Wednesday, March 3, 2010

Benefits of Having A Dispensing Collective in Your Community

  • Dispensing collectives provide benefits to the sick and suffering in your community. Dispensaries remove common barriers to accessing cannabis medicines. Often patients are not skilled or physically able to cultivate their medicines. A rapid onset of a serious illness normally does not afford a patient the several months and extensive costs it takes to produce quality cannabis medicines. A dispensary can provide these medicines as an alternative to potentially dangerous illicit transactions.
  • Dispensing collectives provide psychosocial health benefits to patients in your community. Often patients find more than just safe and effective medicines in a collective setting. They find a community to be a part of and in turn experience much higher levels of satisfaction and wellness than a patient who is isolated away from others.
  • Dispensing collectives provide key heath and social services to their patients. Dispensaries offer a wide array of cannabis therapies, giving patients the opportunity to share experiences on what may work best for different afflictions and find different methods of ingestion, such as tinctures and extracts to treat their symptoms. Collectives also provide a vast selection of social services to their patients, including counseling, support groups, help with housing and meals, hospice care, and alternative therapies like massage and yoga. These support services give most patients the opportunity to experience and try treatments they normally could not afford or known existed.
  • Dispensing collectives increase public safety in the areas around them. Many cities and towns have found that crime and unwanted behaviors have decreased in an area where a well-run and regulated dispensing collective exists. Collectives take security seriously, often employing multiple security guards and implementing security cameras and alarm systems. These are natural deterrents to those who engage in unwanted behaviors and they normally move to a less monitored area, increasing safety for the collective and the neighborhood it serves.
  • Dispensing collectives are good neighbors and can revitalize an area. Collectives instill good neighbor policies with their members that encourage them to be conscious and positive forces in the areas around the collective. A collective brings new people to the area to access services, which brings foot traffic to neighboring businesses and increases the vitality of the neighborhood by bringing customers to areas they normally would not visit. They patronize other businesses for convenience.
  • Dispensing collectives create jobs in the community. With unemployment rates at extremely high levels, it is important to realize that a dispensing collective will employ at least 10-15 people, including management, service personnel, security, and community liaison positions.
  • Dispensing collectives provide much needed revenue through business and sales taxes. A well-run dispensing collective can provide a great deal of revenue through normal business taxes and to the county through sales taxes. Oakland passed Measure F in July 2009 taxing collectives at 1.8% or 15 times the normal business rate. The measure passed with 80% of voters’ approval. Many other cities are putting the same type of measure on the upcoming ballots for special election.
  • Collectives are not for profit organizations. Collectives use excess revenue to fund local projects and worthwhile organizations, such as food banks, homeless shelters, and educational assistance funds.

Frequently Asked Questions About Medical Cannabis Dispensing Collectives

  • Is a health services collective that sells medical cannabis legal? Yes. To clarify the voter initiative passed in 1996, Proposition 215, the state legislature passed the Medical Marijuana Program Act (MMP) known as State Bill 420 in 2003, establishing that patients and caregivers may collectively or cooperatively cultivate and distribute cannabis medicines. The Act exempts collectives and cooperatives from criminal sanctions associated with “sales” and maintaining a place where sales occur. In 2005 California’s Third District Court of Appeals affirmed their legality in the case of People v. Urziceanu, which held that the MMP provides collectives a defense to marijuana distribution charges. In August 2008, the California Attorney General issued guidelines declaring “a properly organized and operated collective or cooperative that dispenses medical marijuana through a storefront may be lawful under California law.”
  • Why do patients need access to a dispensing collective instead of growing their own? While some long-term patients have the time, space, and skill to cultivate cannabis, the majority of patients do not have the skills or ability to produce medicine. For those patients dispensing collectives are the only option for safe and legal access to these therapies. For example, many of the most serious and debilitating illnesses require immediate relief. It is unreasonable to exclude those patients most in need because they are incapable of gardening or cannot wait months for relief.
  • What are other communities doing to help patients? Many communities have recognized the essential service that dispensing collectives provide and have allowed their operations or have adopted ordinances regulating their operations. Regulations are a way cities can ensure the needs of patients in their community are being met while exerting control of the organizations. It is officials’ duty to implement state law, even if they have not supported cannabis legislation in the past. Dozens of cities and many counties have adopted ordinances regulating collectives to ensure the patients in their community have access to these therapies.
  • Who should administer dispensary regulation in our community? To ensure that patients, caregivers and collectives are protected, general regulatory oversight duties, such as permitting, record maintenance, and general protocols should be the responsibility of a local Department of Public Health (DPH) or the Planning Department. Besides security matters, law enforcement is ill suited in handling matters related to health and medicine.
  • How many collectives do wee need in our city? Arbitrary caps on the number of collectives can be counter-productive. Like other services, competitive market forces and consumer choice will be decisive. Collectives that provide better care and service to patients will flourish and those that do not will fail. Capping the number can result in limits of consumer choice resulting in decreased quality of care and often-higher prices. It can also force patients with limited mobility to travel farther than they would normally need to in order to access their medicine and care.
  • What types of zoning restrictions are needed for this type of organization? Restrictions on where collectives can locate are often unnecessary and create barriers to access. Dispensing collectives are not shown to create increases in crime or bring harm to their neighborhoods, regardless of where they are located. It is unnecessary and burdensome to require patients to travel to areas often far away from public transit to access their medicines. It is important to balance patient need with concerns

Patient Conditions for which Cannabis Medicines can be Beneficial

Patient Conditions for which Cannabis Medicines can be Beneficial

  • Cancer and Chemotherapy Treatment- Cannabis is most effective to combat the side effects of the treatments used to fight cancer. Most notably are its extremely effective in curbing nausea and increasing the appetite of patients experiencing the harsh side effects of chemotherapy and radiation. It also can reduce the pain associated with the disease.
  • HIV/AIDS- HIV/AIDS patients often experience wasting syndrome from the disease and the multitudes of medicines used to combat the disease. Cannabis stimulates their appetite allowing them to eat more regularly and avoid the common traits associated with wasting syndrome, as well as helps ease the pains associated with the disease itself.
  • Pain Afflictions- Research shows that cannabis is a safe and effective treatment for a variety of pain related afflictions, including deep tissue pains, muscle and back pain, and neuropathic or shooting pains. Cannabis does not have the dangerous side effects of other opiate-based painkillers and is not known to be toxic at any level of ingestion, making it a much safer medicine for pain.
  • Multiple Sclerosis- Cannabis improves spactisity and improves tremors in MS patients. It helps control involuntary muscle contraction, balance, bladder control, speech, and eyesight in these patients. Cannabis helps with the immune system, which is thought to be the underlying pathogenic process in MS patients.
  • Gastrointestinal Disorders- Cannabis has value as an anti-emetic and analgesic medication. It helps combat the symptoms brought on by disorders such as Crohn’s Disease, Irritable Bowel Syndrome, and Ulcerative Colitis. Cannabis interacts with the endogenous cannabinoid receptors in the digestive tract, which can result in calming spasms, assuaging pain, and improving motility. Cannabis has also been shown to have anti-inflammatory properties and recent research has demonstrated that cannabinoids are immune system modulators, either enhancing or suppressing immune response.
  • Movement Disorders- Cannabis is effective in treating muscular spasticity, a common condition, affecting millions of people. This condition afflicts individuals who have suffered strokes, as well as those with multiple sclerosis, cerebral palsy, paraplegia, quadriplegia, and spinal cord injuries. Conventional medical therapy offers little to address spasticity problems. Because cannabinoids have antispasticity, analgesic, antitremor, and antiataxia properties, cannabis is extremely effective in treating these disorders, and lacks the side effects and dangers of Vallium or other prescribed medicines.
  • Aging- Cannabis has been found to help many patients suffering from conditions that afflict older patients, including arthritis, chronic pain, cancer, Alzheimer's disease, diabetes, and spasticity associated with such diseases as Parkinson's.
  • Arthritis- There are two common types of arthritis, rheumatoid arthritis and osteoarthritis, but both affect the joints, causing pain and swelling, and limiting movement. The analgesic properties of cannabis make it useful in treating the pain associated with arthritis, both on its own and as an adjunct therapy that enhances the efficacy of opioid painkillers. Cannabis has also been shown to have powerful immune-modulation and anti-inflammatory properties suggesting that it could play a role in treating arthritis, and not just in symptom management.

Thursday, October 8, 2009

Proven: Cannabis is Safe Medicine

Proven: Cannabis is safe medicine

Ian Williams Goddard, 1996


In reaction to medical cannabis access referendums on the ballots in Arizona and California, former presidents Gerald Ford, Jimmy Carter, and George Bush signed a letter stating that they ``categorically oppose'' access to cannabis for its many proven therapeutic uses such as the prevention of blindness and epileptic seizures [1].

Their chief concern was that legal medical access would send the message that cannabis is safe. The presidents can, however, lay their safety concerns to rest because the scientific literature overwhelmingly confirms that cannabis is both an effective and safe medicine.

The Cannabis Safety Profile

The journal PHARMACOLOGICAL REVIEWS [2] reports that decades of research prove that, "Compared with legal drugs...marijuana does not pose greater risks." Yet based upon mortality statistics, we can safely conclude that cannabis is one of the safest medical drugs known, for, while prescription drugs, defined as safe by the FDA, kill up to 27,000 and aspirin up to 1,000 Americans per year, cannabis kills 0 per year [3].

When we know the facts we can understand why in 1988, after extensive review of the scientific literature, the DEA's own administrative judge Frances Young concluded that ``Marijuana is one of the safest therapeutically active substances known to man.'' [4]

Opponents of legal cannabis access would have us believe that there is not enough research available to determine its safety. Nothing could be further from the truth. Cannabis is one of the most thoroughly researched drugs in history, and the evidence gathered over the centuries clearly proves that it is safe:

* The Indian Hemp Drugs Commission Report (1894): an exhaustive seven-volume, 3,281-page report that concludes: "Moderate [cannabis] use produces practically no ill effects." [5][6][7]

* The Panama Canal Military Study (1916-1929), amassing extensive data on the health impact of cannabis smoking upon American soldiers stationed in Panama, recommended that "No steps be taken by the Canal Zone authorities to prevent the sale or use of Marihuana." The research also concluded that, "There is no evidence that Marihuana...is...'habit- forming.'" [7][8]

* The LaGuardia Report (1939-1944), commissioned by New York City Mayor Fiorello LaGuardia, which included evidence gathered over thousands of years, concluded that "Smoking marihuana does not lead to addiction... does not lead to morphine, heroin, or cocaine addiction" and that "the publicity concerning the catastrophic effects of marihuana smoking in New York City is unfounded." [7][9]

* The Baroness Wootton Report (1968), commissioned by the Advisory Committee on Drug Dependence of the United Kingdom Home Office, concluded, "There is no evidence that...serious physical dangers are directly associated with the smoking of cannabis." The report also noted that "Cannabis use does not lead to heroin addiction" and that "there is no evidence that [cannabis]...is producing in otherwise normal people conditions of dependence or psychosis, requiring medical treatment." [7][10]

The HARVARD MEDICAL SCHOOL MENTAL HEALTH LETTER [11] reports the findings of other major cannabis studies:

In three major studies conducted in Jamaica, Costa Rica, and Greece, researchers have compared heavy long-term cannabis users with non-users and found no evidence of intellectual or neurological damage, no changes in personality, and no loss of the will to work or participate in society.

The Jamaican study states that, even as cannabis use in Jamaica "is pervasive" and is used "in heavier quantities with greater THC potency than in the U.S.," its use is "without deleterious social or psychological consequences." [12]

What's more, the three studies cited, the largest human cannabis studies to date, also revealed that heavy long-term cannabis users scored slightly higher on IQ tests, had slightly lower rates of illness and cancer, and lived longer on average than non-users. Users also proved to be more relaxed and sociable than non-users [4][12][13]. The best evidence indicates, contrary to GovtMedia disinformation, that cannabis is safe and good for you.

In line with the findings of the Panama Canal study and the LaGuardia Report, current research confirms that the addictive potential of cannabis is very low. The journal TRENDS IN PHARMACOLOGICAL SCIENCES states that research shows cannabis has "limited potential for development of...psychological dependence due to the weak reinforcing properties of Delta-9-THC." [14] BRAIN RESEARCH journal observes that "cannabinoid dependence and withdrawal phenomena are minimal."[15]

Research proves that cannabis is nontoxic. For example, in the journal FUNDAMENTAL AND APPLIED TOXICOLOGY [16], Dr. William Slikker, director of the Neurotoxicology Division of the National Center for Toxicological Research (NCTR), described the health of monkeys exposed to very high levels of cannabis for an extended period:

The general health of the monkeys was not compromised by a year of marijuana exposure as indicated by weight gain, carboxyhemoglobin and clinical chemistry/hematology values.

When THE ARKANSAS TIMES [17] asked Dr. Merle Paule of NCTR about evidence of cannabis toxicity and the health of the monkeys in the study, Dr. Paule said, "There's just nothing there. They were all fine."

The journal TOXICOLOGY LETTERS [18] published a study that found no link between cannabis smoking and lung cancer. The seven researchers in the study concluded:

It has been suggested that marijuana smoking is a proximal cause of respiratory cancer. However, these intimations have not been borne out by epidemiological investigation.

Not only is the evidence linking cannabis smoking to cancer negative, but the largest human studies cited indicated that cannabis users had lower rates of cancer than nonusers. What's more, those who smoked both cannabis and tobacco had lower rates of lung cancer than those who smoked only tobacco -- a strong indication of chemo-prevention [4][12][13]. Even more, in 1975 researchers at the Medical College of Virginia found that cannabis showed powerful antitumor activity against both benign and malignant tumors (the government then banned all future cannabis/cancer research) [4]. In fact, the NEW ENGLISH DISPENSATORY of 1764 recommends boiled cannabis roots for the elimination of tumors [19]. Powerful evidence that cannabis not only does not cause cancer, but that it may prevent and even cure cancer.

The few studies that the GovtMedia drums into the public mind over and over, which claim to show that cannabis is a harmful drug, are almost all the work of the the government's top hired gun, Dr. Gabriel Nahas. The NEW ENGLAND JOURNAL OF MEDICINE described Nahas's work as "psychopharmacological McCarthyism that compels him to use half-truths, innuendo and unverified assertions." The JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION also condemned his work, stating, "Examples of biased selection and...omissions of facts abound in every chapter." [20]

Conclusion:

Not only does the best scientific research overwhelmingly confirm that cannabis is both an effective medicine and a safe drug, but that it may both prevent and cure cancer and may be generally beneficial to health. What this shows us most clearly, in light of the consensus to the contrary, is the enormous power of a Big Lie.

With its vast resources, the "GovtMedia elite" are able to fabricate and fob off a pharmacological fraud against both cannabis and the public interest. Through sheer repetition and consistent suppression of contrary information, they are able to construct an edifice of public consensus which even the hardest scientific facts fail to topple.

The truth is no stronger than the ability of true information to surpass the public distribution of false and misleading information. The GovtMedia has a greater ability to distribute a Big Lie than any other sector of society has to distribute the truth. However, this report right here contains copious quantities of carefully referenced scientific facts that consistently and conclusively confirm that cannabis is safe -- thereby exploding the GovtMedia's Big Lie.

As truth is only as powerful as it is known, do all that is in your power to make these powerful facts known, that we might put an end to the destructive and illogical prohibition of the proven safe and effective drug cannabis, for possession of which 10 million Americans have been arrested since 1965 [21].

[1] "Three Former U.S. Presidents Oppose Medical Marijuana Measures," Associated Press (10/30/96).

[2] PHARMACOLOGICAL REVIEWS: Health Aspects of Cannabis. 1986, 38:1, 1-20. pg. 17.

[3] Bureau of Mortality Statistics, 1988. U.S. Public Health Service statistics. National Institute of Drug Abuse statistics. U.S. Surgeon General's Report.

[4] The Emperor Wears No Cloths. Jack Herer, Queen of Clubs Pub, 1991. Recommended: 213-392-1806.

[5] INTERNATIONAL JOURNAL OF ADDICTIONS. Spring 1968, digest of 1894 Indian Hemp Drugs Commission Report.

[6] The Indian Hemp Drugs Commission Report of 1894. Jefferson Press, Silv.Spring, MD, 1969, John Kaplan.

[7] http://www.natlnorml.org/research/studies.shtml

[8] MILITARY SURGEON. 1933, vol:73, pages 269-280.

[9] The La Guardia Report, reprinted in "The Marijuana Papers," Indianapolis: Bobbs-Merrill, 1966.

[10] The Consumer's Union Report: Licit & Illicit Drugs. Mt. Vernon, New York, 1971.

[11] HARVARD MEDICAL SCHOOL MENTAL HEALTH LETTER: Marijuana. L. Grinspoon, vol. 4, no. 5. Nov, 1987.

[12] Ganja in Jamacia: A Medical Anthropological Study of Chronic Marijuana Use. 1975. Anchor Books, NY.

[13] Cannabis in Costa Rica: A Study of Chronic Marijuana Use, 1980-82, Institute for the Study of Human Issues, 3401 Science Center Philadelphia, PA.

[14] TRENDS IN PHARMACOLOGICAL SCIENCES: Neurobiology of Marijuana Abuse. 1992, 13:201-206. pg. 203.

[15] BRAIN RESEARCH: Chronic cannabinoid administration alters cannabinoid receptor binding in rat brain: a quantitative autoradiographic study. 1993, 616:293-302. pg. 300.

[16] FUNDAMENTAL AND APPLIED TOXICOLOGY: Chronic Marijuana Smoke Exposure in the Rhesus Monkey. 1991, Aug; 17, 321- 34.

[17] THE ARKANSAS TIMES: Refer Madness. 9/16/93.

[18] TOXICOLOGY LETTERS, "No Increase in Carcinogen-DNA Adducts in the Lungs of Monkeys Exposed Chronically to Marijuana Smoke," 1992, Dec;63 (3): 321-32.

[19] Marijuana: The First 12,000 Years. Plenum Press, 1980.

[20] The Great Drug War, Macmillan Publishing, 1987.

[21] Marijuana Policy Project, 202-462-5747, P.O. Box 77492, Capitol Hill, Washington, D.C. 20013. http://www.mpp.org, MPP@MPP.ORG

(c) 1996 Ian Williams Goddard - (*) free to copy nonprofit w/ attribute.

Medical Cannabis Research

New Study of Medical Cannabis Shows Scientific Value for Patients with Neuropathic Pain
On Monday, February 12th, Neurology published a long overdue study by Dr. Donald Abrams, which indicates that smoked marijuana effectively reduces chronic pain for people living with HIV/AIDS. The study builds on other international evidence and a 1999 Institute of Medicine (IOM) report, "Marijuana and Medicine, Assessing the Science Base."
Institute of Medicine Report
Responding to the passage of medical cannabis initiatives in California and Arizona, the White House Office of Drug Control Policy (the federal drug czar) commissioned the Institute of Medicine (IOM) to review the scientific evidence on the potential health benefits and risks of marijuana and its constituent cannabinoids. In 1999, the Institute released their report, Marijuana and Medicine: Assessing the Science Base. The report emphasizes the need for well-formulated, scientific research on the therapeutic effects of marijuana and its cannabinoid components.
General Research
This section includes general research on the efficacy of medical cannabis. It includes American and international research.
Condition-Based Research
ASA's educational booklets on medical cannabis and aging, arthritis, cancer, chronic pain, gastro-intestinal disorders, HIV/AIDS, movement disorders, and multiple sclerosis.
Additional Resources
This section includes a glossary of medical cannabis terms, a history of medical cannabis, and a database of clinical research.
DEA Administrative Law Judge Rules that Cannabis Research is "in the public interest"
U.S. Department of Justice-appointed Administrative Law Judge Mary Ellen Bittner issued an 87-page ruling today in favor of removing the government obstruction to medical cannabis research in the United States. University of Massachusetts-Amherst Professor Lyle Craker has led a six-year struggle to gain a DEA license to grow research-grade cannabis so that studies can be conducted to determine the full extent of marijuana's medical value.

Wednesday, September 30, 2009

White Papers from GLACA

Chapter 1: Federal and State Law

Executive Summary

In 1996, California voters passed the country's first medical cannabis (marijuana) law.[1]One of the most significant developments in California since then is the evolution of a distribution mechanism to ensure safe and affordable access for the more than 300,000 legal patients in the state. While California moved incrementally to implement its law over the last thirteen years, twelve additional states passed medical cannabis laws of their own. Support for medical cannabis grew nationwide as the number of medical cannabis states increased. Medical cannabis enjoys the support of more than 80% of Americans.[2] This strong support is complemented by ongoing research into the therapeutic properties of cannabis, including findings that clearly show medical efficacy.[3]

Unfortunately, the federal government still holds that "marijuana has no currently accepted medical use in treatment in the United States," ignoring well established scientific evidence.[4] This position, along with a U.S. Supreme Court ruling in June 2005, has given the government the authority to enforce federal laws against cannabis - even in states where its medical use is legal.[5] At the same time, the U.S. Supreme Court's decision not to overturn or invalidate medical cannabis laws in California or elsewhere allowed the continuing implementation of such laws.

California's 1996 Compassionate Use Act (CUA) calls on local, state, and federal officials to develop a plan for the safe and affordable distribution of cannabis. Although the federal government has shown no interest in cooperating with the State of California to develop an effective distribution mechanism, local and state officials, patients, and advocates have taken the initiative to do so. Since 2004, more than three-dozen cities and counties have developed regulatory ordinances for medical cannabis collective and cooperative associations, sometimes called "dispensaries."[6] These facilities have flourished over time with hundreds currently operating across the state. As collectives and cooperatives became well established in California, elected officials and law enforcement realized that sensible regulations reduce crime and complaints, and that neighboring businesses often benefit from collective and cooperative operation.[7]

Collectives began to flourish in the Los Angeles area beginning in 2004. This prompted the Los Angeles County Board of Supervisors in 2006 to adopt a regulatory ordinance covering the unincorporated areas of the county. To address the proliferation of collectives inside Los Angeles city limits, the City Council has been working to develop a regulatory ordinance since 2007. The development of a regulatory ordinance in the City of Los Angeles has been a complicated evolutionary process. Unfortunately, the first draft proposals for a regulatory ordinance did not meet the expectations of patients and advocates, causing confusion, delays, and a further proliferation of collectives in the city.

Advocates are now calling for a prompt conclusion to the development of a regulatory ordinance in the City of Los Angeles. In addition, advocates have made a series of recommendations that should assist the City Council in expeditiously arriving at an ordinance acceptable to all involved. These recommendations include: adopting safety and operational protocols already in use by local collectives, implementing a process for verifying non-for-profit status, requiring security precautions, protecting the confidentiality of membership records, and establishing reasonable location requirements. Advocates are calling on the City Council to finalize development of a regulatory ordinance as soon as possible. This report provides information for local officials and the public to rapidly adopt an ordinance that will avoid further confusion, delays and possible litigation.

National Political Landscape

A substantial majority of Americans support safe and legal access to medical cannabis. Public opinion polls in every part of the country show majority support cutting across political and demographic lines. Among them, a Time/CNN poll in 2002 showed 80% national support;[8] a survey of AARP members in 2004 showed 72% of older Americans support legal access, with those in the western states polling 82% in favor.[9]

This broad support, contrasted with an intransigent federal government that refuses to acknowledge medical uses for cannabis, led Americans to create state-based solutions. The laws that voters and legislators have adopted are intended to minimize the effects of the federal government's prohibition on medical cannabis by allowing qualified patients to use it without state or local interference. Beginning with California in 1996, voters passed initiatives in eight states plus the District of Columbia -- Alaska, Colorado, Maine, Montana, Nevada, Oregon, and Washington. State legislatures similarly passed laws to protect patients from criminal penalty in Hawaii, Michigan, New Mexico, Rhode Island, and Vermont.[10]

Momentum for these state-level provisions for compassionate use and safe access has continued to build as more research on the therapeutic uses of cannabis is published. In addition, the public advocacy of well-known cannabis patients such as the Emmy-winning talk show host Montel Williams has increased public awareness and created political pressure for state and local solutions around medical cannabis.

Even though the U.S. Supreme Court ruled in June 2005, in Gonzales v. Raich, that the federal government had the discretion to enforce such laws it certainly wasn't required to do so.[11] In fact, the Supreme Court questioned the wisdom of such enforcement efforts. Furthermore, the Court's decision not to invalidate or overturn California's medical cannabis law points to the ability of federal and state laws to coexist, even when they differ. In the wake of the Raich decision, the Attorneys General of California, Hawaii, Oregon, and Colorado all issued legal opinions or statements reaffirming their state's medical cannabis laws.[12] The duty of state and local law enforcement is to the enforcement and implementation of state, not federal, law.

California Law and Federal Interference

In 1996, the voters of California adopted Proposition 215, the Compassionate Use Act (CUA), legalizing the medical use of cannabis with a doctor's approval.[13] Since then, the twelve additional states that have passed medical cannabis laws were established despite, and arguably because of, a federal policy that refutes the medical efficacy of cannabis.[14] The current federal position is that "marijuana has no currently accepted medical use in treatment in the United States,"[15] which ignores well established and growing scientific evidence of medical efficacy.[16]

For years, the Bush Administration attempted to undermine California's medical cannabis law by using the Justice Department and the Drug Enforcement Administration (DEA) to raid, arrest and prosecute people who were otherwise in compliance with state law.[17]As a result, thousands of people have been unnecessarily and adversely impacted by the actions of the Bush Administration.

From the passage of the CUA in 1996, both the Clinton and Bush Administrations ignored the recommendation of California voters "To encourage the federal and state governments to implement a plan to provide for the safe and affordable distribution of marijuana to all patients in medical need of marijuana."[18] However, in an effort to provide safe access for thousands of California patients who cannot cultivate medical cannabis themselves, a distribution model was successfully developed. Collectively and cooperatively run medical cannabis "dispensaries" began to form and take root as a viable method of distribution.[19]

After the California legislature passed the Medical Marijuana Program Act (SB 420) in 2003, clarifying the right of patients and their primary caregivers to collectively or cooperatively cultivate, several cities adopted ordinances regulating the dispensation of medical cannabis.[20] Then, in 2005, California's appellate court ruled in People v. Urziceanu that as long as patients' associations operated collectively or cooperatively they should be protected under state law.[21]

Also in 2005, the State of California established a policy of taxing the sale of medical cannabis at storefront collectives.[22] In a decision made that year by the Board of Equalization, collectives were required to obtain seller's permits and remit sales tax revenue to the state. This revenue, which was estimated to total $100 million in 2007, goes to the state's general budget and is a significant funding source for a cash-strapped state such as California.[23]

In August 2008, further legitimizing storefront medical cannabis collectives, the California Attorney General issued guidelines acknowledging their legality and providing recommendations for complying with state law.[24] Some of the Attorney General recommendations included: a) collective or cooperative operation; b) non-profit operation; c) membership application and patient/caregiver verification; d) payment of sales tax to the state; and e) prohibition of sales to non-members.

During the implementation of medical cannabis laws in California and the development of safer methods of access for patients, state courts issued several landmark rulings. Appellate court decisions in City of Garden Grove v. Superior Court[25] and County of San Diego v. San Diego NORML[26] found that California's medical cannabis law held up to scrutiny and, most importantly, that it was not preempted by federal law. Both decisions underscored the obligation of local officials to uphold state law and that "it is not the job of the local police to enforce the federal drug laws."[27] Given refusals by the California Supreme Court and the U.S. Supreme Court to review these cases, they were made binding across the state.

Most recently, the Third District Court of Appeal for California ruled in Butte County v. Williams that patients and their primary caregivers have a right to associate collectively and cooperatively and can file suit if that right is violated.[28] Another case, Qualified Patients Association v. City of Anaheim, which is currently pending before the Fourth District Court of Appeal, addresses whether it is lawful for local governments to establish outright bans on collectives.

Now, with better definition around California's medical cannabis laws and an obligation by local officials to uphold state law, advocates are looking to harmonize federal law with the laws of states like California. As the Bush Administration's attempts to undermine California's medical cannabis law recedes into historical obsolescence, patients and advocates alike are hopeful that a new policy will be developed and implemented under the Obama Administration. Senator Obama made repeated public statements during his presidential election campaign that he was "not going to be using Justice Department resources to try to circumvent state laws on this issue."[29] Since taking office, President Obama and his Administration have continued to make declarative statements signaling a new federal policy regarding medical cannabis.[30]

Risk of Federal Interference Still Remains

Although the Obama Administration has indicated a willingness to change federal medical cannabis policy, patients, providers and advocates are cautiously optimistic. Reasons for such caution include years of DEA raids and Justice Department prosecutions that have resulted in harsh penalties for people complying with state law. Despite repeated statements by the new Administration, more than a half-dozen DEA raids have occurred since President Obama took office.

While many believe that the DEA raids under the Obama Administration are the result of Bush Administration holdovers, the risk of federal interference still remains. The U.S. Attorney General has made public statements, which still reserve the right to enforce federal law against those medical cannabis providers that violate both federal and state law.[31] Such statements offer significant consolation to collective and cooperative operators who comply with state law. However, according to advocates and legal experts, Justice Department officials have misinterpreted state law issues in several pending federal cases.[32] Such misinterpretations have left medical cannabis providers wary of how the federal government may enforce the law and rightfully concerned about future DEA actions.

Chapter 2: Medical Cannabis Collectives and Cooperatives

What Are Medical Cannabis Dispensing Collectives and Why Are They Needed?

A majority of medical cannabis patients are not able to cultivate medicine themselves and cannot find a caregiver to grow it for them. Most of California's estimated 300,000 patients obtain their medicine from Medical Cannabis Dispensing Collectives or Cooperatives (MCDC), sometimes referred to as "dispensaries." MCDCs are typically storefront facilities that provide medical cannabis grown by their legally qualified members to other patient-members in need.[33] MCDCs do not obtain cannabis from the illicit market, nor do they provide it to anyone who is not a member.

There are currently hundreds of storefront MCDCs operating in California with closed memberships allowing only qualified patients and primary caregivers to obtain cannabis and only after memberships are approved (upon verification of patient documentation). Some facilities offer on-site consumption, providing a safe and comfortable place where patients can medicate. An increasing number offer additional services for their patient membership, including massage, acupuncture, legal trainings, free meals, and counseling. MCDCs also provide important social benefits for patients according to research published by the University of California at Berkeley.[34]

Medical Cannabis Dispensing Collectives Are Legal

The California legislature adopted Senate Bill 420 (SB 420) in 2004, which expressly states that Qualified Patients and Primary Caregivers may associate collectively or cooperatively to cultivate cannabis for medical purposes.[35] The courts have interpreted this statute to mean that Medical Cannabis Dispensing Collectives and Cooperatives (MCDC), where patients may buy their medicine, are legal entities under state law. California's Third District Court of Appeal affirmed the legality of collectives and cooperatives in 2005 in the case of People v. Urziceanu, which held that SB 420, otherwise known as the Medical Marijuana Program Act (MMPA), provides MCDCs a defense to cannabis distribution charges. Drawing from the voter's directive in Proposition 215 to implement a plan for the safe and affordable distribution of medical cannabis, the court found that the MMPA and its legalization of MCDCs represented the state government's initial response to this mandate.[36]

In August of 2008, the California Attorney General published "Guidelines for the Security and Non-Diversion of Marijuana Grown for Medical Use" designed to help clarify the laws surrounding medical cannabis. These guidelines make it clear that patients' associations authorized under California Health and Safety Code 11362.775 are legal, and as such, are not subject legal sanctions for possession with intent to sell or sales of cannabis under Sections 11359 and 11360, respectively. Part of the function of a patients' association is to allocate the costs and benefits of the collective cultivation effort, and in this context, buying and selling cannabis within the membership of the MCDC is legal.

Section IV(C)(1) of the Attorney General's guidelines specifically recognize that legal collectives and cooperatives may maintain storefronts to provide medicine to members:

"Although medical marijuana 'dispensaries' have been operating in California for years, dispensaries, as such, are not recognized under the law. As noted above, the only recognized group entities are cooperatives and collectives. (Section 11362.775). It is the opinion of this Office that a properly organized and operated collective or cooperative that dispenses medical marijuana through a storefront may be lawful under California law [emphasis added], but that dispensaries that do not substantially comply with the guidelines set forth in Section IV(A) and (B), above, are likely operating outside the protections of Proposition 215 and MMP, and that individuals operating such entities may be subject to arrest and criminal prosecution under California law. For example, dispensaries that merely require patients to complete a form summarily designating the business owner as their primary caregiver - and then offering marijuana in exchange for cash 'donations' - are likely unlawful."

It is unreasonable to arbitrarily label all of the storefront MCDCs operating in Los Angeles with the Attorney General's term "dispensaries," while ignoring the clear fact that the state's highest ranking law enforcement official specifically concedes that lawful collectives and cooperatives may maintain storefronts.

What People v. Mentch Means for Medical Cannabis Dispensing Collectives

Lobbyists representing law enforcement interests and some medical cannabis opponents wrongly assert that the 2009 California Supreme Court decision in People v. Mentchmakes Medical Cannabis Dispensing Collectives and Cooperatives (MCDC) illegal.[37]This is a clear misreading of the decision, and in some cases, the argument may be propagated to intentionally confuse the issue of legal access under California law. While it is true that the Mentch decision upholds a narrow definition of the term "Primary Caregiver" in Proposition 215, the ruling only concerns an individual's claim to be a Primary Caregiver under state law; it does not address the legality of patients. collectives and cooperatives. The Lungren v. Peron decision from 1997 already stated that MCDCs could not be caregivers.[38] So, applying Mentch to MCDCs, including those that maintain storefront facilities in Los Angeles, is misguided and not legally valid.

Medical Cannabis Dispensing Collective Regulations

There are more than three-dozen cities and counties in California that have adopted local laws regulating the operation of Medical Cannabis Dispensing Collectives and Cooperatives (MCDC).[39] The City of Los Angeles is among many additional cities that are currently deliberating how to implement such laws in their own jurisdictions. Americans for Safe Access (ASA) provides legal and political support for local governments in arriving at the most sensible regulations that will meet the needs of patients and address issues raised by local residents and neighborhood businesses.

Given the number of MCDCs around the state, there is ample evidence that regulations have benefited patients and members of the community alike.[40] Regulated MCDCs benefit the community by: a) providing access to medical cannabis for our most vulnerable citizens - the sick and injured; b) offering a safer environment for patients than having to obtain their medicine on the illicit market; c) improving the health of patients through a social support network; and d) helping patients with other social services, such as food and housing. Creating MCDC regulations combats crime because: a) security has been shown to reduce crime in the vicinity; b) street sales of cannabis tend to decrease; and c) patients and operators are vigilant in reporting any criminal activity to police. Because of successful regulations, MCDCs are helping revitalize neighborhoods that bring new customers to neighboring businesses and have generally not been a source of community complaints.

Medical Cannabis Dispensing Collectives Reduce Crime and Improve Public Safety

One of the main concerns of residents and community groups about Medical Cannabis Dispensing Collectives and Cooperatives (MCDC) is the perception that criminal activity is more likely to occur in their vicinity. In fact, evidence shows that collectives help to reduce crime and improve public safety. Crime statistics and the accounts of local officials surveyed by Americans for Safe Access indicate that crime is actually reduced by the presence of an MCDC.[41] In addition, complaints from citizens and surrounding businesses are either negligible or are significantly reduced with the implementation of local regulations. After adopting a ordinance regulating MCDCs in 2006, the Kern County Sheriff noted in his staff report that "regulatory oversight at the local levels helps prevent crime directly and indirectly related to illegal operations occurring under the pretense and protection of state laws authorizing Medical Marijuana Dispensaries." In the year after the Kern regulations took effect, the sheriff specifically pointed out that existing MCDCs have not caused noticeable secondary effects or problems for law enforcement.

The presence of a storefront MCDC in the neighborhood can actually improve public safety and reduce crime. Most MCDCs take security for their members and staff more seriously than other businesses. Security cameras are often used both inside and outside the premises, and security guards are often employed to ensure safety. Both cameras and security staff serve as a general deterrent to criminal activity and other problems on the street. Those likely to engage in such activities will tend to move to a less-monitored area, thereby ensuring a safe environment not only for collective or cooperative members and staff but also for neighbors and businesses in the surrounding area. Residents in areas surrounding MCDCs have reported to Americans for Safe Access marked improvements to the neighborhood. Oakland City Administrator Barbara Killey, who oversees that city's regulatory ordinance, noted, "The areas around the collectives may be some of the most safest areas of Oakland now because of the level of security, surveillance, etc. since the ordinance passed." Likewise, Santa Rosa Mayor Jane Bender noted that since the city passed its ordinance, there appears to be "a decrease in criminal activity. There certainly has been a decrease in complaints. The city attorney says there have been no complaints either from citizens nor from neighboring businesses."

Those MCDCs that go through the permitting process or otherwise comply with local ordinances tend, by their very nature, to be those most interested in meeting community standards and being good neighbors. Cities enacting ordinances for the operation of collectives may even require security measures, but it is a matter of good business practice for MCDC operators since it is in their own best interest. Many local officials surveyed by Americans for Safe Access said collectives operating in their communities have presented no problems, or what problems there may have been significantly diminished once an ordinance or other regulation was instituted. Former Santa Cruz Mayor Mike Rotkin said his city's collectives get cooperation from the local police because they "well run and well regulated and located in an area acceptable to the City. Because they are under strict city regulation, there is less likelihood of theft or violence and less opposition from angry neighbors. It is no longer a controversial issue in our city."

Chapter 3: Regulating Safe Access in Los Angeles

Medicinal Cannabis Dispensing Collectives in Los Angeles

The first medical cannabis association in Los Angeles started providing medicine to patients suffering from cancer and HIV/AIDS in Venice in 1995, before voters approved Proposition 215. That facility was closed by the Los Angeles County Sheriff's Department, and subsequently relocated to West Hollywood. The Los Angeles Cannabis Resource Center operated with the city's blessing until 2001, when Drug Enforcement Administration (DEA) agents raided and permanently closed the organization.

Medical Cannabis Dispensing Collectives or Cooperatives (MCDC) began to reopen in West Hollywood and Los Angeles in 2004. The City of West Hollywood moved quickly to establish a moratorium on new MCDCs in 2005, and then to adopt an ordinance regulating their operation.

The first MCDC in Los Angeles opened on Wilshire Blvd. in 2004, and was raided and closed by the Los Angeles Police Department in 2005. This early police action did not stop other MCDCs from opening it the city. MCDCs found it easy to open in Los Angeles because the municipal code only required operators to obtain a Tax Registration Certificate. MCDCs were not anticipated by the code, and there was no requirement for a business license or permit, or any mechanism to track the establishment of new MCDCs.

Los Angeles City Councilmember Dennis Zine made a motion to study regulations for MCDCs in 2005, after the number of facilities in the city began to rise. The proliferation of new MCDCs continued until September 2007, when the City Council adopted an Interim Control Ordinance (ICO) establishing a moratorium on new facilities until permanent regulations could be developed and adopted. After a brief pause, however, new facilities began to open again in Los Angeles using a loophole in the ICO, which has now been removed.

One hundred and eighty-six collectives registered with the City Clerk's office under the terms of the ICO. Theses facilities provided documentation establishing that they were operating legally before the effective date of the moratorium. Since that time, some of these facilities have been forced to relocate as a result of Drug Enforcement Administration (DEA) interference and intimidation in the form of paramilitary-style raids or letters threatening property owners who rent to facilities with prosecution and civil asset forfeiture. Patients' associations that registered under the ICO and subsequently relocated filed hardship applications for their new locations with the City Clerk's office.

The Hardship Exemption for Los Angeles Collectives

Today, approximately one hundred and thirty Medical Cannabis Dispensing Collectives (MCDC) operate at the same address at which they registered with the City Clerk's office before the 2007 Interim Control Ordinance (ICO) established a moratorium on new facilities. As a result of the threatening DEA letters sent to landlords, many MCDCs were forced to close or move. In order to ensure that those MCDCs forced to move would still be legitimate in the eyes of the city, advocates supported the former City Attorney's inclusion of a Hardship Exemption in the ICO. Even though the number of Hardship Exemption Applications pending with the city continued to grow at a steady pace, the PLUM Committee failed to begin reviewing any of them until 2009.

A flaw in the Hardship Exemption enabled collectives that had not registered with the City Clerk's office before the effective date of the ICO to file for the exemption. Having noticed the flaw, hundreds of applicants used the loophole to open new storefront collectives in the city. By the summer of 2009, the number of pending Hardship Applications had surpassed 500. In an attempt stem the tide of a steadily increasing number of MCDCs, City Councilmember Jose Huizar moved to close the loophole in the ordinance.[42] Just the threat of closing the loophole caused the number of collectives in Los Angeles to increase even further. To this date, hundreds of Hardship Exemption Applications remain pending with the PLUM Committee.

The medical cannabis collectives that complied with the ICO by registering their operations with the city, but were later forced to move due to DEA interference, should promptly be given a thorough and objective evaluation before the PLUM Committee. In reviewing the Hardship Exemptions for these collectives, the PLUM Committee should consider fidelity and compliance in making a recommendation on their applications. In addition, because the city allows for transfers of ownership during the ICO, the PLUM Committee should also properly review which collectives have been sold or otherwise transferred and why. Some applicants that were denied Hardship Exemptions are threatening lawsuits. And, though the merit of such litigation remains unclear, it is important to quickly resolve the Hardship Applications in order to mitigate actions like these and avoid further delay in adopting a permanent regulatory ordinance.

City Attorney's Ordinance Fails to Address the Los Angeles City Council's Request

In 2008, the Planning Department convened a working group with representatives from the patient community and city staff to make recommendations on permanent regulations. This working group based its discussions on the existing medical cannabis ordinance adopted by the Los Angeles County Board of Supervisors in 2006.[43] City staff terminated the working group meetings in November 2007, saying they had enough input to move forward.

In April of 2008, the Los Angeles City Attorney published an initial draft ordinance for consideration in the Planning and Land Use Management Committee (PLUM).[44] The draft ordinance was so restrictive that it essentially outlawed the model of storefront Medical Cannabis Dispensing Collectives (MCDC) already operating lawfully in the city. Patients and advocates who served on the Medical Marijuana Working Group, along with other community members, joined City Councilmember Dennis Zine in rejecting the City Attorney's draft and calling on the committee to request a new ordinance based on the existing Los Angeles County model and the working group's input.

In February of 2009, then City Attorney Rocky DelGadillo published a draft ordinance for the City Council's review. Like past versions, this draft failed to address the outline and direction given by City Council. Rather, basic misinterpretations and blatant disregard of input provided by community members led to a draft ordinance that failed to comprehend the reality of the medicinal cannabis community.

In a response to a letter from Councilmember Zine in November 2008, former City Attorney Rocky DelGadillo equated all of the storefront facilities, including those that registered under and complied with the ICO, to that of Attorney General Brown's definition of an illegal "dispensary." While a small fraction of "dispensaries" may run astray of the Attorney General's guidelines the majority operates within the closed circuit, patient organized collective as described and recognized as legal by the California Attorney General.

Provisions for the regulatory process described in the February 2009 draft unnecessarily burdens the overworked city staff by requiring that each collective provide the name, address and other membership information to the City. Providing this personal information would only create more paperwork and time consumed by city staff. Furthermore the February draft requires that each patient cultivator be identified. This presents challenges in patient confidentiality and self-incrimination. It is not wise for collectives to openly identify the patient cultivators given that the LAPD has a history of working in conjunction with the Drug Enforcement Administration (DEA).

Prohibitions on items such as edibles that are discussed in the February 2009 draft are illogical and unreasonable. Edible products are the primary source of non-smoked cannabis for many patients who either cannot or will not intake smoked cannabis. Edible cannabis preparations are a safe way to ingest cannabis.

Furthermore, the regulations failed to address issues such as diversion of medication, ways to reduce neighborhood impact and most importantly member screening. The February 2009 draft ordinance was yet another attempt by the former City Attorney to stall the process of permanent regulations being adopted. Unfortunately, the City Attorney refused to change the poorly drafted ordinance and the City Council was forced to wait until a new City Attorney took office in 2009.

Recommendations for Regulating Collectives in the City of Los Angeles

Because of the failure by the former City Attorney's office to develop a draft ordinance that meets the needs of both patients and communities, advocates are urging several improvements to the new draft ordinance. Furthermore, patients and advocates support the Interim Control Ordinance (ICO), but have a strong desire to complete the development of regulations for Medical Cannabis Dispensing Collectives in the City of Los Angeles in the near future. In order to avoid further confusion, costly litigation, and delayed implementation, patients and advocates oppose any further extension of the ICO, and recommend completing the permanent regulations as soon as possible.

The areas of focus for recommended changes to the draft ordinance include, safety and operational protocols, verification of not-for-profit status, security requirements, confidentiality of membership records, and location requirements:

1. Adopt safety and operational protocols already in use at MCDCs in Los Angeles.

Local patients' associations in the Greater Los Angeles Collectives Alliance (GLACA) have already adopted effective safety and operational protocols that should be included in the permanent regulations wherever possible. Protocols that guard against diversion of cannabis to non-patients, ensure proper verification of qualified patients, establish a limit on the amount of cannabis dispensed to each patient, and encourage "good neighbor" policies have well served patients, providers and members of the community. A copy of the GLACA safety and operational protocols is included in the Appendix of this report.

2. Verify that MCDCs operate in a not-for-profit manner.

The Medical Marijuana Program Act (SB 420) and the California Attorney General guidelines indicate that patients. associations must operate in a not-for-profit capacity. As such, the city should require proof that MCDCs are incorporated as statutory cooperatives or bona fide nonprofit corporations; or that they are operated in a not-for-profit manner. Operation in a not-for-profit manner might include reinvesting excess revenue in services for members or patient advocacy, or supporting other beneficial community activity.

3. Require MCDCs to maintain an appropriate level of security.

In order to abate criminal activity in the vicinity of licensed MCDCs, the city should require staff training on security, the employment of professional security personnel, as well as the use of adequate video cameras and alarms. While input by Los Angeles Police Department (LAPD) on the MCDC Security Plan is warranted, requiring LAPD approval may be problematic. LAPD still regards all collectives or cooperatives, no matter how organized or operated pursuant to state law, as illegal. There must be objective standards set, which can be verified by LAPD without a requirement for subjective evaluations.

4. Keep MCDC membership records confidential, including information about those patients who grow cannabis.

Because medical cannabis remains illegal under federal law, there is still considerable risk to divulging personal information about MCDC members and patient-cultivators. Member patient information is susceptible to federal subpoena and access to this information is tantamount to self-incrimination. In addition, there are requirements under the Health Information Portability and Accountability Act (HIPPA) of 1996 that may prevent local and federal officials from legally obtaining certain patient information. As such, membership information should be kept confidential and proprietary.

Each member of a legally organized and operated MCDC is entitled to bring medicine to the associations. storefront facility (or other location) for provision to other members without sufficient amounts of medicine. In this regard, every collective member is a potential cultivator. Requiring disclosure of individual patient-cultivators does not recognize the state of California law, not does it anticipate legal operation. This misguided approach assumes that MCDCs acquire medicine from the illicit market, and seeks to deter, investigate, and prosecute legal medical cannabis patients whose conduct is appropriate under state law.

5. Make MCDC locations requirements reasonable by avoiding large buffer zones around an arbitrary list of "sensitive uses."

Well-operated and regulated storefront MCDCs are good and inconspicuous neighbors, and as such need not be forced to comply with onerous location requirements. Requiring a large buffer zone from a laundry list of arbitrary "sensitive uses" will unintentionally prohibit MCDCs by making legal sites impossible to find. This will have an adverse impact on the safety and wellbeing of legal patients, who rely on these facilities for safe access to medication. This de facto ban on storefronts run contrary to the will of voters in Los Angeles and the instructions of the Los Angeles City Council.

Regulated MCDCs belong in commercial and retail zones, just like pharmacies and other health care businesses. Restrictions on these facilities should be at least more lenient than the location regulations required of the city's adult-oriented businesses, which must be located more than 500 feet from schools, churches, and parks.[45] While larger buffer zones between MCDCs may be appropriate to prevent clustering in certain neighborhoods, other location requirements should be reasonable and, when warranted, flexible.

Conclusion

It has now been established through legislation and litigation, as well as through guidelines issued by the California Attorney General that Medical Cannabis Dispensing Collectives and Cooperatives (MCDC) are legal under state law. There is also plenty of evidence that MCDCs do not attract crime, but instead decrease crime in surrounding areas and are a benefit to community members and neighboring businesses.

While most patients' associations in the City of Los Angeles have done their best to comply with local requirements, the proliferation of MCDCs has been a source of concern. The evolution in the development of a regulatory ordinance for MCDCs in Los Angeles has brought city officials closer to an ordinance satisfactory to all involved. However, further prompt deliberation is still necessary to complete this effort. Patients and advocates are urging the city to finalize a draft ordinance as soon as possible, and to avoid any additional extension of the ICO.

Fortunately, there are plenty of experienced advocates assisting the city in this effort and their recommendations should guide the city in developing the next draft ordinance. Furthermore, the city should incorporate the suggested language defining safety and operational protocols, verification of non-for-profit status, security requirements, confidentiality of membership records, and location requirements. By choosing to incorporate the recommendations of advocates, the city can keep to a minimum future problems related to regulating MCDCs in Los Angeles.

Thursday, September 10, 2009

ASA Guide to Using Cannabis Medicines

Using Marijuana

Smoking

Smoking marijuana produces the most immediate effects and permits the most refined control of your dosage. Smoking any material is not good for the lungs, but the amount of marijuana you need to smoke is so small that you need not be overly concerned. It is better to smoke the flowers rather than the leaves as this also reduces the amount you will need to smoke.

Vaporizing

Cannabis vaporizers are designed to let users inhale active cannabinoids while avoiding harmful smoke toxins. They do so by heating cannabis to a temperature that is just below the point of combustion where smoke is produced. At this point, THC and other medically active cannabinoids are emitted with little or none of the carcinogenic tars and noxious gases found in smoke. Many medical marijuana patients who find smoked marijuana highly irritating report effective relief inhaling through vaporizers. Also, vaporizers are very efficient so they can save money in the long term.

Eating

Marijuana can be eaten. When consumed this way, it is usually baked in brownies or cookies, and sometimes made into a candy. It takes longer to feel the effects when eaten, and may take longer for you to learn to control your dosage. However, when you do feel the effects, they may be stronger than those felt by smoking. You may also feel a certain heaviness in your body. This will not hurt you. Schedule your time so that you can relax when you take it.

Tea

Like other herbs, marijuana may be made into a tea. Boil the water first and pour it over the marijuana. Let it steep for longer than you would for common black tea; approximately an hour and a half. Add 1 teaspoon of butter. The effects are similar to eating it.

Tincture

To prepare a tincture, use 5 parts fresh marijuana to 1 part vodka. If you are using dried marijuana, as is usually the case, use 10 parts marijuana to 1 part vodka. An easy way to do this if you don’t have measuring equipment, is to fill whatever container you are using (glass is preferable as you don’t want to leech any residues from metal containers) to thirds full with marijuana, then fill the container with vodka and let stand for a week or more. Afterward, strain the solution. If you use a larger portion of marijuana, the resulting tincture will be more potent.

Compress

Follow the recipe as for tea. Make as much as you need to thoroughly soak the cloth you intend to use. Apply to pain and leave on ½ hour.

Marinol

Marinol is a synthetic petrochemical analog of THC, one of the active elements found in marijuana. Some patients find that it helps relieve nausea yet takes a long time to work. Do not smoke this product. It has the potential for overdose. Use only under the supervision of a doctor.

Side Effects

Marijuana is one of the safest medicines: it is impossible to consume enough to produce a toxic effect in the body. However, if you are unfamiliar with it, there are some effects which you should be aware of so that you can use it more effectively.

Uneasiness

Marijuana usually has a soothing and comforting effect on the mind. Sometimes, however, people do experience feelings of anxiety. If this happens to you, there are several things you can do. Try to stay in environments where you feel naturally comfortable. If you feel anxious, sit or lay down, breathe deeply, and relax. If you have loved ones with you, hold each other for a while. If you have a pet, hold or stroke it. Eating will often quickly reduce the feeling of anxiety. Then, the next time you use it, try reducing your dosage. Because of our social training, you may have feelings of guilt. Know that you have a right to your medicine.

Hunger & Thirst

Many patients use marijuana to stimulate appetite. If you are not using marijuana for this purpose, drink water or juice. If you wish to eat, eat good nourishing food rather than sweets.

Redness in the Eyes

This will not hurt you. If you must go out in public and are concerned about others’ reaction to the redness, wear sunglasses or use eye drops.

Drowsiness

If marijuana makes you sleepy, take a nap if you can and wish to. As with all medicines that can produce drowsiness, don’t drive or operate heavy machinery.

Sleeplessness

If you find that you can’t sleep for a while after using marijuana, try reducing your dosage and avoid using it for about two hours or so before you want to sleep.

Short-term Memory Loss

Sometimes people find it difficult to carry on a complicated conversation, keep track of details, or perform complex tasks. If this happens to you, schedule your time so that you don’t have to do these things when using your medicine.

Giddiness

Many people find that things which normally don’t seem funny become quite amusing when they use marijuana. Most people enjoy this effect. If you must deal with situations where humor would be inappropriate in your judgement, schedule your time so that you don’t have to deal with them when you are taking your medicine.