreover,Nye

&Nissen, decided in 1949, predated Congress’s 1951 amendment of section

2(b);priortothe1951amendment,theword“willful”wasabsentfromsection

two.SeeActofOct.31,1951,ch.655,65Stat.710,717(LEXIS).ThatCongress

did not add “willful” to section 2(a) in 1951 does not mean that Congress

35

intended to eliminate the specific intent or “willfulness” for section

2(a)liability; indeed, theoppositeconceptionof therationaleunderlying the

omissionisstronger.SeeBaruchWeiss,WhatWereTheyThinking?:TheMental

StatesoftheAiderandAbettorandtheCauserUnderFederalLaw,70Fordham

L.Rev.1341,1447(2002)(“Infact,whatlittleinformationthatexistsseemsto

suggest . . . thattheword[willfully]wasaddedbyCongress[in1951]notto

differentiatebetweenthetwotypesofaccomplices,butrathertoconfirmJudge

LearnedHand’srepeatedeffortstoequatethem.Thewordwasneededtobring

thecausingsubsectionin linewiththeaidingandabettingsubsection,which

had no need for theword because its verbs – aid, abet, counsel, command,

induce, and procure – sufficiently convey the concept of willful[ness].”)

(quotationmarksomitted)).

[¶45] Here, the employer’s compliance with the WCB’s order to

reimburseBourgoin’sstate-law-compliantmedicalexpensesis insufficientto

giverisetothespecificintentelementofaidingandabetting,regardlessofwith

whichprongundersectiontwotheUnitedStatesmayormaynotchargethe

employer.TheCourtdoesnotanalyzehowthegovernmentwouldbeableto

meet itsburdentoprovebeyondareasonabledoubtthattheemployeritself

actually desired or wished that Bourgoin be successful in committing the

36

underlying federal offense; I donot agree thatmereknowledge is sufficient.

AccordingtotheCourt,however,theemployer“wouldbeaidingandabetting

Bourgoin—inhispurchase,possession,anduseofmarijuana—byactingwith

knowledgethatitwassubsidizingBourgoin’spurchaseofmarijuana.”Court’s

Opinion¶20(emphasisadded).Tosupportthisproposition,theCourtcitesto,

amongothersourcesoflaw,Rosemondv.UnitedStates,134S.Ct.1240,1248-50

(2014).Thatcase,however,“didnotdeal...withdefendantswhoincidentally

facilitateacriminalventureratherthanactivelyparticipateinit.”Id.at1249

n.8.TheRosemondCourtdiscussedthetypeofactivitythatwouldnotgiverise

totherequisitespecificintent:“Ahypotheticalcaseistheownerofagunstore

whosellsafirearmtoacriminal,knowingbutnotcaringhowthegunwillbe

used.Weexpressnoviewaboutwhatsortoffacts,ifany,wouldsufficetoshow

thatsuchathirdpartyhastheintentnecessarytobeconvictedofaidingand

abetting.”Id.

[¶46]Incontrast,theemployerinthiscaseisevenfurtherremovedfrom

Bourgoin than the gun store owner is from the “criminal” in theRosemond

hypothetical; completely disinterested in Bourgoin’s use or possession of

marijuana—and indeed only reimbursing him for his medical expenses as

ordered by the WCB—the employer is not an active participant in the

37

substantive “offense” of Bourgoin’s possession. Contrary to the Court’s

conclusion,Idonotagreethatmereknowledgeconstitutesactiveparticipation

in the commission of a crime, the effective accomplishment of which the

accomplicehimself orherselfmustwish ordesire tobringabout inorder to

establish the requisite specific intent that theoffenseof aiding andabetting

demands.

[¶47] In fact, theexistenceof this litigationvitiates thespecific intent

element that the government would have to prove if it even decided to

prosecutetheemployer.Regardless,whetherthegovernmentwouldbeableto

prove the requisitemens reabeyond a reasonable doubt is speculative, and

becausespeculativeconflictsandhypotheticalsdonotgiverisetopreemption,

see, e.g., Exxon Corp., 437U.S. at 131, reliance on the doctrine of aiding and

abettingtodeclarethatitwasCongress’smanifestpurposetopreempttheWCB

fromorderingreimbursementisfartootenuous.Insum,Idonotagreethatthe

employer would commit an offense against the federal government by

reimbursing Bourgoin for his valid medical expenses pursuant to the WCB

order,especiallyinlightofthestrongpresumptionagainstpreemptioninthis

state-controlled area of workers’ compensation—a domain that has

38

traditionallybeenregulatedunderthepolicepowersofthestates.SeeCiampi,

681A.2dat8.

[¶48] The Court also discusses the employer’s offense of aiding and

abettinginavacuum,devoidofanymentionofthesubstantiveoffense,which

would be Bourgoin’s state-law-compliant use and possession of medical

marijuana.TheCourtpointstonofederalprosecutionofpossessionofmedical

marijuana, let alone a federal prosecution of aiding and abetting a singular

person’s simple possession of medical marijuana. 12 Because proof of the

existenceofasubstantivecrime isalsoanelementofanaidingandabetting

charge,seeIndelicato,611F.2dat385,theCourtcannotreachtheconclusion

that the employer has aided or abetted Bourgoin’s use or possession of

marijuana without similarly declaring that Bourgoin’s use or possession of

marijuanaconstitutesafederaloffense.ThisomissionallowstheCourttoavoid

a discussion that would necessarily be required to include the preemptive

12Indeed,CongresshasrepeatedlyenjoinedtheDepartmentofJusticefromexpendinganyfunds

topreventstates fromadministering theirstate-law-compliantmedicalmarijuanaprograms. SeeConsolidatedAppropriationsAct,2018,Pub.L.No.115-141,§538,132Stat.348(“NoneofthefundsmadeavailableunderthisActtotheDepartmentofJusticemaybeused. . . toprevent[astateorterritory] from implementing their own laws that authorize the use, distribution, possession, orcultivation of medical marijuana.”) (LEXIS); Consolidated Appropriations Act, 2017, Pub.L.No.115-31,§537,131Stat.135(LEXIS)(similar);ConsolidatedAppropriationsAct,2016,Pub.L.No. 114-113, § 542, 129 Stat. 2242 (LEXIS) (similar); Consolidated and Further ContinuingAppropriationsAct,2015,Pub.L.No.113-235,§538,128Stat.2130(LEXIS)(similar).Todate,theinjunctionremainsineffect.SeeConsolidatedAppropriationsAct,2018,Pub.L.No.115-141,§538,132Stat.348(makingappropriationsthroughthefiscalyearendingSeptember30,2018).

39

effect of the CSA on Bourgoin’s state-law-compliant use and possession of

medicalmarijuana.TheCourtusesthedoctrineofaidingandabettingasthe

vehicletodeclarethattheMMUMAispreemptedbytheCSAinthiscase,but

becausethegovernmentwouldnotbeabletoprovethattheemployerhasthe

specificintenttoaidorabetBourgoin’sstate-law-compliantuseandpossession

ofmedicalmarijuana,theCourt’srelianceontheaidingandabettingdoctrine

ismisguided.Theemployeralsoacknowledgedatoralargumentthatdespite

thefactthatthefirststatemedicalmarijuanalawwasenactedmorethantwo

decadesagoin1996,13andthefactthattwenty-ninestates,twoterritories,and

theDistrictofColumbianowhavelawsineffectthatallowfortheuseofmedical

marijuana,14it could not point to any federal prosecution against amedical

13Cal.HealthandSafetyCode§11362.5(Deering2018)(LEXIS).

14Alaska,seeAlaskaStat.§§17.37.010to.080(LEXISthrough2017);Arizona,seeAriz.Rev.Stat.Ann.§§36-2801to-2819(LEXISthroughFirstReg.Sess.of53rdLegis.(2017)andFirstSpecialSess.of53rdLegis.(2018)andEmergencyLegis.from20182dReg.Sess.,effectiveasofMay16,2018);Arkansas, see Ark. Const. amend. XCVIII (LEXIS, through 2018 Fiscal Sess. and 2018 SecondExtraordinary Sess.); California, seeCal.Health andSafetyCode§§11362.1 to .9 (Deering2018)(LEXIS); Colorado, see Colo. Const. art. XVIII, § 14 (LEXIS, through First Reg. Sess. and FirstExtraordinary Sess. of 71st Gen. Assembly); Connecticut, seeConn. Gen. Stat. §§ 21a-408 to 429(LEXIS through Pub. Acts 18-1 through 18-6, 18-8, 18-24); Delaware, seeDel. Code Ann. tit. 16,§§4901A to 4928A (LEXIS through 81 Del. Laws, ch. 253); District of Columbia, see D.C. Code§§7-1671.01to .13(LEXISthroughJune4,2018);Florida,seeFla.Stat.§381.986(LEXISthrough2018Reg.Sess.);Hawaii,seeHaw.Rev.Stat.Ann.§§329-121to-131(LEXISthroughAct12of2018Sess.);Illinois,see410Ill.Comp.Stat.Ann.130/1to/999(LEXISthroughP.A.100-585ofthe100thLegis. Sess.);Maine, see22M.R.S. §§2421to2430-B (2017);Maryland, seeMd.CodeAnn.,Misc.HealthCarePrograms§§13-3301to-3316(LEXISthroughJune1,2018);Massachusetts,seeMass.Ann.Lawsch.94D,§§1-3(LEXISthroughAct98ofthe2018Legis.Sess.);Michigan,seeMich.Comp.LawsServ.§§333.26421to.26430(LEXISthrough2018Pub.Act170);Minnesota,seeMinn.Stat.§§152.22to.37(LEXISthroughch.118(excludingportionsofchs.103,113,and115of2018Reg.

40

provider for authorizing a patient to usemarijuana formedicinal purposes,

much less to anemployeror insurance carrierprovidingreimbursement for

authorized medical marijuana treatment. It is speculative to anticipate a

federalprosecutionofanemployerwhoreimbursesanemployeeformedical

expensespursuanttoaWCBordermandatingittodoso.

[¶49]BecauseIwouldholdthatthereisnopositiveconflictbetweenthe

CSAandtheMMUMAinthiscase, Iaddresstheremainderoftheemployer’s

argumentsonappeal.

Sess.ofMinn.90thLegis.));Montana,seeMont.CodeAnn.§§50-46-301to-345(LEXISthrough2017Reg.Sess.of65thLegis.andNov.2017SpecialSess.);Nevada,seeNev.Rev.Stat.Ann.§§453A.010to.810(LEXISthroughchs.1-505,507-560,562-565,567,569,572-587,589-608of79thReg.Sess.(2017));NewHampshire,seeN.H.Rev.Stat.Ann.§§126-X:1to:11(LEXISthroughAct48of2018Reg.Sess.);NewJersey,seeN.J.Stat.Ann.§§24:6I-1to-16(LEXISthrough218thFirstAnnualSess.,L.2018,c.15andJ.R.5);NewMexico,seeN.M.Stat.Ann.§§26-2B-1to-7(LEXISthrough2018Reg.Sess. enactments of 53rd Legis.); New York, seeN.Y. Pub. Health Law §§3360 to3369-e (LEXISthrough 2018 chs. 1-47, 50-58); North Dakota, seeN.D. Cent. Code §§ 19-24.1-01 to -40 (LEXISthroughendof2017Reg.Legis.Sess.);Ohio,seeOhioRev.CodeAnn.§§3796.01to.30(LEXISthroughLegis.passedby132ndGen.AssemblyandfiledwithSec’yofStatethroughfile66(HB354));Oregon,seeOr.Rev.Stat.§§475.300to.375(LEXISthroughemergencylegis.throughchs.1-50,52-59,62-71,73-92of2018Legis.Sess.);Pennsylvania,see35Pa.Cons.Stat.§§10231.101to.2110(LEXISthrough2018Reg.Sess.Acts1-21);RhodeIsland,see21R.I.Gen.Laws§§21-28.6-1to-17(LEXISthroughch.28ofJan.2018Sess.);Vermont,seeVt.Stat.Ann.tit.18,§§4471to4474m(LEXISthroughch.110andMunicipalAct15ofthe2017AdjournedSess.(2018));Washington,seeWash.Rev.CodeAnn.§§69.51A.005to.903(LEXISthrough2018ch.6);WestVirginia,seeW.Va.CodeAnn.§§16A-1-1to-16-1(LEXISthrough2018Reg.Sess.Legis.);Guam,see10GuamCodeAnn.§§122501to122529(LEXISthroughP.L.34-71,12/15/2017);PuertoRico,see9000PRRegla8686(LEXISthroughrulesreceivedbeforeJanuary23,2018).

41

C. PrivateHealthInsurers

[¶50]Theemployerarguesthattheplainlanguagecontainedinsection

2426(2)(A)oftheMMUMAdemonstratesalegislativeintentthatnothirdparty

shouldberequiredtoreimburseapersonfortheiruseofmedicalmarijuana.

See 22 M.R.S. § 2426(2)(A) (2017). We review issues of statutory

interpretationdenovo.SeeEstateofSullwoldv.SalvationArmy,2015ME4,¶7,

108A.3d1265.

[¶51] “The cardinal rule of statutory construction is to ascertain and

effectuate the intent of the legislature.” State v. Hudson, 470 A.2d 786, 788

(Me.1984).“[A]well-settledruleofstatutoryinterpretationstatesthatexpress

mention of one concept implies the exclusion of others not listed.” Musk v.

Nelson,647A.2d1198,1201(Me.1994);seealsoLeev.Massie,447A.2d65,68

(Me.1982)(“[T]hemaxim[of]expressiouniusestexclusioalterius...isregarded

aswellrecognizedinMaine....”(quotationmarksomitted)).Weonly“look

beyondtheplainmeaningandconsiderotherindiciaoflegislativeintent”if“the

statutorylanguageisambiguous.”Damonv.S.D.WarrenCo.,2010ME24,¶10,

990A.2d1028.

[¶52]TheMMUMAstatesthatit“maynotbeconstruedtorequire...[a]

governmentmedicalassistanceprogramorprivatehealthinsurertoreimburse

42

aperson for costs associatedwith themedicaluseofmarijuana.” 22M.R.S.

§2426(2)(A). The MMUMA does not define “private health insurer.” See

22M.R.S. §2422 (2017). However, theWorkers’ Compensation Act (WCA)

defines “employer,” “[i]f the employer is insured,” to include “the insurer,

self-insurerorgroupself-insurer.” 39-AM.R.S.§102(12)(2017). Underthe

WCA, “insurance company” is separately defined as “any casualty insurance

companyorassociationauthorizedtodobusinessinthisStatethatmayissue

policies”anddoesnotincludeemployers.Id.§102(14).See,e.g.,Deabayv.St.

RegisPaperCo.,442A.2d963,964(Me.1982)(distinguishingbetweenprivate

healthinsurersandself-insuredemployersundertheWCA).

[¶53]Wemustfirstlooktotheplainmeaningof“privatehealthinsurer”

undertheMMUMAandconstruethatlanguagetoavoidanabsurd,inconsistent,

orillogicalresult. SeeHansonv.S.D.WarrenCo.,2010ME51,¶12,997A.2d

730.Readinconjunctionwiththeentiresentencewithinwhichthephraseis

contained,thereexistonlytwocategoriesofthirdpartiesthatshouldbeexempt

frompayingfortheuseofmedicalmarijuana:governmentmedicalassistance

programs or private health insurers. The use of the disjunctive word “or”

betweenthetwotypesofthirdparties,andtheabsenceofanyotherpotential

third-partypayors,indicatestheintenttosetforthanexhaustivelistofthird

43

parties exempt from reimbursement, consistent with the statutory

interpretationcanonofexpressiounius. SeeMusk,647A.2dat1201;seealso

Lee,447A.2dat68.Employers,includingthosethatareself-insured,arenot

thefunctionalequivalentstootherwiseprivatehealthinsurers.Iwouldhold

thatforthepurposesofWCAclaims,“privatehealthinsurers”isunambiguous

as used in the MMUMA and does not include self-insured employers for

purposesofcompensationundertheWCA.

D. ReasonableandProperTreatment

[¶54]Theemployerarguesthatmedicalmarijuanaisnotareasonable

andproperformoftreatmentundertheWCAbecauseitisillegalundertheCSA;

ithasnotbeenshowntohaveanacceptedlevelofsafety;thereisnocontrol

overthequalityofthesubstance;andthereisnocontroloveritsbilling.We

review issues of statutory interpretation de novo. See Estate of Sullwold,

2015ME4,¶7,108A.3d1265.

[¶55] “WhenconstruingprovisionsoftheWorkers’CompensationAct,

our purpose is to give effect to the Legislature’s intent.” Graves v.

Brockway-SmithCo.,2012ME128,¶9,55A.3d456(quotationmarksomitted).

PursuanttotheWCA,“[a]nemployeesustainingapersonalinjuryarisingoutof

and in the course of employment . . . is entitled to reasonable and proper

44

medical, surgical and hospital services, nursing, medicines, andmechanical,

surgicalaids,asneeded,paidforbytheemployer.”39-AM.R.S.§206(2017).

[¶56] TheWCAdoesnotdefinewhat“reasonableandproper”means.

See generally 39-A M.R.S. § 102 (2017). However, we have held that the

“reasonableandproper”languagecontainedwithintheWCAis“unambiguous

on its face” and that “the Legislature sought to provide payment by the

employerforallreasonableandpropermedical...services...requiredbyan

employeesustainingapersonal injuryarisingoutofand in thecourseofhis

employment.”15Cotev.Georgia-PacificCorp.,596A.2d1004,1005(Me.1991)

(quotationmarksomitted). Whendeterminingwhetheraparticularmedical

expenseis“reasonableandproper”undertheWCA,wehavestatedthat“[e]ach

casemustbedecidedaccordingtoitsownparticularfactsandaccordingtothe

statute’s ultimate purpose to provide reasonable relief from the effects of a

work-related injury.” Brawn v. Gloria’s Country Inn, 1997ME 191, ¶ 11,

698A.2d 1067 (emphasis added). See, e.g., id. ¶¶ 10, 15 (holding that a

part-timeassistantandvantoaccommodateawheelchairwerereasonableand

15Before1992,theWCA’s“reasonableandproper”languagewascontainedin39M.R.S.A.§52

(1964),butaftertheActwasoverhauledin1992,thesamelanguagebecamepartofsection206;although the languagemoved, it has retained the samemeaning. See P.L. 1991, ch. 885, § A-8(effectiveOct. 7, 1992); see alsoL.D. 2464, Statementof Fact, PartA,at211 (115thLegis. 1992)(“Section206 reorganizes and substantially enacts theprovisionsof the formerTitle39, section52....”).

45

properwhenmedicallynecessaryforthatparticularemployee);Cote,596A.2d

at1005-06(holdingthathousekeepingwasnotreasonableandproperwhenit

hadnoaccompanyingmedicalcomponent);Archerv.MDSBldg.,Inc.,2004ME

17,¶¶2,6,841A.2d801(holdingthatelectiveamputationofatoetoreplacea

thumblostinaworkinjurywasreasonableandproperbecausetheamputation

wasa“directconsequence”ofreasonableandpropertreatment).

[¶57]TurningtotheparticularfactsofBourgoin’sowncase,Bourgoin

suffersfromseverechronicpainsyndrome,whichincludessymptomsofpain

andmusclespasmsinhisback,legs,arms,andchest.Bourgoinhasattempted

many treatments since he was placed on total disability in 1989, including

nerveblocks,aquatherapy,andpainmanagementthroughopioidmedication.

Eventually,thecontinueduseofopioidmedicationresultedinseverenegative

sideeffects,includingnarcoticdependence,withdependencydatingasfarback

as the 1990s, and suicidal ideation. The hearing officer found that strong

narcotic medications “have already been tried and they have failed

Mr.Bourgoin miserably.” As a result, and after consultation with his

psychiatrist, hisprimarydoctor recommended ceasingnarcoticmedications,

and in Januaryof2012,Bourgoinobtainedamedicalmarijuanacertification

fromaphysician.Bourgoinhasusedmedicalmarijuanasincehiscertification

46

to successfully treat his chronic pain, and the hearing officer found that

Bourgoin“hasexperiencedsignificantbenefitfrommedicalmarijuana,andthat

opioidshavealreadybeenshowntobeafailure.”

[¶58]Withnoreferencetothe“particularfacts”ofBourgoin’scase,the

employer here argues that medical marijuana is per se unreasonable and

improperforBourgoinbecausepossessionofmarijuanaisunlawfulunderthe

CSA.Iwoulddeclinetoadoptthisargumentandwouldconcludethatmedical

marijuanawas reasonable and proper here based on the particular facts of

Bourgoin’sowncase,asestablishedbytherecordbeforeus.Specifically,the

severityandchronicnatureofhispain,hismanyandvariedattempts to try

different treatments, none of which were effective, and the ultimate

effectivenessofmedicalmarijuana forhisparticularsituation, showthat the

medicaluseofmarijuanawasreasonableandproperinthiscase.

E. RejectionofIME’sFindings

[¶59] The employer argues that there was not clear and convincing

evidencetocontradicttheindependentmedicalexaminer’s(IME)findings,and

that the hearing officer’s analysis was flawed because it failed to consider

47

whethermedicalmarijuanacaneverbereasonable“givenits illegalityunder

theCSA.”

[¶60] A hearing officer must adopt the medical findings of the IME

“unlessthereisclearandconvincingevidencetothecontraryintherecordthat

doesnotsupportthemedicalfindings.”39-AM.R.S.§312(7)(2017).Although

ahearingofficer’sdecision“onallquestionsoffactisfinal,”ahearingofficer’s

conclusionthatanemployeesatisfiedhisorherburdentoprovebyclearand

convincingevidencethattheindependentmedicalexaminer’sfindingsshould

berejectedisaconclusionoflawthatissubjecttoappellatereview.39-AM.R.S.

§318(2017).16Insuchacase,“wedeterminewhetherthehearingofficercould

havebeenreasonablypersuadedbythecontrarymedicalevidencethatitwas

highlyprobable that the recorddidnot support the IME’smedical findings.”

Sprague v. Lucas Tree Experts, 2008ME162, ¶ 24, 957A.2d 969 (quotation

marksomitted).

[¶61]Inthiscase,thehearingofficerfoundittobehighlyprobablethat

therecorddidnotsupporttheIME’sfindings.Specifically,thehearingofficer

was persuaded by the testimony of Dr. Sulak regarding the benefits of

16CertainportionsoftheWCA,including39-AM.R.S.§318(2017),wereamendedafterthedecree

inthiscasewasentered,see,e.g.,P.L.2015,ch.297,§13(effectiveOct.15,2015),thoughnotinanywayrelevanttothisdiscussion.

48

marijuana for the treatmentof long-term, chronic pain, andBourgoin’sown

testimonyregardingtheeffectsofmarijuanaonhislevelofpain.Thehearing

officerfoundthisevidencetobemorepersuasivethantheIME’sfindings.The

IME concluded that, because medical marijuana had no currently accepted

medicaluseunderfederallaw, itwasnotareasonableandpropertreatment

foranypatient,regardlessofitsefficacyinagivencircumstance.

[¶62]Becausetherecordcontains(1)numerousexamplesoftheways

in which medical marijuana has reduced Bourgoin’s chronic pain since

beginningtheregimenofmedicalmarijuanause;and(2)evidenceoftraditional

opioidmedication’s failure to reducehis chronicpain, Iwouldhold that the

hearingofficercouldhavebeenreasonablypersuadedbythecontrarymedical

evidence,and,asaresult, thathedidnoterrwhenheconcluded that itwas

highlyprobablethattherecorddidnotsupporttheIME’smedicalfindings.

[¶63]Accordingly,IwouldaffirmthedecisionoftheAppellateDivision.

ALEXANDER,J.,dissenting.

[¶64] I am pleased to join Justice Jabar’s thoroughly researched and

carefullywrittendissentingopinion.Iwriteseparatelybecauseintheextensive

49

discussion of the law of preemption, wemust not lose sight of the injured

workerwhomthisopinionisreallyabout.

[¶65] Gaetan Bourgoin has endured chronic, disabling pain from a

workplace injury he sustained three decades ago. The result of the Court’s

opiniontodayistodepriveBourgoinofreimbursementformedicationthathas

finallygivenhimrelieffromhischronicpain,andtoperhapsforcehimtoreturn

totheuseofopioidsandotherdrugsthatfailedtorelievehispainandmayhave

placedBourgoin’slifeatrisk.

[¶66] Theessentialelementsofthisappealarethatotherstatesallow

appropriatemedicalpersonneltoprescribeorcertifymarijuanatotreathealth

conditions;thesestatesallowemployersandprivateinsurerstoreimbursefor

marijuana prescriptions or certificates; and the certificates and

reimbursements are technically violations of federal law, but the federal

governmenthasnottakencriminalorcivilactiontopreventthesecertifications

orreimbursementsoratleastnosuchfederalprosecutionisindicatedinthe

record.

[¶67] Based on the status of the law in 2016, the Appellate Division

approvedthecertificatesandthereimbursements.TheCourt’sopinionrejects

the Appellate Division’s findings and, based on its speculation that federal

50

enforcementpracticemightchange,theCourtholdsasamatteroflawthatthe

AppellateDivisionerredinapprovingthecertificatesandreimbursementsfor

Mr.Bourgoin.Court’sOpinion¶¶26-30.Inthis,theCourtisreachingtoofar,

speculatingaboutthefutureratherthanlookingatthepresent,aswasproperly

addressedbytheAppellateDivision.

[¶68]Fromthatresult,Irespectfullydissent.

Anne-MarieL.Storey,Esq.(orally),andJohnK.Hamer,Esq.,RudmanWinchell,Bangor,forappellantsTwinRiversPaperCompany,LLC,andSedgwickClaimsManagementServicesNormanG.Trask,Esq.(orally),Currier&Trask,P.A.,PresqueIsle,forappelleeGaetanH.BourgoinThomasE.Getchell,Esq.,TroubhHeisler,Portland,foramicuscuriaeUniversityofMaineSystemWorkersCompensationBoardAppellateDivisioncasenumber15-0022FORCLERKREFERENCEONLY