# Gaetan H. Bourgoin v. Twin Rivers Paper Company, LLC

> Supreme Judicial Court of Maine · June 14, 2018 · 187 A.3d 10

URL: https://www.frixlaw.com/law-library/cases/4284308

## Case

- **Full name:** Gaetan H. BOURGOIN v. TWIN RIVERS PAPER COMPANY, LLC, Et Al.
- **Court:** Supreme Judicial Court of Maine
- **Decided:** June 14, 2018
- **Citations:** 187 A.3d 10; 2018 ME 77
- **Precedential status:** Published
- **Opinion:** Opinion
- **Judges:** Saufley, Alexander, Mead, Gorman, Jabar, Hjelm, Humphrey
- **Cited by:** 17 later opinions in the Frix Law Library

## Citator (automated)

- No negative treatment found by the automated citator. That is not the same as a confirmation that the case is good law; read the citing cases.
- Full citator and citing cases: https://www.frixlaw.com/law-library/cases/4284308

## How later opinions describe it (automated extraction)

- concluding that “where an employer is subject to an order that would require it to subsidize an employee’s acquisition of medical marijuana[,] there is a positive conflict between federal and state law, and as a result, the CSA preempts the [Maine Medical Use of Marijuana Act]…
- holding that a WC insurer “would be aiding and abetting [the claimant]—in his purchase, possession, and use of marijuana—by acting with knowledge that it was subsidizing [his] purchase of marijuana”

## Opinion text

MAINE	SUPREME	JUDICIAL	COURT Reporter	of	Decisions
Decision: 2018	ME	77
Docket: WCB-16-433
Argued: September	13,	2017
Decided: June	14,	2018

Panel: SAUFLEY,	C.J.,	and	ALEXANDER,	MEAD,	GORMAN,	JABAR,	HJELM,	and	HUMPHREY,	JJ.
Majority: SAUFLEY,	C.J.,	and	MEAD,	GORMAN,	HJELM,	and	HUMPHREY,	JJ.
Dissent: JABAR	and	ALEXANDER,	JJ.
Dissent: ALEXANDER,	J.

GAETAN	H.	BOURGOIN

v.

TWIN	RIVERS	PAPER	COMPANY,	LLC,	et	al.

HJELM,	J.

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

issued	a	certification	to	use	medical	marijuana	as	a	result	of	chronic	back	pain.

He successfully petitioned the Workers’ Compensation Board for an order

requiring	his	former	employer,	Twin	Rivers	Paper	Company,	LLC,	to	pay	for	the

medical	marijuana. On	this	appeal	from	the	decision	of	the	Appellate	Division

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

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

Maine	Medical	Use	of	Marijuana	Act	(MMUMA). We	conclude	that	in	the	narrow

circumstances of this case—where an employer is subject to an order that
2

would	require	it	to	subsidize	an	employee’s	acquisition	of	medical	marijuana—

there	is	a	positive	conflict	between	federal	and	state	law,	and	as	a	result,	the

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

through	Pub.	L.	No.	115-181). We	therefore	vacate	the	decision	of	the	Appellate

Division.1

I. BACKGROUND

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

Management	Services	(collectively,	Twin	Rivers)	appeal	from	a	decision	of	the

Workers’	Compensation	Board	Appellate	Division	affirming	a	hearing	officer’s

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

marijuana	used	by	its	employee,	Gaetan	H.	Bourgoin.

[¶3] We draw the following facts, which are supported by the record,

from	the	hearing	officer’s	decree. See	Bailey	v.	City	of	Lewiston,	2017	ME	160,

¶	2,	168	A.3d	762.

1 Twin	Rivers	also	challenges	the	Appellate	Division’s	decision	on	several	alternative	grounds:

(1)	that Twin Rivers is a “private health insurer” and therefore is not required to reimburse an
employee for medical marijuana treatment pursuant to 22 M.R.S. § 2426(2)(A) (2017); (2) that
medical marijuana is not a “reasonable and proper” treatment pursuant to the Maine Workers’
Compensation	Act,	39-A	M.R.S.	§	206	(2017);	and	(3)	that	the	hearing	officer	erred	by	rejecting	the
findings	of	the	independent	medical	examiner,	see	id.	§	312(7)	(2017). Because	the	order	requiring
Twin	Rivers	to	pay	for	Bourgoin’s	medical	marijuana	is	barred	by	the	CSA,	we	need	not	and	do	not
reach	these	other	reasons	why	Twin	Rivers	contends	the	order	should	be	set	aside.
2 The	decree	was	entered	on	March	16,	2015,	before	the	change	in	title	from	“hearing	officer”	to

“administrative	law	judge.” See	P.L.	2015,	ch.	297	(effective	Oct.	15,	2015).
3

[¶4] Bourgoin worked as a paper machine laborer for Fraser Papers,

which	was	subsequently	acquired	by	Twin	Rivers,	at	a	paper	mill	in	Madawaska

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

agreement	of	the	employer,	Bourgoin	was	placed	on	total	disability	as	a	result

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

remains	on	total	disability.

[¶5] As a result of his workplace injury, Bourgoin suffers from severe

chronic pain syndrome. Bourgoin consulted with a number of pain

management specialists and attempted a variety of treatments, including

opioid	medications,	for	his	pain. Due	to	adverse	side	effects	of	his	continued

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

Bourgoin stopped using narcotic medications. In January of 2012, Bourgoin

obtained a medical marijuana certification and since then has used medical

marijuana	to	manage	his	chronic	pain. See	22	M.R.S.	§§	2421	to	2430-B	(2017).

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

medical	and	related	services”	with	the	Workers’	Compensation	Board	seeking

payment	from	Twin	Rivers	for	the	cost	of	the	medical	marijuana. Twin	Rivers

opposed	the	petition	on	the	ground,	among	others,	that	an	order	requiring	it	to
4

pay	for	Bourgoin’s medical marijuana	is	barred	by	the	CSA	even	if	his	use	of

medical	marijuana	were	permitted	by	the	MMUMA. Following	a	hearing,	the

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

March	of	2015. Twin	Rivers	appealed	to	the	Appellate	Division,	which	affirmed

the	hearing	officer’s	decision	in	August	of	2016. We	then	granted	Twin	Rivers’

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

(Tower	2016).3

II. DISCUSSION

[¶7] Twin	Rivers	argues	that	the	Controlled	Substances	Act,	21	U.S.C.S.

§§	801-904	(LEXIS	through	Pub.	L.	No.	115-181),	preempts	application	of	the

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

reimburse	Bourgoin	for	the	use	of	medical	marijuana. Federal	preemption	is	a

question	of	law	that	we	review	de	novo. Guardianship	of	Smith,	2011	ME	51,

¶	10,	17	A.3d	136.

A. Preemption	Principles

[¶8] The	preemption	analysis	must	begin	with	the	Supremacy	Clause	of

the	United	States	Constitution,	which	“unambiguously	provides	that	if	there	is

3 The restyled	Maine Rules of Appellate Procedure do not	apply because this appeal	was filed

prior	to	September	1,	2017. See	M.R.	App.	P.	1	(restyled	Rules).
5

any	conflict	between	federal	and	state	law,	federal	law	shall	prevail.” Gonzales

v.	Raich,	545	U.S.	1,	29	(2005);	see	U.S.	Const.	art.	VI,	cl.	2	(“This	Constitution,

and	the	Laws	of	the	United	States	.	.	.	shall	be	the	supreme	Law	of	the	Land.”).

There are two “cornerstones” that guide our preemption analysis: first, “the

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

enacting	the	federal	law;	and	second,	“in	all	pre-emption	cases,	and	particularly

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

traditionally occupied, we start with the assumption that the historic police

powers	of	the	States	were	not	to	be	superseded	by	the	Federal	[law]	unless	that

was	the	clear	and	manifest	purpose	of	Congress.” Wyeth	v.	Levine,	555	U.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. Gregory	v.	Ashcroft,	501	U.S.	452,	458 (1991)	(quotation	marks

omitted).

[¶9] Federal	law	can	preempt	state	law	in	three	ways:	first,	by	express

preemption, where Congress expressly states that federal law preempts the

state	law;	second,	by	field	preemption,	where	Congress	explicitly	or	implicitly

leaves “no room” for state law, or where federal law is “so dominant” that it
6

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

conflict	preemption,	where	the	state	law	“actually	conflicts	with	federal	law.”

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);	Guardianship	of	Smith,	2011	ME	51,	¶	10,	17	A.3d	136. It	is	the	third

type	of	preemption—conflict	preemption—that	is	at	issue	here.

[¶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

objectives of Congress.” Hillsborough Cty., 471 U.S. at 713 (quotation marks

omitted);	see	also	Arizona,	567	U.S.	at	399.

[¶11] Here,	Congress	expressly	regulated	the	consequence	of	any	conflict

that	arises	between	the	CSA	and	state	law	by	including	the	following	provision

in	the	CSA:

No	provision	of	this	title	shall	be	construed	as	indicating	an
intent	on	the	part	of	the	Congress	to	occupy	the	field	in	which	that
7

provision	operates,	including	criminal	penalties,	to	the	exclusion	of
any	State	law	on	the	same	subject	matter	which	would	otherwise
be	within	the	authority	of	the	State,	unless	there	is	a	positive	conflict
between	that	provision	of	this	title	and	that	State	law	so	that	the	two
cannot	consistently	stand	together.

21	U.S.C.S.	§	903	(emphasis	added). Through	this	statutory	provision,	Congress

has eliminated field preemption—but it has preserved the supremacy of the

CSA	where	its	provisions	conflict	with	state	law	in	a	way	that	makes	compliance

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

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

(Me.	1996). In	this	way,	Congress	has	specified	that	the	principles	of	conflict

preemption	are	to	be	invoked	to	determine	if	state	laws	must	yield	to	the	CSA.

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

dispositive question presented here is whether Twin Rivers is necessarily in

violation	of	the	CSA	if	it	were	to	comply	with	the	Board’s	order	to	pay	for	the

medical	marijuana	that	Bourgoin	is	authorized	to	use	pursuant	to	the	MMUMA.

B. The	Controlled	Substances	Act

[¶12] Nearly	half	a	century	ago,	the	United	States	Congress	enacted	the

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

L.	No.	91-513,	84	Stat.	1236	(LEXIS). Subchapter	I	of	the	Act,	which	was	Title	II

in	the	original	legislation,	constitutes	the	Controlled	Substances	Act,	21	U.S.C.S.
8

§§	801-904,	which	establishes	laws	pertinent	to	drug	control	and	enforcement.

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

States	Supreme	Court	has	characterized	the	CSA	as	“a	closed	regulatory	system

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

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

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

“findings and	declarations”	regarding	controlled	substances);	United	States	v.

Moore, 423 U.S. 122, 134-35 (1975) (discussing the legislative history of the

CSA).

[¶13] The	CSA	classifies	substances	subject	to	that	legislation	into	five

schedules that are differentiated based on three factors: their respective

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

medical	use,	and	risks	they	pose	even	when	used	under	medical	supervision.

See	21	U.S.C.S	§	812(a),	(b). Marijuana	is	classified	as	a	Schedule	I	drug,	see	id.

§ 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 accepted medical use for treatment, and pose unacceptable safety
9

risks	even	under	medical	supervision,	see	id.	§	812(b)(1)(A)-(C).4 This	means

that,	with	one	exception	that	is	not	applicable	here,	see	infra	n.5,	federal	law

bars	the	prescribed	use	of	marijuana—and	of	any	other	Schedule	I	drug—even

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

§§	812(b)(1)(A)-(C)	(listing	the	“findings”	required	to	classify	a	substance	as	a

Schedule I drug), 829 (establishing parameters for prescriptions of schedule

II-V	drugs);	see	also	Raich,	545	U.S.	at	14,	27;	United	States	v.	Oakland	Cannabis

Buyers’ Coop., 532 U.S. 483, 494 (2001); Mont. Caregivers Ass’n, LLC v. United

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

Telecomms.,	Inc.,	174	P.3d	200,	204	(Cal.	2008);	People	v.	Crouse,	388	P.3d	39,

41-42	(Colo.	2017).

[¶14] Although the CSA requires periodic updates of the schedules of

controlled substances by the United States Attorney General, see 21 U.S.C.S.

§§	811,	812(a),	marijuana	has	remained	a	Schedule	I	drug	ever	since	the	CSA

was	enacted	in	1970. See	Raich,	545	U.S.	at	15	n.23	(discussing	the	history	of

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

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

4 Substances	listed	in	the	other	four	schedules	are	deemed	to	present	lesser	concerns	in	relation

to	one	or	more	of	the	three	criteria	used	for	categorization	purposes. See	21	U.S.C.S.	§	812(b)(2)-(5)
(LEXIS	through	Pub.	L.	No.	115-181).
10

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

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

(Aug.	12,	2016),	and	in	2009,	see	Denial	of	Petition	to	Initiate	Proceedings	to

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

also	Americans	for	Safe	Access	v.	Drug	Enf’t	Admin.,	706	F.3d	438,	440-41,	452

(D.C.	Cir.	2013)	(affirming	the	denial	of	a	petition	to	reclassify	marijuana	in	a

less	restrictive	schedule);	Washington	v.	Sessions,	17	Civ.	5625 (AKH),	2018	U.S.

Dist.	LEXIS	30586,	at	*5-7	(S.D.N.Y.	Feb.	26,	2018)	(summarizing	the	procedure

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

determination, and recent attempts at rescheduling the classification of

marijuana);	Denial	of	Petition	to	Initiate	Proceedings	to	Reschedule	Marijuana,

76	Fed.	Reg.	40,551,	40,551-40,589	(July	8,	2011).

[¶15] Because	marijuana	is	a	Schedule	I	substance,	the	CSA	makes	it	a

crime to knowingly or intentionally “manufacture, distribute, or dispense, or

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

21	U.S.C.S.	§	841(a)(1),	as	well	as	to	“knowingly	or	intentionally	.	.	.	possess	a

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

projects approved by the government—a circumstance not	present here. See 21	U.S.C.S. § 823(f)
(LEXIS	through	Pub.	L.	No.	115-181);	United	States	v.	Oakland	Cannabis	Buyers’	Coop.,	532	U.S.	483,
490 (2001) (“For marijuana (and other drugs that have been classified as ‘schedule I’ controlled
11

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

which	is	defined	as	any	individual	who	“commits	an	offense	against	the	United

States	or	aids,	abets,	counsels,	commands,	induces	or	procures	its	commission,”

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 person may be

substances),	there	is	but	one	express	exception,	and	it	is	available	only	for	Government-approved
research	projects,	[section]	823(f).”).

We note that section 844(a) of the CSA creates another exception to criminal liability for
possession of scheduled drugs, but that exception is inapplicable to marijuana. Pursuant to that
exception,	possession	of	a	controlled	substance	is	permitted	if	it	“was	obtained	directly,	or	pursuant
to	a	valid	prescription	or	order,	from	a	practitioner,	while	acting	in	the	course	of	[that	practitioner’s]
professional	practice.” 21	U.S.C.S.	§	844(a)	(LEXIS	through	Pub.	L.	No.	115-181);	see	also	id.	§	802(21)
(LEXIS	through	Pub.	L.	No.	115-181)	(defining	“practitioner”). This	exception	does	not	extend	to	the
possession of marijuana, however, because, by categorizing it as a Schedule I drug, Congress has
determined	that	marijuana	has	“no	currently	accepted	medical	use	in	treatment”	and	that	there	is	“a
lack of accepted safety for use of the drug or other substance under medical supervision.” Id.
§	812(b)(1)(B)-(C)	(LEXIS through Pub. L. No. 115-181); see also Oakland Cannabis Buyers’ Coop.,
532	U.S.	at	491	(stating	that,	as	designated	in	the	CSA,	“marijuana	has	‘no	currently	accepted	medical
use’ at all” (quoting 21 U.S.C.S. § 812 (LEXIS through Pub. L. No. 115-181))); see also Gonzales v.
Oregon,	546	U.S.	243,	269	(2006)	(stating	that	“Congress’	express	determination	that	marijuana	had
no	accepted	medical	use	foreclosed	any	argument	about	statutory	coverage	of	drugs	available	by	a
doctor’s prescription”); Gonzales v. Raich, 545 U.S.	1, 24	(2005) (“The [CSA] regulatory scheme is
designed	to	foster	the	beneficial	use	of	those	medications	[listed	in	Schedules	II	through	V],	to	prevent
their	misuse,	and	to	prohibit	entirely	the	possession	or	use	of	substances	listed	in	Schedule	I,	except
as	a	part	of	a	strictly	controlled	research	project.”);	United	States	v.	Harvey,	794	F.	Supp.	2d	1103,
1105-07	(S.D.	Cal.	2011)	(concluding	that,	under	California	law,	a	“doctor’s	recommendation”	for	use
of	medical	marijuana	is	not	a	“valid	prescription	or	order”	under	section	844(a)	of	the	CSA),	aff’d,	659
F.3d	1272,	1274	(9th	Cir.	2011)	(with	an	“addition	[that]	[w]hat-ever	else	‘order’	might	mean	under
[section]	844(a)	of	the	[CSA],	it	does	not	include	a	mere	recommendation	from	a	physician	pursuant
to the [California] Compassionate Use Act”). Further, the lawful parameters for prescribing
controlled	drugs	or	substances	pursuant	to	the	CSA	do	not	extend	to	Schedule	I	drugs	or	substances.
See	21	U.S.C.S.	§	829	(LEXIS	through	Pub.	L.	No.	115-181).

Thus, a “written certification” for medical marijuana authorized by the MMUMA, 22 M.R.S.
§§	2422(16),	2423-B	(2017),	even	when	issued	by	a	medical	“practitioner”	as	defined	by	the	CSA,	21
U.S.C.S.	§	802(21),	or	a	“medical	provider”	as	defined	by	the	MMUMA,	22	M.R.S.	§	2422(4-C)	(2017),
is	not	a	“valid	prescription	or	order”	that	would	exempt	the	resulting	marijuana	possession	from	the
purview	of	the	CSA.
12

responsible	for	a	crime	he	has	not	personally	carried	out	if	he	helps	another	to

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

(2014). As	the	Rosemond	Court	recognized,	“almost	every	court	of	appeals	has

held	[that]	a	defendant	can	be	convicted	as	an	aider	and	abettor	without	proof

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

(quotation	marks	omitted)	(alteration	omitted). Thus,	“a	person	is	liable	under

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

affirmative	act	in	furtherance	of	that	offense,	(2)	with	the	intent	of	facilitating

the	offense’s	commission.” Id.	at	1245.

[¶16] The	mens	rea	required	for	aiding	and	abetting	is	an	“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

circumstances	constituting	the	charged	offense.” Id.	at	1248-49. Put	another

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

participates	in	a	criminal	scheme	knowing	its	extent	and	character	intends	that

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

(emphasis	added);	see	also	id.	at	1250	(“The	law	does	not,	nor	should	it,	care

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

foreboding. Either way, [the defendant] has the same culpability, because
13

either	way	[the	defendant]	has	knowingly	elected	to	aid	in	the	commission	of	a

[crime].”	(emphasis	added)). Therefore,	were	Twin	Rivers	to	comply	with	the

administrative order by subsidizing Bourgoin’s use of medical marijuana, it

would	be	engaging	in	conduct	that	meets	all	of	the	elements	of	criminal	aiding

and	abetting	as	defined	in	section	2(a).6

6 Title	18	U.S.C.S.	§	2	(LEXIS	through	Pub.	L.	No.	115-181)	contains	two	separate	bases	on	which

a	third	party	may	be	held	criminally	liable. As	discussed	in	the	text,	section	2(a)	imposes	liability
upon a person who aids and abets another person in committing the predicate crime. See supra
¶¶	15-16. Section	2(b),	in	contrast,	criminalizes	the	conduct	of	any	individual	who	“willfully	causes
an	act	to	be	done	which	if	directly	performed	by	[that	person]	or	another	would	be	an	offense	against
the	United	States.” (Emphasis	added).

Although,	in	its	2014	opinion,	the	Rosemond	Court	addressed	the	mens	rea	requirement	for	aiding
and	abetting	by	citing	generally	to	section	2,	the	statutory	language	that	it	quoted	and	substantively
analyzed	is	found	specifically	in	section	2(a). See	Rosemond	v.	United	States,	134	S.	Ct.	1240,	1243-45
(2014). Section 2(a) does not require “willful[]” conduct because facilitation of the activity with
knowledge	of	its	illegal	nature	is	sufficient	to	form	a	basis	for	criminal	liability. See	id.	at	1248-50;
see also, e.g., United States v. Slatten, 865 F.3d	767, 793 (D.C. Cir. 2017)	(“To establish aiding	and
abetting,	the	government	had	to	prove,	beyond	a	reasonable	doubt,	that	[the	defendant]	intentionally
‘facilitated	any part of the criminal venture,’ with enough ‘knowledge of the crime to enable [the
defendant] to make the relevant legal (and indeed, moral) choice’ to opt out instead.” (quoting
Rosemond, 134 S. Ct. at	1246, 1249)	(alterations omitted)); United States v. Ford, 821 F.3d	63, 69
(1st	Cir.	2016)	(“The	words	‘aids	[and]	abets’	.	.	.	all	suggest	that	a	person	violates	section	2	only	if	the
person has ‘chosen, with full knowledge, to participate in the illegal	scheme.’” (quoting Rosemond,
134	S. Ct. at 1250) (emphasis added)); United States v. Encarnación-Ruiz, 787 F.3d 581, 589-91
(1st	Cir.	2015)	(discussing	the	applicability	of	Rosemond	to	the	crime	of	aiding	and	abetting	another
person’s	criminal	conduct	and	stating	that	section	2(a)	contains	no	explicit	mens	rea	requirement
but	that	courts	have	imposed	a	“knowledge”	element);	United	States	v.	Watson,	Nos.	3:11-CR-079	and
3:15-CV-044,	2016	U.S.	Dist.	LEXIS	88180,	at	*14	(S.D.	Ohio	July	7,	2016)	(concluding	“that	[section]
2(a)	describes	an	‘inchoate’	offense,	or,	as	Justice	Kagan	writes	in	Rosemond,	it	codifies	the	‘common-
law standards for accomplice liability.’ Section 2(b), in contrast, does describe a substantive
offense.”). Gauged by the language of	section	2(a) and these judicial explanations of	the criminal
exposure	created	by	that	statute,	Twin	Rivers	would	act	in	contravention	of	the	CSA	if	it	were	to	fund
Bourgoin’s	acquisition	of	medical	marijuana.

Justice	Jabar’s	dissenting	opinion	cites	to	section	2	generally	but	draws	its	analysis	on	the	element
of	willfulness	that	is	found	in	section	2(b)	and	not	in	section	2(a),	and,	on	that	basis,	concludes	that
Twin	Rivers	would	fall	beyond	that	statute’s	reach. See	Jabar,	J.,	Dissenting	Opinion	¶¶	40-45. This
14

[¶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.

Pursuant	to	the	least	severe	penalty	range	for	a	violation	of	section	844—and,

consequently,	for	aiding	or	abetting	another	person’s	violation	of	section	844—

the	sentence,	at	minimum,	is	a	mandatory	fine	of	$1,000,	and	it	may	also	include

as	much	as	one	year	of	incarceration,	with	an	even	greater	sentence	if	certain

aggravating	factors	are	present,	such	as	a	prior	conviction	for	any	drug	offense,

including	offenses	established	by	the	CSA. See	21	U.S.C.S.	§	844(a);	see	also	id.

§	841(b)(1)(A)	(enhancing	a	mandatory	sentence	based	on	prior	convictions	of

“felony	drug	offenses”	to	a	range	of	at	least	twenty	years	in	prison	to	a	life	term).

C. The	CSA	and	Maine’s	Medical	Marijuana	Law

[¶18] This description of the scope and effect of	federal regulation of

marijuana	brings	us	to	the	point	where the	CSA	and	Maine	law	intersect. As

relevant	to	this	case,	the	Maine	Medical	Use	of	Marijuana	Act,	22	M.R.S.	§§	2421

formulation	of	liability	is	entirely	different	from	that	set	out	in	section	2(a),	addressed	in	the	text,	see
supra	¶¶	15-16,	which	is	based	on	conduct	that	aids	and	abets	another’s	criminal	activity.

Therefore,	irrespective of	whether	Twin	River’s	subsidization	of	Bourgoin’s	medical	marijuana
would	expose	Twin	Rivers	to	prosecution	pursuant	to	section	2(b),	that	conduct	would	nonetheless
aid	and	abet	Bourgoin’s	violation	of	the	CSA	and	render	Twin	Rivers	criminally	liable	pursuant	to
section	2(a).
15

to	2430-B,	allows	a	“qualifying	patient”7	such	as	Bourgoin	to	possess	a	limited

amount	of	marijuana	for	medical	use. Id.	§§	2422(9),	2423-A(1)	(authorizing

the	possession	of	marijuana). The	written	certification	by	a	medical	provider,

which	is	effective	for	one	year,	is	based	on	the	professional’s	opinion	that	the

“qualifying patient is likely to receive therapeutic benefit” from the medical

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

condition.” Id.	§	2423-B.

[¶19] These	conflicting	federal	and	state	laws,	and	their	embodiment	of

competing	policies	and	underlying	conclusions	about	the	efficacy	of	marijuana

as	a	legitimate	therapeutic	substance,	frame	the	narrow	issue	that	is	central	to

this	case:	given	this	network	of	statutes,	can	Twin	Rivers	be	required	to	pay	for

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

federal	law	but	allowed	by	the	State	because	a	MMUMA	certification	had	been

issued	to	him?

[¶20] Compliance with both is an impossibility. Were Twin Rivers to

comply	with	the	hearing	officer’s	order	and	knowingly	reimburse	Bourgoin	for

the cost of the medical marijuana as permitted by the MMUMA, Twin Rivers

7 A	“qualifying	patient”	is	“a	person	who	has	been	diagnosed	by	a	medical	provider	as	having	a

debilitating	medical	condition	and	who	possesses	a	valid	written	certification	regarding	medical	use
of	marijuana	in	accordance	with	section	2423-B.” 22	M.R.S.	§	2422(9)	(2017).
16

would	necessarily	engage	in	conduct	made	criminal	by	the	CSA	because	Twin

Rivers would be aiding and abetting Bourgoin—in his purchase, possession,

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

Bourgoin’s	purchase	of	marijuana. See	18	U.S.C.S.	§	2(a);	21	U.S.C.S.	§	844(a);

Rosemond, 134 S. Ct. at 1248-50; see also, e.g., United States v. Pinillos-Prieto,

419	F.3d	61,	63-66	(1st	Cir.	2005)	(describing	a	third-party	intermediary	drug

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

States	v.	Dingle,	114	F.3d	307,	309-12	(D.C.	Cir.	1997)	(affirming	the	defendant’s

conviction	for	aiding	and	abetting	illegal	drug	possession).8 Conversely,	if	Twin

Rivers complied with the CSA by not reimbursing Bourgoin for the costs of

medical	marijuana,	Twin	Rivers	would	necessarily	violate	the	MMUMA-based

order	of	the	hearing	officer.

[¶21] Several courts have held that a consumer’s state-law-compliant

choice to use medical marijuana does not trigger the limited preemption

provision	of	section	903. See,	e.g.,	Reed-Kaliher	v.	Hoggatt,	347	P.3d	136,	141-42

(Ariz.	2015);	Ter	Beek	v.	City	of	Wyoming,	846	N.W.2d	531,	537-38	(Mich.	2014);

8
Furthermore, although Justice Jabar’s dissenting opinion, see Jabar, J., Dissenting Opinion
¶¶	45-46, draws on the hypothetical situation posed in Rosemond, where a third-party gun store
owner	knows	but	does	not	care	how	an	illegally	sold	gun	will	be	used,	Twin	Rivers	would	not	be
“incidentally	facilitat[ing]	a	criminal	venture”	but	rather	would	be	“actively	participat[ing]	in	it”	by
knowingly	paying	for	Bourgoin’s	purchase	and	possession	of	medical	marijuana. Rosemond,	134	S.	Ct.
at	1249	n.8.
17

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

Ct.	App.	2010). This	is	because	state	laws,	such	as	the	MMUMA,	provide	safe

harbor	from	state	prosecution,	but	do	not—and	cannot—create	a	“state	right

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

bearing	on	federal	criminalization	or	exposure	to	federal	prosecution	for	that

conduct. Mont.	Caregivers	Ass’n,	LLC,	841	F.	Supp.	2d	at	1150;	see	also	Raich,

545	U.S.	at	26-27;	Garcia	v.	Tractor	Supply	Co.,	154	F.	Supp.	3d	1225,	1229-30

(D.N.M.	2016);	Qualified	Patients	Ass’n,	187	Cal.	App.	4th	at	757;	Ter	Beek,	846

N.W.2d	at	540. This	case,	however,	does	not	call	for	us	to	determine	whether

that	legal	analysis	would	protect	the	MMUMA	generally. The	cases	of	broader

application,	however,	help	to	reveal	the	critical	point	that,	in	the	case	before	us,

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

would	require	Twin	Rivers	to	engage	in	conduct	that	constitutes	a	violation	of

the	CSA.

[¶22] The	preemptive	effect	of	the	CSA	on	state	marijuana	laws	has	been

addressed in several cases involving circumstances similar to the one

presented	here,	where	a	party—such	as	Twin	Rivers—was	confronted	with	a

mandate	to	engage	in	conduct	that	would	be	violative	of	the	CSA. Two	courts,

for	example,	have	held	that	a	state	law	authorizing	medical	marijuana	use	does
18

not	require	an	employer	to	treat	an	employee’s	medical	use	of	marijuana	as	a

reasonable workplace accommodation. See Garcia, 154 F. Supp. 3d at 1230;

Emerald	Steel	Fabricators,	Inc.	v.	Bureau	of	Labor	&	Indus.,	230	P.3d	518,	536

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

employment based on a positive test for cannabis metabolites was a form of

unlawful discrimination because he was using medical marijuana for a

disabling	medical	condition. 154	F.	Supp.	3d	at	1227. The	court	granted	the

employer’s	motion	to	dismiss	the	complaint	because,	in	that	context,	the	CSA

preempted	New	Mexico’s	medical	marijuana	law. Id.	at	1229-30. In	part,	the

court	reasoned	that	“[t]o	affirmatively	require	[the	employer]	to	accommodate

[the	employee’s]	illegal	drug	use	would	mandate	[the	employer]	to	permit	the

very	conduct	the	CSA	proscribes.” Id.	at	1230	(emphasis	added).

[¶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,	a	form	of	conflict	preemption,	see	supra	¶	10,	and	therefore	that

“[t]o	the	extent	that	[the	state	medical	marijuana	law]	affirmatively	authorizes

the	use	of	medical	marijuana,	federal	law	preempts	that	subsection,	leaving	it

without effect.” Emerald Steel Fabricators, Inc., 230 P.3d at 529 (quotation
19

marks	omitted);	see	also	Washburn	v.	Columbia	Forest	Prods.,	Inc.,	134	P.3d	161,

167-68	(Or.	2006)	(Kistler,	J.,	concurring)	(stating	that	“[t]he	fact	that	the	state

may choose to exempt medical marijuana users from the reach of the state

criminal	law	does	not	mean	that	the	state	can	affirmatively	require	employers

to	accommodate	what	federal	law	specifically	prohibits”).

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

marijuana	cannot	be	converted	into	a	sword	that	would	require	another	party,

such	as	Twin	Rivers,	to	engage	in	conduct	that	would	violate	the	CSA.

[¶25] In	a	third	case	of	relevance,	although	presenting	a	very	different

factual situation, the Supreme Court of Colorado considered whether the

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

Constitution,	see	Colo.	Const.	art. XVIII, §	14—may	be	enforced	in	a	way	that

would	violate	the	CSA. Crouse,	388	P.3d	at	40. The	Colorado	law	required	law

enforcement	officers	to	return	seized	medical	marijuana	if	the	person	whose

marijuana had been seized was later acquitted of the underlying state drug

charge. Id.	at	40-41. The	officers	declined	to	comply	with	that	law	because	they

claimed	that,	by	doing	so,	they	would	be	distributing	marijuana	in	violation	of

the CSA. Id. at 41. The court held that “[b]ecause compliance with one law

necessarily	requires	noncompliance	with	the	other,	there	is	a	positive	conflict
20

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

consistently	stand	together.” Id.	at	42	(quotation	marks	omitted). Analytically,

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

Compelling an employer to subsidize an employee’s medical marijuana 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)—just	as	Colorado	law	would	have	required	law	enforcement	officers

to	distribute	drugs	in	violation	of	the	CSA.

[¶26] In	affirming	the	hearing	officer’s	decision,	the	Appellate	Division9

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

assigned	low	priority	to	the	prosecution	of	medical-marijuana-based	violations

of	federal	drug	laws. David	W.	Ogden,	Deputy	Att’y	Gen.,	U.S.	Dep’t	of	Justice,

Memorandum for Selected United States Attorneys: Investigations and

Prosecutions	in	States	Authorizing	the	Medical	Use	of	Marijuana	1-2	(Oct.	19,

2009); see also Noll v. Lepage Bakeries, Inc., Me. W.C.B. No. 16-25, ¶¶ 14-15

(App.	Div.	2016). Any	reliance	on	this	internal	departmental	policy,	however,

9 In	its	preemption	analysis	set	out	in	the	decision	it	issued	in	this	case,	the	Appellate	Division

incorporated	a	discussion	found	in	a	decision	issued	the	same	day	in	a	different	case,	Noll	v.	Lepage
Bakeries,	Inc.,	Me.	W.C.B.	No.	16-25,	¶¶	11-15	(App.	Div.	2016). We	therefore	address	the	Board’s
reasoning	as	described	in	the	latter	case.
21

is	entirely	misplaced. Such	a	policy	is	transitory,	as	is	irrefutably	demonstrated

by	its	recent	revocation	by	the	current	administration.10

[¶27] Even	more	significantly,	the	Ogden	Memo	itself	made	clear	that	it

was directed only to the question of enforcement of laws but did nothing to

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

Justice,	Memorandum	for	Selected	United	States	Attorneys:	Investigations	and

Prosecutions	in	States	Authorizing	the	Medical	Use	of	Marijuana	1;	see	United

States	v.	Hicks,	722	F.	Supp.	2d	829,	833-34	(E.D.	Mich.	2010)	(addressing	the

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

direct	its	resources	elsewhere	does	not	mean	that	the	federal	government	now

lacks	the	power	to	prosecute	those	who	possess	marijuana”). In	fact,	the	Ogden

Memo	expressly	states	that	it merely provided	“guidance	regarding	resource

10 That	federal	policy	change	occurred	in	early	2018,	when	the	United	States	Attorney	General

issued a memorandum declaring that “previous nationwide guidance specific to marijuana
enforcement	is	unnecessary	and	is	rescinded,	effective	immediately.” Jefferson	B.	Sessions	III,	Att’y
Gen., U.S. Dep’t of Justice, Memorandum for All United States Attorneys: Marijuana Enforcement
(Jan.	4,	2018). This	rescinded	prosecutorial	policies	that	had	not	included	medical	marijuana	among
its	enforcement	priorities. See	James	M.	Cole,	Deputy	Att’y	Gen.,	U.S.	Dep’t	of	Justice,	Memorandum
for	All	United	States	Attorneys:	Guidance	Regarding	Marijuana	Enforcement	(Aug.	29,	2013);	James
M.	Cole,	Deputy	Att’y	Gen.,	U.S.	Dep’t	of	Justice,	Memorandum	for	United	States	Attorneys:	Guidance
Regarding	the	Ogden	Memo	in	Jurisdictions	Seeking	to	Authorize	Marijuana	for	Medical	Use	(June	29,
2011); David W. Ogden, Deputy	Att’y Gen., U.S. Dep’t of Justice, Memorandum for Selected United
States	Attorneys:	Investigations	and	Prosecutions	in	States	Authorizing	the	Medical	Use	of	Marijuana
1-2	(Oct.	19,	2009)	(stating	that	the	“pursuit	of	[the	Department’s]	priorities	should	not	focus	federal
resources	in	.	.	.	States	on	individuals	whose	actions	are	in	clear	and	unambiguous	compliance	with
existing	state	laws	providing	for	the	medical	use	of	marijuana”).
22

allocation [and] does not ‘legalize’ marijuana or provide a legal defense to a

violation	of	federal	law.	.	.	. Nor	does	clear	and	unambiguous	compliance	with

state	law	.	.	.	create	a	legal	defense	to	a	violation	of	the	[CSA].” David	W.	Ogden,

Deputy	Att’y	Gen.,	U.S.	Dep’t	of	Justice,	Memorandum	for	Selected	United	States

Attorneys: Investigations and Prosecutions in States Authorizing the Medical

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

1148-49	(“A	reasonable	person,	having	read	the	entirety	of	the	Ogden	Memo,

could	not	conclude	that	the	federal	government	was	somehow	authorizing	the

production and consumption of marijuana for medical purposes. Any

suggestion	to	the	contrary	defies	the	plain	language	of	the	Memo.”). Therefore,

even	if	the	policy	expressed	in	the	Ogden	Memo	were	alive	today,	it	could	not

weaken	the	conclusion	that	there	is	a	positive	conflict	between	the	CSA	and	the

MMUMA	as	applied	here.

[¶28] Most	importantly,	however,	the	magnitude	of	the	risk	of	criminal

prosecution	is	immaterial	in	this	case. Prosecuted	or	not,	the	fact	remains	that

Twin	Rivers	would	be	forced	to	commit	a	federal	crime	if	it	complied	with	the

directive	of	the	Workers’	Compensation	Board.11 See	Skinner	v.	Ry.	Labor	Execs.’

11 The	Board	also	relied	on	two	decisions	issued	by	the	New	Mexico	intermediate	appeals	court

in cases that raised the type of issue presented here, namely, whether the New Mexico Workers’
Compensation	Act	required	an	employer	to	reimburse	an	eligible	employee	for	the	cost	of	medical
marijuana	that	the	employee	was	permitted	to	use	pursuant	to	New	Mexico’s	medical	marijuana	act.
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	[of	the	applicable	law]	in	the	future.”).

III. CONCLUSION

[¶29] Through	its	enactment	of	the	MMUMA,	the	Maine	Legislature	has

exempted qualifying patients and other specified individuals from state

prosecution	that	otherwise	could	arise	from	the	medical	use	of	marijuana. The

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

application	of	federal	law	that	positively	conflicts	with	state	law. See	U.S.	Const.

art.	VI,	cl.	2. So	long	as marijuana	remains	a	Schedule	I	substance	under	the

CSA, see 21 U.S.C.S. § 812(c)(Sched. I)(c)(10), an employer that is ordered to

compensate an employee for medical marijuana costs is thereby required to

commit	a	federal	crime	defined	by	the	CSA. See	18	U.S.C.S.	§	2(a);	21	U.S.C.S.

§	844(a). This	creates	a	positive	conflict	between	the	CSA	and	this	application

See Lewis v. Am. Gen. Media, 355 P.3d 850 (N.M. Ct. App. 2015); Vialpando v. Ben’s Auto Servs.,
331	P.3d	975 (N.M. Ct. App. 2014). In the earlier of those cases the court declined to reach the
question	of	federal	preemption,	concluding	in	effect	that	the	employer	had	not	preserved	the	issue.
Vialpando,	331	P.3d	at	979-80. In	the	second	case,	the	court,	relying	in	part	on	Vialpando—an	opinion
that did not reach the merits of the issue—rejected the contention that the CSA trumped any
requirement	that	the	employer	subsidize	the	cost	of	medical	marijuana	because,	the	court	reasoned,
the	DOJ	enforcement	memos	rendered	the	prospect	of	prosecution	under	the	CSA	to	be	speculative.
Lewis,	355	P.3d	at	858-59. To	the	limited	extent	these	cases	address	the	merits	of	the	preemption
issue,	the	analysis	is	less	than	compelling,	and	we	decline	to	follow	their	lead.
24

of the MMUMA. See 21	U.S.C.S. § 903. As invoked against Twin Rivers, the

MMUMA requires what federal law forbids, and the authority ostensibly

provided	by	the	Maine	law	is	“without	effect.” Mut.	Pharm.	Co.,	Inc.	v.	Bartlett,

570	U.S.	472,	486-87	(2013)	(quotation	marks	omitted);	Robards,	677	A.2d	at

543	(quotation	marks	omitted).

[¶30] Because	the	CSA	preempts	the	MMUMA	when	the	MMUMA	is	used

as	the	basis	for	requiring	an	employer	to	reimburse	an	employee	for	the	cost	of

medical	marijuana,	the	order	based	on	the	MMUMA	must	yield. We	therefore

vacate	the	decision	of	the	Appellate	Division.

The	entry	is:

Judgment vacated. Remanded to the Workers’
Compensation Appellate Division with
instructions	to	vacate	the	decision	of	the	hearing
officer	and	remand	for	denial	of	the	petition	for
payment	of	medical	expenses	and	services.

JABAR,	J.,	with	whom	ALEXANDER,	J.,	joins,	dissenting.

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

Controlled	Substances	Act	(CSA)	preempts	the	Maine	Medical	Use	of	Marijuana

Act	(MMUMA)	in	this	case.
25

A. Preemption	Analysis

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

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

legislated	.	.	.	in	a	field	which	the	States	have	traditionally	occupied,	.	.	.	we	start

with	the	assumption	that	the	historic	police	powers	of	the	States	were	not	to	be

superseded	by	the	Federal	Act	unless	that	was	the	clear	and	manifest	purpose

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

omitted). Central	to	this	initial	assumption	is	the	theoretical	underpinning	that

our	nation	was	founded	upon:	“federalism	.	.	.	allow[s]	the	States	great	latitude

under	their	police powers	to	legislate as	to	the	protection	of	the	lives,	limbs,

health,	comfort,	and	quiet	of	all	persons.” Gonzales	v.	Oregon,	546	U.S.	243,	270

(2006) (quotation marks 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,	we	have	been	clear:

In cases where federal law is said to bar state action in fields of
traditional state regulation, such as workers’ compensation
legislation,	there	is	an	assumption	that	the	historic	police	powers
of	the	States	were	not	to	be	superseded	by	the	Federal	Act	unless
that	was	the	clear	and	manifest	intent	[of	Congress].

26

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

(quotation	marks	omitted). “The	case	for	federal	pre-emption	is	particularly

weak	where	Congress	has	indicated	its	awareness	of	the	operation	of	state	law

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

concepts	and	to	tolerate	whatever	tension	there	is	between	them.” Bonito	Boats,

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

omitted)	(quotation	marks	omitted).

[¶33] In	order	to	determine	whether	the	CSA	preempts	the	MMUMA	here,

we	must	determine	whether	it	is	the	“clear”	or	“manifest”	purpose	of	Congress

to	preempt	a	state	workers’	compensation	board	from	ordering	an	employer	to

reimburse	an	employee	for	valid	medical	expenses	related	to	properly	certified

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

provision	regarding	preemption:

No	provision	of	this	title	shall	be	construed	as	indicating	an
intent	on	the	part	of	the	Congress	to	occupy	the	field	in	which	that
provision	operates,	including	criminal	penalties,	to	the	exclusion	of
any	State	law	on	the	same	subject	matter	which	would	otherwise
be	within	the	authority	of	the	State,	unless	there	is	a	positive	conflict
between	that	provision	of	this	title	and	that	State	law	so	that	the	two
cannot	consistently	stand	together.

27

21	U.S.C.S.	§	903	(LEXIS	through	Pub.	L.	No.	115-181)	(emphasis	added);	Court’s

Opinion	¶	11. Our	question	now	becomes	whether	a	“positive	conflict”	exists

here.

[¶34] A positive conflict arises “when compliance with both state and

federal	requirements	is	impossible.” Robards	v.	Cotton	Mill	Assocs.,	677	A.2d	540,

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

preeminent	scholar	of	constitutional	law,	and	his	co-authors,

The	phrase	positive	conflict	.	.	.	so	that	the	two	cannot	consistently
stand together in section 903 has been interpreted as narrowly
restricting the preemptive reach of the CSA to cases of an actual
conflict with federal law such that compliance with both federal
and	state	regulations	is	a	physical	impossibility. Justice	Scalia	has
written that the plain language of section 903 states a
congressional intent that the CSA preempt only state laws that
require someone to engage in an action specifically forbidden by
the CSA. As a California appellate court succinctly put it, mere
speculation	about	a	hypothetical	conflict	is	not	the	stuff	of	which
preemption	is	made.

It is not physically impossible to comply with both the CSA and
state marijuana laws; nothing in the more liberal state laws
requires anyone to act contrary to the CSA. Only if a state law
required	a	citizen	to	possess,	manufacture,	or	distribute	marijuana
in violation of federal law would it be impossible for a citizen to
comply	with	both	state	and	federal	law. Similarly,	if	a	state	were	to
make	state	officers	the	manufacturers	or	distributors	of	marijuana,
it	might	well	be	impossible	for	those	officials	to	comply	with	both
state and federal law. No state marijuana law, however, has
attempted	to	require	state	or	local	officials	to	violate	the	CSA	in	this
manner.

28

Erwin Chemerinsky et al., Cooperative Federalism and Marijuana Regulation,

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

(quotation	marks	omitted).

[¶35] Turning	to	the	supposedly	conflicting	laws,	the	MMUMA	allows	a

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

marijuana”	if	a	“qualifying	patient	is	likely	to	receive	therapeutic	benefit”	from

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

22	M.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, or possess with intent to manufacture, distribute, or

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

The	CSA	also	makes	it	unlawful	to	knowingly	or	intentionally	possess	marijuana.

Id.	§	844(a)	(LEXIS	through	Pub.	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

person	or	entity—to	possess,	manufacture,	or	distribute marijuana. In	other

words,	compliance	with	both	the	federal	law	and	the	Workers’	Compensation

Board	(WCB)	order	is	possible:	reimbursement	does	not	require	the	employer

to	physically	manufacture,	distribute,	dispense,	or	possess	marijuana,	and,	as	a
29

result,	no physical	impossibility exists	between	the	federal	law and	the WCB

order	in	this	case. Adopting	Chemerinsky’s	analysis	of	section	903	of	the	CSA,

because	there	is	no	physical	impossibility	here,	and	because	Congress	has	not

expressed a clear and manifest preemptive intent regarding state workers’

compensation boards and reimbursement for state-law compliant medical

marijuana	use,	see	Ciampi,	681	A.2d	at	8,	no	positive	conflict	exists.

[¶37] The	employer	and	the	Court	point	to	the	Colorado	case	of	People	v.

Crouse	to	support	the	argument	that	reimbursement	creates	a	positive	conflict.

388	P.3d	39	(Colo.	2017);	Court’s	Opinion	¶	25. That	case,	however,	serves	to

highlight	the	exact	reason	that	no	positive	conflict	exists	in	Bourgoin’s	case. 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

officers	to	physically	distribute	seized	medical	marijuana	to	individuals	who	had

been	charged	and	acquitted	of	the	crime	that	led	to	the	seizure. Id.	at	40. The

conflict existed because of the actual physical impossibility that existed

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

required	to	physically	distribute	the	marijuana,	and	the	CSA	makes	distribution

unlawful. Id.	at	42;	21	U.S.C.S.	§	841(a).
30

[¶38] This	case	is	unlike	People	v.	Crouse. There	is	a	difference	in	both

nature	and	degree	between	following	a	WCB	order	to	reimburse	a	worker	for

medical	treatment	authorized	by	a	physician	and	approved	by	the	WCB	and	a

state	law	that	requires	police	officers	to	physically	distribute	marijuana. The

key	distinction	is	that	the	police	officers’	actions	in	Crouse	fit	within	an	actual,

proscribed	activity	specifically	defined	by	the	CSA. See	Crouse,	388	P.3d	at	41.

Because the officers would be required to “deliver,” meaning engage in “the

actual,	constructive,	or	attempted	transfer	of	a	controlled	substance,”	there	was

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

(quotation	marks	omitted);	see	also	21	U.S.C.S.	§	802(8),	(11)	(LEXIS	through

Pub. L. No. 115-181). Here, unlike in Crouse, the employer’s reimbursement

does	not	fall	into	any	category	of	defined	or	proscribed	activity	under	the	CSA.

Because	the	employer	is	not	required	to	physically	engage	in	activity	that	the

CSA	proscribes,	there	is	no	positive	conflict	in	this	case.

B. Aiding	and	Abetting

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

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

MMUMA	here—is	unpersuasive	because	the	government	would	not	be	able	to

prove	that	the	employer	would	be	acting	with	the	specific	intent	necessary	to
31

establish	the	requisite	mens	rea	element	of	the	offense	of	aiding	and	abetting.

See	18	U.S.C.S.	§	2	(LEXIS	through	Pub. L.	No.	115-181). Further,	the	Court’s

analysis	on	aiding	and	abetting	is	speculative	because	it	is	not	specific	or	certain

enough	to	show	that	there	is	a	positive	conflict	in	this	case	such	that	the	Court

can	conclude	that	preemption	here	is	the	“manifest”	purpose	of	Congress. See

Wyeth, 555 U.S. at 565. At most, whether the government would be able to

prove	the	mens	rea	element	is	hypothetical,	and	hypotheticals	do	not	give	rise

to	preemption. See,	e.g.,	Exxon	Corp.	v.	Governor	of	Maryland,	437	U.S.	117,	131

(1978); see also Rice v. Norman Williams Co., 458	U.S. 654, 659 (1982) (“The

existence of a hypothetical or potential conflict is insufficient to warrant the

pre-emption	of	the	state	statute. A	state	regulatory	scheme	is	not	preempted

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

party’s compliance with the statute might 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	“willfully	causes	an	act	to	be	done	which	if	directly	performed

by [that person] or another would be an offense against the United States.”

18	U.S.C.S. §	2. In 1938, Judge Learned Hand set forth a definition of the
32

necessary	mens	rea	for	all	aiding	and	abetting	offenses,	stating	that	in	order	to

be	guilty	of	aiding	and	abetting,	it	is	necessary	that	the	alleged	aider	or	abettor

“participate	in	[the	venture]	as	in	something	that	he	wishes	to	bring	about,	that

he	seek	by	his	action	to	make	it	succeed.” United	States	v.	Peoni,	100	F.2d	401,

402 (2d Cir. 1938) (emphasis added). About a decade later, in Nye & Nissen

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

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

abetting. See	336	U.S.	613,	618-19	(1949).

[¶41] Since	Nye	&	Nissen,	federal	courts	have	continued	to	hold	that	the

accomplice must	wish	or desire	to	bring	about	the	success	of	the principal in

committing	the	underlying	substantive	offense	in	order	to	be	punishable	as	a

principal. See	United	States	v.	Zafiro,	945	F.2d	881,	887	(7th	Cir.	1991)	(“To	be

proved	guilty	of	aiding	and	abetting,	.	.	.	the	defendant	[must	have]	desired	the

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,

611	F.2d	376,	385	(1st	Cir.	1979)	(“To	sustain	a	conviction	on	the	aiding	and

abetting	.	.	.	counts,	the	government	had	to	prove	beyond	a	reasonable	doubt

that appellant willfully associated himself in some way with the criminal

venture	and	willfully	participated	in	it	as	he	would	in	something	he	wished	to
33

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

(“[T]he	government	must	prove	beyond	a	reasonable	doubt	that	the	defendant

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

accomplished.”).

[¶42] In	other	words,	the	crime	of	aiding	and	abetting	is	a	specific	intent

crime. See	United	States	v.	Nacotee,	159	F.3d	1073,	1076	(7th	Cir.	1998)	(“To	be

liable	under	an	aiding	and	abetting	theory	.	.	.	a	defendant	must	have	had	the

specific	intent	to	aid	in	the	commission	of	the	crime	in	doing	whatever	she	did

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

1987)	(“Aiding	and	abetting	in	the	criminal	law	requires	not	only	knowledge	of

the principal’s objective but a desire to help him attain it.”). In Zafiro, Judge

Posner	explained	further,

To be proved guilty of aiding and abetting, [it] must be
established[] that the defendant desired the illegal activity to
succeed. The	purpose	of	this	requirement	is	a	little	mysterious	but
we	think	it	is	to	identify,	and	confine	punishment	to,	those	forms	of
assistance	the	prevention	of	which	makes	it	more	difficult	to	carry
on	the	illegal	activity	assisted.

945	F.2d	at	887.

[¶43] In	distancing	its	own	analysis	and	view	of	liability	for	aiding	and

abetting	from	that	set	forth	here,	the	Court	distinguishes	between	the	criminal

liability	element	contained	in,	on	the	one	hand,	18	U.S.C.S.	§	2(a) and,	on	the
34

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

discussion—of	the	general	principles	underlying	aiding	and	abetting	liability—

is	not	premised	on	that	distinction. The	Court’s	discussion	fails	to	adequately

account	for	the	origin	of	the	specific	intent	element	that	both	section	2(a)	and

2(b)	contain. It	is	the	common	law—not	the	statutory	law—that	generates	the

necessary	specific	intent	element	of	section	two	liability	for	aiding	and	abetting,

and Congress’s decision not to set forth the requisite mental state in section

2(a)	does	not	mean	that	the	element	is	lacking,	or	that	it	is	anything	other	than

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

511	U.S.	600,	605-06	(1994)	(“Indeed,	we	have	noted	that	the	common-law	rule

requiring	mens	rea	has	been	followed	in	regard	to	statutory	crimes	even	where

the	statutory	definition	did	not	in	terms	include	it.”)	(quotation	marks	omitted).

[¶44] In	this	context,	the	common	law	establishes	the	requisite	mens	rea

element	for	all	of	section	two. See	Nye	&	Nissen,	336	U.S.	at	618-19	(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);	prior	to	the	1951	amendment,	the	word	“willful”	was	absent	from	section

two. See	Act	of	Oct.	31,	1951,	ch.	655,	65	Stat.	710,	717	(LEXIS). That	Congress

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, the opposite conception of the rationale underlying the

omission	is	stronger. See	Baruch	Weiss,	What	Were	They	Thinking?:	The	Mental

States	of	the	Aider	and	Abettor	and	the	Causer	Under	Federal	Law,	70	Fordham

L.	Rev.	1341,	1447	(2002)	(“In	fact,	what	little	information	that	exists	seems	to

suggest	.	.	.	that	the	word	[willfully]	was	added	by	Congress	[in 1951] not	to

differentiate	between	the	two	types	of	accomplices,	but	rather	to	confirm	Judge

Learned	Hand’s	repeated	efforts	to	equate	them. The	word	was	needed	to	bring

the	causing	subsection	in	line	with	the	aiding	and	abetting	subsection,	which

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

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

(quotation	marks	omitted)).

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

reimburse Bourgoin’s	state-law-compliant	medical	expenses	is	insufficient	to

give	rise	to	the	specific	intent	element	of	aiding	and	abetting,	regardless	of	with

which	prong	under	section	two	the	United	States	may	or	may	not	charge	the

employer. The	Court	does	not	analyze	how	the	government	would	be	able	to

meet	its	burden	to	prove	beyond	a	reasonable	doubt	that	the	employer	itself

actually desired or wished that Bourgoin be successful in committing the
36

underlying federal offense; I do not agree that mere knowledge is sufficient.

According	to	the	Court,	however,	the	employer	“would	be	aiding	and	abetting

Bourgoin—in	his	purchase,	possession,	and	use	of	marijuana—by	acting	with

knowledge	that	it	was	subsidizing	Bourgoin’s	purchase	of	marijuana.” Court’s

Opinion	¶	20	(emphasis	added). To	support	this	proposition,	the	Court	cites	to,

among	other	sources	of	law,	Rosemond	v.	United	States,	134	S.	Ct.	1240,	1248-50

(2014). That	case,	however,	“did	not	deal	.	.	.	with	defendants	who	incidentally

facilitate	a	criminal	venture	rather	than	actively	participate	in	it.” Id.	at	1249

n.8. The	Rosemond	Court	discussed	the	type	of	activity	that	would	not	give	rise

to	the	requisite	specific	intent:	“A	hypothetical	case	is	the	owner	of	a	gun	store

who	sells	a	firearm	to	a	criminal,	knowing	but	not	caring	how	the	gun	will	be

used. We	express	no	view	about	what	sort	of	facts,	if	any,	would	suffice	to	show

that	such	a	third	party	has	the	intent	necessary	to	be	convicted	of	aiding	and

abetting.” Id.

[¶46] In	contrast,	the	employer	in	this	case	is	even	further	removed	from

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

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,	I	do	not	agree	that	mere	knowledge	constitutes	active	participation

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

accomplice himself or herself must wish or desire to bring about in order to

establish the requisite specific intent that the offense of aiding and abetting

demands.

[¶47] In fact, the existence of this litigation vitiates the specific intent

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

prosecute	the	employer. Regardless,	whether	the	government	would	be	able	to

prove the requisite mens rea beyond a reasonable doubt is speculative, and

because	speculative	conflicts	and	hypotheticals	do	not	give	rise	to	preemption,

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

abetting	to	declare	that	it	was	Congress’s	manifest	purpose	to	preempt	the	WCB

from	ordering	reimbursement	is	far	too	tenuous. In	sum,	I	do	not	agree	that	the

employer would commit an offense against the federal government by

reimbursing Bourgoin for his valid medical expenses pursuant to the WCB

order,	especially	in	light	of	the	strong	presumption	against	preemption	in	this

state-controlled area of workers’ compensation—a domain that has
38

traditionally	been	regulated	under	the	police	powers	of	the	states. See	Ciampi,

681	A.2d	at	8.

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

abetting	in	a	vacuum,	devoid	of	any	mention	of	the	substantive	offense,	which

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

marijuana. The	Court	points	to	no	federal	prosecution	of	possession	of	medical

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

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

existence of a substantive crime is also	an element of an aiding and abetting

charge,	see	Indelicato,	611	F.2d	at	385,	the	Court	cannot	reach	the	conclusion

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

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

marijuana	constitutes	a	federal	offense. This	omission	allows	the	Court	to	avoid

a discussion that would necessarily be required to include the preemptive

12 Indeed,	Congress	has	repeatedly	enjoined	the	Department	of	Justice	from	expending	any	funds

to prevent states from administering their state-law-compliant medical marijuana programs. See
Consolidated	Appropriations	Act,	2018,	Pub.	L.	No.	115-141,	§	538,	132	Stat.	348	(“None	of	the	funds
made	available	under	this	Act	to	the	Department	of	Justice	may	be	used	.	.	.	to	prevent	[a	state	or
territory] from implementing their own laws that authorize the use, distribution, possession, or
cultivation of medical marijuana.”) (LEXIS); Consolidated Appropriations Act, 2017, Pub.
L.	No.	115-31,	§	537,	131	Stat.	135	(LEXIS)	(similar);	Consolidated	Appropriations	Act,	2016,	Pub.
L.	No. 114-113, § 542, 129 Stat. 2242 (LEXIS) (similar); Consolidated and Further Continuing
Appropriations	Act,	2015,	Pub.	L.	No.	113-235,	§	538,	128	Stat.	2130	(LEXIS)	(similar). To	date,	the
injunction	remains	in	effect. See	Consolidated	Appropriations	Act,	2018,	Pub.	L.	No.	115-141,	§	538,
132	Stat.	348	(making	appropriations	through	the	fiscal	year	ending	September	30,	2018).
39

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

medical	marijuana. The	Court	uses	the	doctrine	of	aiding	and	abetting	as	the

vehicle	to	declare	that	the	MMUMA	is	preempted	by	the	CSA	in	this	case,	but

because	the	government	would	not	be	able	to	prove	that	the	employer	has	the

specific	intent	to	aid	or	abet	Bourgoin’s	state-law-compliant	use	and	possession

of	medical	marijuana,	the	Court’s	reliance	on	the	aiding	and	abetting	doctrine

is	misguided. The	employer	also	acknowledged	at	oral	argument	that	despite

the	fact	that	the	first	state	medical	marijuana	law	was	enacted	more	than	two

decades	ago	in	1996,13	and	the	fact	that	twenty-nine	states,	two	territories,	and

the	District	of	Columbia	now	have	laws	in	effect	that	allow	for	the	use	of	medical

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

13 Cal.	Health	and	Safety	Code	§	11362.5	(Deering	2018)	(LEXIS).

14 Alaska,	see	Alaska	Stat.	§§	17.37.010	to	.080	(LEXIS	through	2017);	Arizona,	see	Ariz.	Rev.	Stat.

Ann.	§§	36-2801	to	-2819	(LEXIS	through	First	Reg.	Sess.	of	53rd	Legis.	(2017)	and	First	Special	Sess.
of	53rd	Legis.	(2018)	and	Emergency	Legis.	from	2018	2d	Reg.	Sess.,	effective	as	of	May	16,	2018);
Arkansas, see Ark. Const. amend. XCVIII (LEXIS, through 2018 Fiscal Sess. and 2018 Second
Extraordinary Sess.); California, see Cal. Health and Safety Code §§	11362.1 to .9 (Deering 2018)
(LEXIS); Colorado, see Colo. Const. art. XVIII, § 14 (LEXIS, through First Reg. Sess. and First
Extraordinary Sess. of 71st Gen. Assembly); Connecticut, see Conn. Gen. Stat. §§ 21a-408 to 429
(LEXIS through Pub. Acts 18-1 through 18-6, 18-8, 18-24); Delaware, see Del. Code Ann. tit. 16,
§§	4901A to 4928A (LEXIS through 81 Del. Laws, ch. 253); District of Columbia, see D.C. Code
§§	7-1671.01	to	.13	(LEXIS	through	June	4,	2018);	Florida,	see	Fla.	Stat.	§	381.986	(LEXIS	through
2018	Reg.	Sess.);	Hawaii,	see	Haw.	Rev.	Stat.	Ann.	§§	329-121	to	-131	(LEXIS	through	Act	12	of	2018
Sess.);	Illinois,	see	410	Ill.	Comp.	Stat.	Ann.	130/1	to	/999	(LEXIS	through	P.A.	100-585	of	the	100th
Legis. Sess.); Maine, see 22 M.R.S. §§ 2421 to 2430-B (2017); Maryland, see Md. Code Ann., Misc.
Health	Care	Programs	§§	13-3301	to	-3316	(LEXIS	through	June	1,	2018);	Massachusetts,	see	Mass.
Ann.	Laws	ch.	94D,	§§	1-3	(LEXIS	through	Act	98	of	the	2018	Legis.	Sess.);	Michigan,	see	Mich.	Comp.
Laws	Serv.	§§	333.26421	to	.26430	(LEXIS	through	2018	Pub.	Act	170);	Minnesota,	see	Minn.	Stat.
§§	152.22	to	.37	(LEXIS	through	ch.	118	(excluding	portions	of	chs.	103,	113,	and	115	of	2018	Reg.
40

provider for authorizing a patient to use marijuana for medicinal purposes,

much less to an employer or insurance carrier providing reimbursement for

authorized medical marijuana treatment. It is speculative to anticipate a

federal	prosecution	of	an	employer	who	reimburses	an	employee	for	medical

expenses	pursuant	to	a	WCB	order	mandating	it	to	do	so.

[¶49] Because	I	would	hold	that	there	is	no	positive	conflict	between	the

CSA	and	the MMUMA	in	this	case,	I address	the	remainder	of	the	employer’s

arguments	on	appeal.

Sess.	of	Minn.	90th	Legis.));	Montana,	see	Mont.	Code	Ann.	§§	50-46-301	to	-345	(LEXIS	through	2017
Reg.	Sess.	of	65th	Legis.	and	Nov.	2017	Special	Sess.);	Nevada,	see	Nev.	Rev.	Stat.	Ann.	§§	453A.010	to
.810	(LEXIS	through	chs.	1-505,	507-560,	562-565,	567,	569,	572-587,	589-608	of	79th	Reg.	Sess.
(2017));	New	Hampshire,	see	N.H.	Rev.	Stat.	Ann.	§§	126-X:1	to	:11	(LEXIS	through	Act	48	of	2018
Reg.	Sess.);	New	Jersey,	see	N.J.	Stat.	Ann.	§§	24:6I-1	to	-16	(LEXIS	through	218th	First	Annual	Sess.,
L.	2018,	c.	15	and	J.R.	5);	New	Mexico,	see	N.M.	Stat.	Ann.	§§	26-2B-1	to	-7	(LEXIS	through	2018	Reg.
Sess. enactments of 53rd Legis.); New York, see N.Y. Pub. Health Law §§ 3360 to 3369-e (LEXIS
through 2018 chs. 1-47, 50-58); North Dakota, see N.D. Cent. Code §§ 19-24.1-01 to -40 (LEXIS
through	end	of	2017	Reg.	Legis.	Sess.);	Ohio,	see	Ohio	Rev.	Code	Ann.	§§	3796.01	to	.30	(LEXIS	through
Legis.	passed	by	132nd	Gen.	Assembly	and	filed	with	Sec’y	of	State	through	file	66	(HB	354));	Oregon,
see	Or.	Rev.	Stat.	§§	475.300	to	.375	(LEXIS	through	emergency	legis.	through	chs.	1-50,	52-59,	62-71,
73-92	of	2018	Legis.	Sess.);	Pennsylvania,	see	35	Pa.	Cons.	Stat.	§§	10231.101	to	.2110	(LEXIS	through
2018	Reg.	Sess.	Acts	1-21);	Rhode	Island,	see	21	R.I.	Gen.	Laws	§§	21-28.6-1	to	-17	(LEXIS	through	ch.
28	of	Jan.	2018	Sess.);	Vermont,	see	Vt.	Stat.	Ann.	tit.	18,	§§	4471	to	4474m	(LEXIS	through	ch.	110
and	Municipal	Act	15	of	the	2017	Adjourned	Sess.	(2018));	Washington,	see	Wash.	Rev.	Code	Ann.
§§	69.51A.005	to	.903	(LEXIS	through	2018	ch.	6);	West	Virginia,	see	W.	Va.	Code	Ann.	§§	16A-1-1	to
-16-1	(LEXIS	through	2018	Reg.	Sess.	Legis.);	Guam,	see	10	Guam	Code	Ann.	§§	122501	to	122529
(LEXIS	through	P.L.	34-71,	12/15/2017);	Puerto	Rico,	see	9000	PR	Regla	8686	(LEXIS	through	rules
received	before	January	23,	2018).
41

C. Private	Health	Insurers

[¶50] The	employer	argues	that	the	plain	language	contained	in	section

2426(2)(A)	of	the	MMUMA	demonstrates	a	legislative	intent	that	no	third	party

should	be	required	to	reimburse	a	person	for	their	use	of	medical	marijuana.

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

interpretation	de	novo. See	Estate	of	Sullwold	v.	Salvation	Army,	2015	ME	4,	¶	7,

108	A.3d	1265.

[¶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-settled	rule	of	statutory	interpretation	states	that	express

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

Nelson,	647	A.2d	1198,	1201	(Me.	1994);	see	also	Lee	v.	Massie,	447	A.2d	65,	68

(Me.	1982)	(“[T]he	maxim	[of]	expressio	unius	est	exclusio	alterius	.	.	.	is	regarded

as	well	recognized	in	Maine	.	.	.	.	”	(quotation	marks	omitted)). We	only	“look

beyond	the	plain	meaning	and	consider	other	indicia	of	legislative	intent”	if	“the

statutory	language	is	ambiguous.” Damon	v.	S.D.	Warren	Co.,	2010	ME	24,	¶	10,

990	A.2d	1028.

[¶52] The	MMUMA	states	that	it	“may	not	be	construed	to	require	.	.	.	[a]

government	medical	assistance	program	or	private	health	insurer	to	reimburse
42

a person for costs associated with the medical use of marijuana.” 22 M.R.S.

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

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

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

self-insurer	or	group	self-insurer.” 39-A	M.R.S.	§	102(12)	(2017). Under	the

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

company	or	association	authorized	to	do	business	in	this	State	that	may	issue

policies”	and	does	not	include	employers. Id.	§	102(14). See,	e.g.,	Deabay	v.	St.

Regis	Paper	Co.,	442	A.2d	963,	964	(Me.	1982)	(distinguishing	between	private

health	insurers	and	self-insured	employers	under	the	WCA).

[¶53] We	must	first	look	to	the	plain	meaning	of	“private	health	insurer”

under	the	MMUMA	and	construe	that	language	to	avoid	an	absurd,	inconsistent,

or	illogical	result. See	Hanson	v.	S.D.	Warren	Co.,	2010	ME	51,	¶	12,	997	A.2d

730. Read	in	conjunction	with	the	entire	sentence	within	which	the	phrase	is

contained,	there	exist	only	two	categories	of	third	parties	that	should	be	exempt

from	paying	for	the	use	of	medical	marijuana:	government	medical	assistance

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

between	the	two	types	of	third	parties,	and	the	absence	of	any	other	potential

third-party	payors,	indicates	the	intent	to	set	forth	an	exhaustive	list	of	third
43

parties exempt from reimbursement, consistent with the statutory

interpretation	canon	of	expressio	unius. See	Musk,	647	A.2d	at	1201;	see	also

Lee,	447	A.2d	at	68. Employers,	including	those	that	are	self-insured,	are	not

the	functional	equivalents	to	otherwise	private	health	insurers. I	would	hold

that	for	the	purposes	of	WCA	claims,	“private	health	insurers”	is	unambiguous

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

purposes	of	compensation	under	the	WCA.

D. Reasonable	and	Proper	Treatment

[¶54] The	employer	argues	that	medical	marijuana	is	not	a	reasonable

and	proper	form	of	treatment	under	the	WCA	because	it	is	illegal	under	the	CSA;

it	has	not	been	shown	to	have	an	accepted	level	of	safety;	there	is	no	control

over	the	quality	of	the	substance;	and	there	is	no	control	over	its	billing. We

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

2015	ME	4,	¶	7,	108	A.3d	1265.

[¶55] “When	construing	provisions	of	the	Workers’	Compensation	Act,

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

Brockway-Smith	Co.,	2012	ME	128,	¶	9,	55	A.3d	456	(quotation	marks	omitted).

Pursuant	to	the	WCA,	“[a]n	employee	sustaining	a	personal	injury	arising	out	of

and in the course of employment . . . is entitled to reasonable and proper
44

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

surgical	aids,	as	needed,	paid	for	by	the	employer.” 39-A	M.R.S.	§	206	(2017).

[¶56] The WCA	does not	define	what	“reasonable	and proper” means.

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

“reasonable	and	proper”	language	contained	within	the	WCA	is	“unambiguous

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

employer	for	all	reasonable	and	proper	medical	.	.	.	services	.	.	.	required	by	an

employee sustaining a personal injury arising out of and in the course of his

employment.”15 Cote	v.	Georgia-Pacific	Corp.,	596	A.2d	1004,	1005	(Me.	1991)

(quotation	marks	omitted). When	determining	whether	a particular	medical

expense	is	“reasonable	and	proper”	under	the	WCA,	we	have	stated	that	“[e]ach

case	must	be	decided	according	to	its	own	particular	facts	and	according	to	the

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

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

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

part-time	assistant	and	van	to	accommodate	a	wheelchair	were	reasonable	and

15 Before	1992,	the	WCA’s	“reasonable	and	proper”	language	was	contained	in	39	M.R.S.A.	§	52

(1964),	but	after	the	Act	was	overhauled	in	1992,	the	same	language	became	part	of	section	206;
although the language moved, it has retained the same meaning. See P.L. 1991, ch. 885, § A-8
(effective Oct. 7, 1992); see also L.D. 2464, Statement of Fact, Part A, at 211 (115th Legis. 1992)
(“Section 206 reorganizes and substantially enacts the provisions of the former Title 39, section
52	.	.	.	.”).
45

proper	when	medically	necessary	for	that	particular	employee);	Cote,	596	A.2d

at	1005-06	(holding	that	housekeeping	was	not	reasonable	and	proper	when	it

had	no	accompanying	medical	component); Archer	v.	MDS	Bldg.,	Inc.,	2004	ME

17,	¶¶	2,	6,	841	A.2d	801	(holding	that	elective	amputation	of	a	toe	to	replace	a

thumb	lost	in	a	work	injury	was	reasonable	and	proper	because	the	amputation

was	a	“direct	consequence”	of	reasonable	and	proper	treatment).

[¶57] Turning	to	the	particular	facts	of	Bourgoin’s	own	case,	Bourgoin

suffers	from	severe	chronic	pain	syndrome,	which	includes	symptoms	of	pain

and	muscle	spasms	in	his	back,	legs,	arms,	and	chest. Bourgoin	has	attempted

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

nerve	blocks,	aquatherapy,	and	pain	management	through	opioid	medication.

Eventually,	the	continued	use	of	opioid	medication	resulted	in	severe	negative

side	effects,	including	narcotic	dependence,	with	dependency	dating	as	far	back

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, his primary doctor recommended ceasing narcotic medications,

and in January of 2012, Bourgoin obtained a medical marijuana certification

from	a	physician. Bourgoin	has	used	medical	marijuana	since	his	certification
46

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

Bourgoin	“has	experienced	significant	benefit	from	medical	marijuana,	and	that

opioids	have	already	been	shown	to	be	a	failure.”

[¶58] With	no	reference	to	the	“particular	facts”	of	Bourgoin’s	case,	the

employer here argues that medical marijuana is per se unreasonable and

improper	for	Bourgoin	because	possession	of	marijuana	is	unlawful	under	the

CSA. I	would	decline	to	adopt	this	argument	and	would	conclude	that	medical

marijuana was reasonable and proper here based on the particular facts of

Bourgoin’s	own	case,	as	established	by	the	record	before	us. Specifically,	the

severity and chronic nature of his pain, his many and varied attempts to try

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

effectiveness of medical marijuana for his particular situation, show that the

medical	use	of	marijuana	was	reasonable	and	proper	in	this	case.

E. Rejection	of	IME’s	Findings

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

evidence	to	contradict	the	independent	medical	examiner’s	(IME)	findings,	and

that the hearing officer’s analysis was flawed because it failed to consider
47

whether	medical	marijuana	can	ever	be reasonable	“given	its	illegality	under

the	CSA.”

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

“unless	there	is	clear	and	convincing	evidence	to	the	contrary	in	the	record	that

does	not	support	the	medical	findings.” 39-A	M.R.S.	§	312(7)	(2017). Although

a	hearing	officer’s	decision	“on	all	questions	of	fact	is	final,”	a	hearing	officer’s

conclusion	that	an	employee	satisfied	his	or	her	burden	to	prove	by	clear	and

convincing	evidence	that	the	independent	medical	examiner’s	findings	should

be	rejected	is	a	conclusion	of	law	that	is	subject	to	appellate	review. 39-A	M.R.S.

§	318	(2017).16 In	such	a	case,	“we	determine	whether	the	hearing	officer	could

have	been	reasonably	persuaded	by	the	contrary	medical	evidence	that	it	was

highly probable that the record did not support the IME’s medical findings.”

Sprague v. Lucas Tree Experts, 2008	ME 162, ¶ 24, 957 A.2d 969 (quotation

marks	omitted).

[¶61] In	this	case,	the	hearing	officer	found	it	to	be	highly	probable	that

the	record	did	not	support	the	IME’s	findings. Specifically,	the	hearing	officer

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

16 Certain	portions	of	the	WCA,	including	39-A	M.R.S.	§	318	(2017),	were	amended	after	the	decree

in	this	case	was	entered,	see,	e.g.,	P.L.	2015,	ch.	297,	§	13	(effective	Oct.	15,	2015),	though	not	in	any
way	relevant	to	this	discussion.
48

marijuana for the treatment of long-term, chronic pain, and Bourgoin’s own

testimony	regarding	the	effects	of	marijuana	on	his	level	of	pain. The	hearing

officer	found	this	evidence	to	be	more	persuasive	than	the	IME’s	findings. The

IME concluded that, because medical marijuana had no currently accepted

medical	use	under	federal	law,	it	was	not	a	reasonable	and	proper	treatment

for	any	patient,	regardless	of	its	efficacy	in	a	given	circumstance.

[¶62] Because	the	record	contains	(1)	numerous	examples	of	the	ways

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

beginning	the	regimen	of	medical	marijuana	use;	and	(2)	evidence	of	traditional

opioid medication’s failure to reduce his chronic pain, I would hold that the

hearing	officer	could	have	been	reasonably	persuaded	by	the	contrary	medical

evidence, and, as a result, that he did not err when he concluded that it was

highly	probable	that	the	record	did	not	support	the	IME’s	medical	findings.

[¶63] Accordingly,	I	would	affirm	the	decision	of	the	Appellate	Division.

ALEXANDER,	J.,	dissenting.

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

carefully	written	dissenting	opinion. I	write	separately	because	in	the	extensive
49

discussion of the law of preemption, we must not lose sight of the injured

worker	whom	this	opinion	is	really	about.

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

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

opinion	today	is	to	deprive	Bourgoin	of	reimbursement	for	medication	that	has

finally	given	him	relief	from	his	chronic	pain,	and	to	perhaps	force	him	to	return

to	the	use	of	opioids	and	other	drugs	that	failed	to	relieve	his	pain	and	may	have

placed	Bourgoin’s	life	at	risk.

[¶66] The	essential	elements	of	this	appeal	are	that	other	states	allow

appropriate	medical	personnel	to	prescribe	or	certify	marijuana	to	treat	health

conditions;	these	states	allow	employers	and	private	insurers	to	reimburse	for

marijuana prescriptions or certificates; and the certificates and

reimbursements are technically violations of federal law, but the federal

government	has	not	taken	criminal	or	civil	action	to	prevent	these	certifications

or	reimbursements	or	at	least	no	such	federal	prosecution	is	indicated	in	the

record.

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

approved	the	certificates	and	the	reimbursements. The	Court’s	opinion	rejects

the Appellate Division’s findings and, based on its speculation that federal
50

enforcement	practice	might	change,	the	Court	holds	as	a	matter	of	law	that	the

Appellate	Division	erred	in	approving	the	certificates	and	reimbursements	for

Mr.	Bourgoin. Court’s	Opinion	¶¶	26-30. In	this,	the	Court	is	reaching	too	far,

speculating	about	the	future	rather	than	looking	at	the	present,	as	was	properly

addressed	by	the	Appellate	Division.

[¶68] From	that	result,	I	respectfully	dissent.

Anne-Marie	L.	Storey,	Esq.	(orally),	and	John	K.	Hamer,	Esq.,	Rudman	Winchell,
Bangor,	for	appellants	Twin	Rivers	Paper	Company,	LLC,	and	Sedgwick	Claims
Management	Services

Norman	G.	Trask,	Esq.	(orally),	Currier	&	Trask,	P.A.,	Presque	Isle,	for	appellee
Gaetan	H.	Bourgoin

Thomas	E.	Getchell,	Esq.,	Troubh	Heisler,	Portland,	for	amicus	curiae	University
of	Maine	System

Workers	Compensation	Board	Appellate	Division	case	number	15-0022
FOR	CLERK	REFERENCE	ONLY

---

Source: Frix Law Library, https://www.frixlaw.com/law-library/cases/4284308. Public record. Not legal advice.
