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HomeMy WebLinkAbout2006-03-29 PUBLIC COMMENTS `:?it F...i 20u[1 OFFICE -HE C'T , CLUJ.. CITY OF OAKLANDMj,"•, 311 i'i�i AGENDA REPORT TO: Office of the City Administrator ATTN: Ms. Deborah Edgerly FROM: Office of the City Administrator, Special Activity Unit DATE: April 12, 2005 RE: Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries SUMMARY This report provides information regarding the operation of Oakland's permitted medical marijuana dispensaries during their first seven months of operation, June through December, 2004. The purposes of the report are to 1) evaluate whether the current dispensaries adequately serve the needs of Oakland patients, 2)provide an update on the issue of onsite consumption, 3)present an overview of Berkeley's Peer Review Process, and 4) compare the permitting fees paid to the costs of implementation and oversight. The report summarizes data submitted by the dispensaries and the patient ID card supplier regarding the numbers of patients served. It also provides feedback from City departments, medical providers and non-profit organizations that work with constituencies that are eligible to use medical marijuana. FISCAL IMPACTS As this is an informational report, there are no fiscal impacts. BACKGROUND On November 5, 1996 California voters passed Proposition 215, the Compassionate Use Act of 1996. SB420 codified and clarified the scope of the Compassionate Use Act and authorized cities to adopt laws consistent with it. On February 3, 2004, the Oakland City Council unanimously passed an ordinance that added Chapter 5.80 to the Oakland Municipal Code(OMC). Chapter 5.80 legislates a business permitting process, regulations, and regulatory fees for the establishment and monitoring of up to four(4) medical marijuana dispensaries in the City of Oakland. (OMC section 5.80.020.) The Administrative Hearing Officer of the City Administrator's Office accepted applications, conducted public hearings, and approved four applications to receive Item: Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Page 2 permits. The permits were effective June 6, 2004 for three of the dispensaries. The fourth was permitted effective December 6,2004, as its approved facility was occupied by the Democratic Party through the November,2004 elections. DISPENSARY ADDRESS PERMIT DATE C.A.R.E. 1900 Telegraph Ave. 6/6/04 SR71 Coffeeshop 377 17t' St. 616/044 OCRCr 578 W.Grand 6/6/04 Compassionate Caregivers 2135 Broadway 12/6/04 KEY ISSUES AND IMPACTS 1. Capacity of the four permitted dispensaries to serve the needs of Oakland residents On January 20, 2005, this office mailed each of the dispensaries a letter requesting the following information: l. Days and hours of operation 2. Number of patient/caregiver visits to the dispensary by month for the period of June through December 2004 3. Within that number, the number of Oakland residents,by month 4. How many visits each month are new patient/caregivers and how many are existing patient/caregivers? 5. Any patient/caregiver reports the dispensary has received regarding; a. Accessibility/need for wider geographical distribution of dispensaries b. Excessive wait time at the dispensary or other dispensaries c. Over-crowding at the dispensary or other dispensaries d. Need for expanded hours of operation e. Availability of product at the dispensary or other dispensaries 6. Any additional information that would be useful to the analysis Additionally, Oakland's designated patient identification card supplier, the Oakland Cannabis Buyer's Cooperative(OCBQ, was queried as to the following: l. Days and hours of operation 2. Number of patients and caregivers issued cards by month for the period of ,tune through December 2004 3. Within that number,the number of Oakland residents, by month 4. Breakdown of patients by"serious medical condition'category, as defined by Oakland Municipal Code Section 5.08.010D California Advocate Relief Exchange z Oakland Compassionate Resource Center Item: Public Safety Committee April 12,2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Pace 3 5. Any patient/caregiver reports received regarding; a. Accessibility/need for wider geographical distribution of dispensaries b. Excessive wait time at dispensaries c. Over-crowding at dispensaries d. Need for expanded hours of operation c. Availability of product at dispensaries 6. Any additional information that would be useful to the analysis Dispensary Statistics On January 28, 2005, dispensary representatives and OCBC met with City staff to submit their responses to the January 20 queries and to discuss other issues of concern. The following summarizes the dispensaries' submitted responses: 1. Days and Hours of Operation OMC Section 5.80.030 authorizes dispensaries to operate between the hours of 7 a.m. and 8 p.m. None of the dispensaries open at 7 a.m. Two operate from 8 a.m. to 8 p.m, seven days a week. A third is open from 9 a.m. to 7:30 p.m. Monday through Saturday and 10 a.m. to 5:00 p.m. Sunday. The fourth is open 9 a.m. to 8 p.m. Monday through Friday and 10 a.m. to 8 p.m. weekends. 2. Number of patient/caregiver visits by month Three dispensaries provided exact counts for each month. SR71 Coffeeshop responded "approximately 8000 visits per month". Based upon their responses, the cannabis dispensaries serviced a substantial and relatively consistent number of patient visits during 2004. Although some of the dispensaries limit patients to one visit per day, it is not known what percentage of these numbers reflect multiple visits by the same patients durin an month. June July Au usl September October November December 12,817 1 12,578 J 12,476 12,550 121084 12,133 1 13,985 3. Number of visits by Oakland residents per month None of the dispensaries was able to provide this information. Prior to receiving the January 20,2005 letter, the dispensaries had been told,through their Conditions of Approval, to maintain only total counts of patients and caregivers and weekly or monthly visit counts. The regulations attached to their permit also specify maintain records of all patients and their primary caregivers using only the identification card number. The dispensaries agreed that they would maintain the additional information in the future. ' Compassionate Caregivers commenced operation December 15,2004, Item: Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Page 4 4. Number of visits per month by new versus existing patients The dispensary that reported"approximately 8000 visits per month"did not separate new and existing patient visits and is therefore, not included in this chart. Totals for the other three indicate that they continue to add new patients while R it their existin atient bases. .tune Iul� Aug. Se t. Oct.1723 1032 753 845 543 4)3 702 1156 2477 3130 13548 13534 3874 5784 5. Capacity Related Feedback None of the permitted dispensaries has received complaints about excessive wait limes or overcrowding. One Oakland dispensary owner, however, noted"word of mouth" reports that patients were traveling to other cities due to excessive wait time in Oakland. One Oakland dispensary owner believes that more geographical distribution of dispensaries is needed to accommodate the large volume of patients and caregivers who are not Oakland residents and must travel long distances to reach the center of Oakland. Two of the owners report that some of their patients work later than the dispensaries are allowed to be open. One of these owners submitted a petition containing 372 names requesting later hours. The reasons given by most who signed the petition were working late, convenience, and traveling from distant places such as Yosemite, Salinas, Sacramento,and Riverside. Representatives from C.A.R.E., SR71 Coffeeshop, OCRC, and OCBC who met with City staff on January 28, 2005, voiced their general support for more dispensaries on the grounds that 1) more dispensaries mean more variety of product and better price competitiveness, 2) more dispensaries would allow for more diverse ethnic representation among dispensary operators and better geographic coverage, 3) since patients shop where they buy their medication, Oakland gains economic benefit from the existence of the dispensaries, 4) more dispensaries could be a good thing if they were controlled, as the existing four are controlled. The dispensaries' remaining responses are discussed below under"Concerns of the Cannabis Dispensary Owners." Item: Public Safety Committee April 12, 2005 I Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Pour Permitted Medical Marijuana Dispensaries Pase 5 Identification Card Supplier Statistics 1. Days and Hours of Operation OCBC issues ID cards Monday through Friday from 10 a.m. to 5 p.m. and Saturday from 10 a.m. to 3 p.m. 2. Number of ID cards issued by month OCBC did not provide this information by month but reported that, during the period of June through December, 2004, OCBC issued 8016 new ID cards to patients and caregivers and 2,927 renewal ID cards for a total of 10,943. Of that total, 1,424 were issued to Oakland residents. (See chart below.) Although the focus of this report is the first seven months of permitted dispensary operation, OCBC also provided some operation-to- date statistics. As of March 9, 2005, OCBC had issued ID cards to 38,000 individuals since they began issuing cards in 1997. OCBC's cards must be renewed annually to remain active, and OCBC estimates there are between 10,000 and 15,000 currently active patients and caregivers_ Of that total,OCBC estimates that 2,000 active patients and caregivers are Oakland residents as of March 9, 2005. 3. Number of ID cards issued to Oakland residents by month June Jul Aug. Sept. Oct. Nov. Dec. Total Patients 177 191 172 208 175 175 233 1331 Care- 8 15 19 11 15 12 13 93 givers 1424 4. Breakdown of Patients by Serious Medical Condition OCBC did not report conditions by number of patients. OCBC reported the following as the ten most listed conditions for patient enrollment: Chronic Pain HIV/AIDS (wasting syndrome) Cancer Psychiatric Disorders (ie Depression, PTSD, Anxiety) Hepatitis B &C Glaucoma Multiple Sclerosis Arthritis/Osteoarthritis Paraplegi a/Quadriplegi a Migraines A spokesman for OCBC explained that it was very time consuming and difficult to gather the requested data,but that a computer system, currently being implemented,would provide it in the future. Item: Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Page 6 OCBC'S remaining responses are discussed below under"Concerns of the Cannabis Dispensary Owners." Other Feedback In addition to the dispensaries and the ID card supplier, this office queried City departments and outside organizations that were likely to have contact with the cannabis dispensary patient population. City departments and other organizations were asked whether they had received any complaints regarding lack of access, excessive wait titres, or any other problem that would indicate inadequate capacity of the cannabis dispensaries. I. Councilmemmber Nadel's office has received complaints from a Berkeley- based provider,Berkeley Patients Group, about being overwhelmed by Oakland patients. Several of this provider's patients also contacted Councilmember Nadel's office to express their desire to have a dispensary that is more accessible to their neighborhood. 2. Councilmember Brooks' office has received complaints from a prospective dispensary operator, Keith Stevenson, and from Debby Goldsbcrry of Berkeley Patients Group about lack of geographic accessibility. Both Mr. Stevenson and Ms. Goldsbcrry submitted applications for dispensary permits during Oakland's original permitting process and have continued to express interest in obtaining Oakland permits. They also provided input to this survey. Their concerns are discussed in items 8 and 9 below. 3. The other five (5) City Council offices have received no complaints or other concerns about the existing dispensaries. 4. The Oaklander's Assistance Office has not received complaints regarding lack of capacity. 5. The Medical Director of HIV Access at Alameda County Medical Center, Highland Hospital, has documented patient diagnosis for ID card purposes for at least fifty(50) low income Alameda County patients, most of whom reside in Oakland. That office had received no complaints about difficulty in obtaining medication from Oakland dispensaries or regarding the price of the medication. 6. The AIDS Project East Bay, reports receiving no complaints about long lines or inability to access medical cannabis from Oakland dispensaries. 7. The Medical Director of the East Bay AIDS Center, has received no reports from his patients regarding lack of access to cannabis. 8, Keith Stephenson, speaking as an African American, a medical marijuana patient, and a prospective dispensary operator, expressed that the Oakland Item: _ Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Page 7 patient community feels greatly underserved. He wrote that San Francisco has 700,000 residents and twenty-four cannabis dispensaries,San Leandro has 135,000 residents and six dispensaries,5 and Oakland has 400,000 residents and only 4 dispensaries. He opined that the shortage and central location of Oakland's dispensaries is forcing Oakland patients to dispensaries in neighboring cities. Mr. Stephnson believes a dispensary is needed in East Oakland. Mr. Stephenson is also concerned that there is no minority ownership of Oakland's permitted dispensaries. 9. Debbie Goldsberry,director of Berkeley Patients Group (BPG) wrote that prior to June, 2004, BPG registered approximately 20 Oakland residents per month. Since then BPG registers an average of 97 Oakland patients per month. Ms. Goldsberry states that 2226 Oakland patients are registered compared to 1226 Berkeley residents,and approximately 40 Oakland residents visit per day according to Ms. Goldsberry. She also reports that 40%of the low-income patients registered for free medicine and additional services are from Oakland. Prior to the issuance of Oakland's Fourth dispensary permit, Ms. Goldsberry applied to operate a cannabis dispensary at 2747 San Pablo Avenue. 2. On-site Consumption At the January 28, 2005 meeting, the dispensary representatives unanimously voiced that their greatest concern is the ban against on-site consumption, which they feel can lead to dangerous behavior, such as patients medicating in their cars on the way home. They are also concerned that they arc losing patients to Berkeley,Hayward, Alameda County, and other jurisdictions that do not have the prohibition. They are aware of the complications involving state and local smoking laws, but feel that there are alternatives such as vaporizers that could be allowed. According to the letter submitted by Debby Goldsberry, Berkeley Patients Group encourages patients to vaporize their medical cannabis, and"since these devices are cost prohibitive for at-home use, our facility has a well-ventilated area for patients to use their medicine most safely." The City of Berkeley has grandfathered its three existing dispensaries without a formal permitting process, and, for these three dispensaries, Berkeley has remained silent on the issue of on-site consumption. However, the Director of Berkeley's Health and Human Services Department relayed to Oakland City staff that Berkeley's Ballot Measure R would have permitted cannabis dispensaries as of right and 'The Planning Manager of the City of San Leandro clarified that the City of San Leandro,with a population ofjust under 80,000,has one medical matijuana grower and no dispensaries and that the City currently has a moratorium on both dispensaries and growers. County Supervisor Nate Miley's office confirmed that there are at least six dispensaries in the unincorporated area and that the County is currently in the process of developing an ordinance to deal with the.issue. Item: Public Safety Committee April 12, 2005 i Deborah Edgerly Office of the City Administrator,Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Pace 8 that its defeat by Berkeley's voters means that if any additional dispensaries are permitted, they will be required to obtain a conditional use permit under the City's existing zoning ordinance. The Medical Director of the East Bay AIDS Center spoke against on-site use, stating that patients leaving a facility in an altered state due to on-site consumption could create problems for the facility, the City, the patient, and the public. The Medical Director of HIV Access at Alameda County Medical Center, Highland Hospital, favors on site consumption utilizing supervised vaporizers, on the grounds that it avoids both the negative personal health issues associated with smoking and the potential public safety dangers involved when patients medicate in their cars. 3. City of Berkeley,s Peer Review Process Berkeley's Measure R, The Patients Access to Medical Cannabis Act of 2004,would have codified a peer review process through the establishment of a Peer Review Committee composed of no more than two spokespersons from each of the existing collectives and dispensaries. The duties of the Committee would have been to monitor the collectives and dispensaries for compliance with safety and operating standards, which were not defined by the ordinance. Additionally, the Committee would screen potential collectives and dispensaries to certify that the prospective facilities had a strategy for compliance with the standards. Measure R failed in the November 2004 election. Nevertheless, according to Berkeley staff, a peer committee has developed and provides oversight of Berkeley's three cannabis outlets. The peer committee establishes working relationships with the neighbors, deals with criminal activity, and develops standards for dispensary operations. The City of Berkeley is not involved with the peer committee and, according to Berkeley staff, the City has received no complaints about the three operating dispensaries. The City's position is a `one strike' policy. The dispensaries are on notice that they can be shut down for almost any negative behavior. For example, one of Berkley's original four dispensaries was closed due to a combination of problems, including several armed robberies that occurred on the premises and bad relations with the neighbors. 4. Permitting Fees Paid and Implementation/Oversight Costs The fee schedule established by OMC Chapter 5.80 was based upon the projected number of patients and caregivers and an amount not to exceed the actual cost of administration and implementation as follows: Number of Patients and Caregivers Annual Permit CQst_Not to Exceed 4 — 500 $ 5,000 Item: Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Pace 9 501 — 1000 $10,000 1001 - 1500 $I5,000 1501 + $20,000 The first three dispensaries were permitted at the$10,000 level. The fourth was permitted at the $20,000 level but the fee was prorated at$10,000 because the permit was issued for 6 months, so that its expiration dale would coincide with that of the other three. The City therefore collected $40,000 in permit fees. The cost of the time spent by City staff on permitting and monitoring the cannabis dispensaries is already well in excess of the first year fees paid by the dispensaries. The previous Administrative Hearing Officer developed the applications, processed eight applications and conducted at least sixteen public hearings prior to selecting the four dispensaries that ultimately received the permits. This consumed the majority of his time from March through May of 2004, The Zoning Department provided analyses of whether the dispensaries met the requirements for distance between each other and from sensitive uses such as schools, libraries, and parks. Additionally the Building Inspection Department and the Fire Department provided inspections for many more locations, as some applicants submitted multiple sites due to concerns about the distance requirements. Although all but one permit was issued prior to the current Administrative Hearing Officer assuming that role,dispensary issues continue to consume an average of one to two days per week- These issues include the permitting of the fourth dispensary, fielding tails and questions from the existing dispensaries, dispensary hopefuls,patients and citizens at large, reviewing data submitted by the dispensaries, and dealing with complaints. The Administrative Regulations of the Dispensary Permits specify that a Hearing Officer is responsible for hearing complaints about the Dispensaries. Staff has recently received several complaints regarding rude treatment of patients, collection of confidential medical data, and receipt of less product than purchased. Complaints that warrant hearings will consume additional staff time in amounts that are difficult to predict at this early stage. Title 5 of Oakland's Municipal Code controls permitting of medical cannabis dispensaries. A public heating is required to suspend or revoke any permit issued under this title. No fee is charged for the public hearing. The time required for dispensary oversight will increase dramatically as reporting and operating regulations are established. Currently, although authorized to audit the dispensaries, there are no regular reporting regulations in place to ensure that the dispensaries are complying with such basics as federal, state, and local tax and payroll Item: Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Page 10 requirements, that they are maintaining adequate liability and worker's compensation insurance, and that they are not"excessively profitable."6 The City has promulgated lew operating standards beyond those specified in the ordinance and the dispensaries have been left to develop their own. The recently received complaints raise concerns regarding self-regulation and signal the need for additional operating standards and regulations and perhaps an annual audit. Regular review of dispensary financial reports would be required to monitor the excessive profits provision of the ordinance. Physical monitoring of the dispensaries should also be done to ensure compliance with both the existing provisions of the OMC and any new regulations promulgated. Although the functions may not all reside in one person, the projected oversight responsibilities performed by the City would require at least one full time equivalent. Funding this would require doubling the dispensary permit Pecs. Concerns of the Cannabis Dispensary Operators Participants in the January 28, 2005 meeting also discussed topics that, although not directly related to the issue of capacity, could have a long term effect on the viability of the cannabis dispensaries. The dispensary operators believe that their first seven months ol'operation has proven that cannabis dispensaries can run without creating neighborhood problems when run by responsible operators and within reasonable regulations. As their businesses are not attracting nuisance activity,they would like to reduce the 1000 foot distance required between dispensaries. The cannabis dispensary operators unanimously voiced their appreciation to the City Council for the progressive, supportive stance the City Council has taken on the issue of medical marijuana. The dispensaries are proud of helping both Oakland residents and outsiders, and are appreciative of the City Council for permitting them to provide their services. They would like the Council members to be aware of the additional services they provide, such as clothing, meals, groceries, and charitable donations,and they issued an open invitation to Council members and their staffs to visit the dispensary facilities. The first paragraph of section 5.80.060 specifies that dispensaries"shall receive only compensation for actual expenses." The plain meaning of that sentence is that the dispensaries would operate in a not-for- profit mode. The second paragraph of section 5,80.060 states that"Retail sales of medical cannabis for Excessive Profits are explicitly prohibited." The permitted dispensaries that attended the January 28,2005 meeting all indicated that they were not functioning as not-for-profit businesses,but were established as profit-making businesses,pointing to the second paragraph of section 5.80.060 as the basis for a for-profit structure. Item: Public Safety Committee April 12, 2005 Deborah Edgerly Office of the City Administrator,Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Page I Finding 1. That the data provided by the City's four(4) cannabis dispensaries indicates that they are consistently serving a large population of patients. 2. That the two dispensaries that were able to provide data on now and existing patients showed a pattern of adding significant numbers of new patients, while maintaining their existing base. This pattern speaks to the dispensary's ability to absorb growth, as well as to patient satisfaction with the dispensaries. 3. That non-collection of residence data by dispensaries made it impossible to tell how many of the patients are Oakland residents. However, of the total ID cards issued by OCBC during the period of June through December, 2004, thirteen (13)percent were issued to Oakland residents. 4. That, with the exception of Councilmember Nadel's office and Councilmember Brooks' office, no City departments, outside organizations,or permitted dispensaries queried have received patient complaints related to the capacity of the dispensaries to effectively serve the patient community. 5. That, although the permitted dispensaries believe they are serving their patients effectively and efficiently, they are not adverse to permitting additional dispensaries, as long as the candidates are well screened and, after being permitted, operate responsibly. 6. That, some Oakland patients are being served by a Berkeley dispensary and others may be attending San Leandro-based dispensaries. 7. That, if the dispensaries' percentages of Oakland patients and patients from other cities matches that of the ID card supplier, thirteen (13)percent of the patients served by Oakland dispensaries are Oakland residents and eighty-seven (87)percent are from other jurisdictions. 8. That the justifications for adding dispensaries provided by survey participants do not involve capacity. Rather, they involve issues of improved geographic and ethnic diversity and improved products and services based on increased competition. SUSTAINABLE OPPORTUNITIES Economic Oakland's four (4) permitted cannabis dispensaries employ a total of ninety-nine (99) people. Because they are clustered in the central area, they likely increase the sales of other businesses in the area. An increase in the number of permitted dispensaries would increase employment. In December 2004, when the fourth permit was issued, the number of patients served increased significantly,providing an indication that additional dispensaries would increase, not just re-distribute, the patients served. Environmental There arc no environmental eoncems raised in this report. Item: Public Safety Committee April 12, 2005 I I ' I I Deborah Edgerly I I Office of the City Administrator, Special Activity Unit Review of the First Seven Months of Operation of Oakland's Four Permitted Medical Marijuana Dispensaries Paee 12 Social Equitv During their first seven months of operation,the permitted cannabis dispensaries have shown that,in general, they can function without creating a nuisance in the neighborhood or draining police resources. Some of the dispensaries provide additional social services to their patients and the surrounding community. DISABILITY AND SENIOR CITIZEN ACCESS There are no disability and senior citizen access concerns raised in this report. ACTION REQUESTED OF THE CITY COUNCIL Staff requests that the Council accept this informational report on the results of the first seven months of Oakland's permitted cannabis dispensary operations. Respectfully submitted, BARBARA B. KILLEY Prepared by: Barbara Killey Administrative Hearing Officer Special Activity Unit, Office of the City Administrator APPROVED AND FORWARDED TO THE PUBLIC SAFETY COMMITTEE. OFFICE OF THE CIT A INISTRATOR Item: Public Safety Committee April 12, 2005 Y1� MARIJUANA ANTI-PROHIBITION PROJECT A A` AMERICAN HARM REDUCTION ASSOCIATION H Compassion and Common Sense PO Box 739, Palm Springs CA 92263-0739 �S Phone — 760-799-2055 L� www.mari"uananews.org — email to mappnowna.hotmail.com March 29, 2006 To: PALM SPRINGS CITY COUNCIL From: LANNY SWERDLOW Subject: MEDICAL MARIJUANA DISPENSARY MORATORIUM Today you will be voting on a medical marijuana dispensary moratorium. We are in support of the moratorium as written except for Section 8, which delegates the writing of the regulation ordinance that is to be written during the 45-day moratorium to the City Manager. We believe that in order to draft an ordinance that will meet the needs of medical marijuana patients as well as the city of Palm Springs, it is necessary that a committee be formed to draft and submit the ordinance directly to the council. I have printed Section 8 below as it is currently written in the proposed moratorium ordinance. Printed in italics below the original section is the revision that we believe will create a regulation ordinance that when submitted to the City Council will have the support of all parties involved. Section 8. The City Manager shall review and consider options for the regulation of medical marijuana dispensaries in the City, including, but not limited to the development of appropriate rules and regulations governing the location and operation such establislunents in the City and shall file a written report describing the measures which the City has taken to address the conditions which led to the adoption of this ordinance with the City Council ten (10) days prior to the expiration of this interim urgency ordinance, and an extension thereof, and such report shall be made available to the public. SECTION 8. The City Manager shall within ten days of the enactment of this ordinance, establish a citizen's committee to consider options for the regulation of medical marijuana dispensaries in the City, including, but not limited to the development of appropriate rules and regulations governing the location and operation of such establishments in the City. The committee will be open to all interested parties including, but not limited to, medical marijuana patients, City and other governmental agencies, health care professionals, business and property owners and other individuals and groups interested in developing regulations for medical marijuana dispensaries to locate I I I Medical Marijuana Dispensary Moratorium March 29, 2006 Page 2 and operate in the City ofPalm Springs. At itsfrst meeting, the committee shall select a chairperson and develop can organizational framework in order to produce a report describing the measures which the City can take to address the conditions which led to the adoption of this ordinance. This report will be presented to the City Council ten (10) days prior to the expiration of this interim urgency ordinance, and an extension thereof, and such report shall he made available to the public. I have enclosed two items for your information relating to medical marijuana dispensaries. Information on the impact of dispensaries on city services and other areas of concern can be found in the enclosed Oakland report on the first seven months of operation of their four licensed and regulated dispensaries. There is also a copy of the proposed ordinance regulating medical marijuana dispensaries for Los Angeles County written by the Los Angeles County Planning Commission. This ordinance has been submitted to the Los Angeles County Board of Supervisors. I have also enclosed information providing you with background on legal issues, cultivation data and, most importantly, the medical uses and health benefits of marijuana. Thank you for your consideration of this revision of the moratorium ordinance. I look forward to answering any questions you might have at the hearing today. Sincerely, Lanny Swerdlow Director z I Jay Thompson From: Jay Thompson Sent: Tuesday, March 28, 2006 5:31 PM To: Jay Thompson Subject: FW: Dispensary Moratorium From: Bill Weird [mailto:weweirdl@yahoo.com] Sent: Tuesday, March 28, 2006 1:46 PM To: RonO@ci.palm-springs.ca.us; MichaelM@ci.palm-springs.ca.us; Gin nyF@ci.palm-springs.ca.us; SteveP@ci.palm-springs.ca.us; ChrisM@ci.palm-springs.ca.us Cc: lannyswerdlow@earthlink.net Subject: Dispensary Moratorium I"m writing to you to request that in your discussions and actions involving the possible moratorium on medical marijuana dispensaries include individuals who are knowledgeable about the law and the correct implementation of it as stated in S13 420 and, very importantly consider the needs of the patients who use marijuana for relief from many medical maladies. I'm co-infected with HIV/HEPC and use marijuana to help alleviate the side effects of the powerful drugs I must take to suppress the viruses. The allopathic medicine keeps my viruses in check but the side effects can be very debilitating. I strongly urge you to allow our Democracy to work as it should, involving all interested and effected parties to participate in the decision process.MAKE LOCAL GOVERNMENT WORK THE WAY THE FOUNDERS OF OUR COUNTRY INTENDED IT TO.INVOLVE THE PEOPLE IN THE PROCESS AND DO YOUR PART IN MAKING OUR DEMOCRACY WORK THE WAY IT IS SUPPOSED TO, IN AN OPEN FORUM WITH ALL INTERESTED PARTIES ALLOWED TO PARTICIPATE IN THE DECISION WHICH EFFECTS THEM Thank you for your anticipated attention to this request William Ware Yahoo! Messenger with Voice. Make PC-to-Phone Calls to the US (and 30+ countries) for 2¢/min or less. 3/28/2006 PALM SPRINGS CAREGIVERS inc A NOT FOR PROFIT COLLECTIVE PROVIDING ALTERNATE HEALTH PRODUCTS AND SERVICES FOR ITS' MEMBER OWNERS Diane Reade President/CEO Palm Springs Caregivers Inc. Tel: 310-559 5385 PRINCIPAL NATURE OF BUSINESS A Not for Profit Home Health Agency & Clinic providing Alternative Health Products and Services solely to patients, aided by their caregivers where applicable, as authorized under Health and Safety Code sections 11362.5 and 11362.7, et seq. PRINCIPAL PRODUCTS OR SERVICES A NOT FOR PROFIT COLLECTIVE PROVIDING ALTERNATE HEALTH PRODUCTS AND SERVICES TO ITS' MEMBER OWNERS. Palm Springs Caregivers Inc. Business address: Palm Springs Caregivers Inc. 2100 N. Palm Canyon Drive, Suite 104-513, Palm Springs, California 92262 (310) 613 0311 Palm Springs Caregivers Inc Values and Principles Palm Springs Caregivers Inc is an autonomous association of persons united voluntarily to meet their common economic, social, and cultural needs and aspirations through a jointly- owned and democratically controlled enterprise. The Palm Springs Caregivers Inc is based on a set of values and principles: Values THE Palm Springs Caregivers Inc is based on the values of: self-help self-responsibility democracy equality equity solidarity In the tradition of the founders of co-operative collectives, Palm Springs Caregivers Inc members believe in the ethical values of honesty, openness, social responsibility, and caring for others. Principles THE Palm Springs Caregivers Inc principles are guidelines by which the collective puts our values into practice: 1. Voluntary and Open Membership to qualifying patients Palm Springs Caregivers Inc is a voluntary organisation, open to all qualified patients and caregivers able to use the services and willing to accept responsibilities of membership, without gender, social, racial, political, or religious discrimination. 2. Democratic Member Control Palm Springs Caregivers Inc is a democratic organization controlled by it's members, who actively participate in setting their policies and making decisions. Men and women serving as elected representatives are accountable to the membership. In primary collective members have equal voting rights (one member, one vote), and co operatives at other levels are also organized in a democratic manner. 3. Member Economic Participation Palm Springs Caregivers Inc members can contribute to, and democratically control the capital of the common property of the collective. Members usually receive limited compensation, if any, on capital subscribed as a condition of membership. Members allocate surpluses for any of the following purposes: developing their collective, possibly by setting up reserves, part of which at least would be indivisible; benefiting members in proportion to their transactions with the collective; and supporting other activities approved by the membership. 4. Autonomy and Independence THE Palm Springs Caregivers Inc is an autonomous, self-help organisation controlled by its' members. If Palm Springs Caregivers Inc enters into agreements with other organisations, including governments, or raise capital from external sources, they do so on terms that ensure democratic control by their members and maintain their collective autonomy. 5. Education, Training and Information Palm Springs Caregivers Inc provides education and training for its' members, elected representatives, managers and employees so they can contribute effectively to the development of their collectives. They inform the general public - particularly young people and opinion leaders - about the nature and benefits of co-operation. 6. Co-operation Among Collectives Palm Springs Caregivers Inc serves its' members most effectively and strengthen the Collective Movement by working together through local, national, regional and international structures. 7. Concern for Community Palm Springs Caregivers Inc works for the sustainable development of their communities through policies approved by their members. Palm Springs Caregivers Inc An important role of Palm Springs Caregivers Inc is to promote and facilitate the nonprofit, collaborative association of legally qualified patients and their primary caregivers who are engaged in the medical cultivation and use of cannabis as authorized under California Health and Safety Code §11362.5 and 11362.7, et seq. Palm Springs Caregivers Inc principal function in this regard is to receive excess medication grown by legally qualified patient- members or their caregivers and make it available to other legally qualified patient-members or their caregivers. Palm Springs Caregivers Inc does not make cannabis available to the general public, or to anyone else who is not a registered member of our collective and entitled to possess it pursuant to California law. Palm Springs Caregivers Inc does not obtain cannabis from any source other than the labor of qualified patient-members, or their primary caregivers acting on the patient's behalf, who are legally authorized by law to grow cannabis for medical purposes. Palm Springs Caregivers Inc does not buy, sell, manufacture, or grow cannabis products. It simply provides a means whereby lawful medical cannabis patients may associate for the purpose of collaboratively and collectively growing cannabis for their personal medical use. Part of this function includes allocation of the costs and benefits of this effort, including the allocation of reasonable compensation for services rendered amongst those associated with Palm Springs Caregivers Inc and allocation of surplus production of cannabis lawfully grown by patients and caregivers, as authorized under California Health and Safety Code §11362.7 et seq. Palm Springs Caregivers Inc operates in strict compliance with both the letter and the spirit of California law. A substantial portion of our revenue is allocated towards public education and advocacy regarding medical cannabis. We also allocate resources to provide the other life-enhancing services in our portfolio. Until now, the dispensing of medical cannabis in the state of California existed outside the confines of the medical setting. Palm Springs Caregivers Inc seeks to bring medical cannabis provision into the "mainstream" of alternative medical care. We believe that medical cannabis can be an important part of comprehensive strategy for wellness. In this regard, we believe that Palm Springs Caregivers Inc more fully represent the will of the voters and the intent of our law. Security Issues Safety for patients and the community is a top priority for a medical cannabis dispensing collective. Legitimate collectives adopt a security culture to ensure safety. Security culture refers to a set of practices and strategies that work together to maintain community standards. Security at Palm Springs Caregivers Inc culture involves the following elements: Employing professional, trained security personnel Staying alert to detect problems before they occur Educating patients to be sure they know the rules Implementing policies to prevent diversion Restricting access to the facility to authorized persons Using appropriate security technology and equipment to monitor and secure the facility Maintaining communication with local law enforcement Training staff to prevent and respond to emergencies Individually, these elements help make Palm Springs Caregivers Inc safer. Taken together, they provide a comprehensive safety strategy that makes us one of the best and most secure neighbors in the community. The security and careful membership screening at Palm Springs Caregivers Inc serves to protect neighborhoods from undesirable elements in general. (4�cic,4 f10S Los Angeles CountyDepartment of Regional Planning+ Planning for the Challenges AheadIF0RV It James E. Hartl, AICP Director of Planning January 12, 2006 TO: Pat Modugno, Chair Esther L. Valadez, Vice Chair Leslie G. Bellamy, Commissioner Harold V. Helsley, Commissioner - - --Wanyne-Rew, Commissioner FROM: Leonard EJra65g Section Head, Ordinance Studies SUBJECT: REPORT BACK ON DRAFT ORDINANCE RELATING TO MEDICAL MARIJUANA DISPENSARIES—CONTINUED RPC HEARING OF JANUARY 18, 2006—Item No. On December 21, 2005, your Commission held a public hearing on a Draft Medical Marijuana Dispensaries Ordinance. At the hearing, you heard testimony from elected officials and medical marijuana advocates, some of whom asked the Commission to consider changes to the proposed ordinance. In order to allow staff time to study and respond to the issues and concerns raised during the public testimony you continued the hearing until January 18, 2006. The following report addresses the issues that Supervisor Don Knabe, Fourth District, suggested the Commission consider, as well as other concerns raised during the hearing. Staff has also attached a revised draft ordinance consistent with the Commission's and staffs recommendations on each of the issues discussed below. A. Issues raised by Supervisor Knabe. 1. Revise the required distance between dispensaries and sensitive uses from 600 feet to 1,000 feet. A required distance of 600 feet was originally proposed because this distance is specified in the County's zoning regulations for the sale of alcoholic beverages. The 600-foot requirement is also the most restrictive distance from sensitive uses currently specified in the County's Zoning Ordinance. The California Health and Safety Code Section 11362.79 (b) bans smoking of medical marijuana within a 1 ,000 of schools, recreation facilities and youth facilities. Additionally, 1,000 feet is the required distance from sensitive uses 320 West Temple Street • Los An9eles, CA 9oo12 • 213-974-6411 • Fax: 213-626-0434 • TDD: 213-617-z292 Report to Regional Planning Commission Medical Marijuana Dispensaries adopted by almost all other jurisdictions. Therefore, the required distance between dispensaries and sensitive uses should be increased to 1,,000 feet. Recommendation: Revise the draft ordinance to change the required distance between dispensaries and sensitive uses from 600 feet to 1,000 feet. (See revised subsection 22.56.196 E.1 .a in the revised draft ordinance.) 2. Prohibit the sale of drug paraphernalia on dispensary sites. State law defines drug paraphernalia as all "equipment, products and materials of any kind which are intended or designed for use in planting, propagating, cultivating, growing, harvesting, manufacturing, compounding, converting, producing, processing, preparing, testing, analyzing, packaging, repackaging, storing, containing, concealing, injecting, ingesting, inhaling, or otherwise introducing into the human body a controlled substance [California Health and Safety Code Section 11364.5(d)]. However, the common equipment for inhaling marijuana only include rolling paper and related tools, pipes, water pipes and vaporizers. This equipment is often necessary for qualified patients to use medical marijuana. Therefore, staff recommends that the sale of paraphernalia in dispensaries be limited to items necessary for use with medical marijuana and to qualified patients and primary caregivers. Staff also recommends that the dispensaries keep, display or offer this equipment in compliance with California Health and Safety Code Section 11364.5 (a), which allows a business to keep, display or offer drug paraphernalia if it is in a separate room or enclosure which is inaccessible to persons under the age of 18 years not accompanied by a parent or legal guardian. Recommendation: Revise the draft ordinance to allow dispensaries to sell rolling papers and related tools, pipes, water pipes, vaporizers and other similar equipment for inhaling medical marijuana, and require dispensaries to comply with State laws on the sale of "drug paraphernalia", and any applicable Business License Commission requirements. (See revised subsection 22.56.196 E.9 in revised draft ordinance.) 3. Alcohol sales and consumption requirements. I. Prohibit the sale and/or consumption of alcohol on dispensary sites. If a dispensary was to sell alcohol it would be subject to both State and County regulations. At the State level, the California Department of Alcoholic Beverage Control (ABC) licenses and regulates the sale of alcohol. Further, the County requires a conditional use permit for any new alcohol sales (on- or off-site consumption) operations. These regulations allow the State and County to properly limit or prohibit sale of alcoholic beverages in conjunction with a dispensary site. Additionally, according to representatives of the County Sheriff, no case histories exist that establishes a link between medical j 2 Report to Regional Planning Commission Medical Marijuana Dispensaries marijuana and alcohol consumption or sales. Therefore, a specific prohibition on the sale and/or consumption of alcohol on-site is not recommended. Recommendation: Do not revise the draft ordinance to prohibit the sale and consumption of alcohol on dispensary sites. U. ' Require 1,000 feet between dispensaries and any business that sell or allows the consumption of alcohol. Again, according to the Los Angeles County Sheriffs Department, there are no case histories linking dispensaries to other businesses that sells or allows the consumption of alcohol. Given that no such significant link has been established, and given that the sale and consumption of alcohol is regulated by the State through licensing procedure and the County through the conditional use permit procedure, a distance requirement between dispensaries and alcohol sales operations is not necessary. Recommendation: Do not revise draft ordinance. 4. Require a security system and a security guard during business hours. Dispensaries are at times targets of burglaries for their inventory and cash. In order to protect the dispensary from possible theft and in order to deter other petty crimes in and around the dispensary, the County should require a licensed security guard during business hours and an operable and utilized security system. This condition has the broad support of the medical marijuana community. Recommendation: Revise draft ordinance to require a security guard during business hours and a security system. (See revised subsection 22.56.196 E.10 of the revised draft ordinance.) 5. Prohibit the sale of edibles on-site. State law on medical marijuana does not specify what form it must take. Medical marijuana can be ingested as well as inhaled. Ingested forms consist of baked goods, beverages, or tinctures. According to the study conducted by the California National Organization for the Reform of Marijuana Laws (CaNORML), marijuana is like tobacco in that its smoke contains toxins that are known to.be hazardous to the respiratory system. The study also shows that chronic marijuana smokers have been shown to suffer an elevated risk of bronchitis and respiratory infections. Therefore, patients who have respiratory problems may prefer or even need ingestible forms of the medicine. For these reasons, the distribution of edibles in the form of baked goods, beverages, or tinctures should be allowed on dispensary sites. In addition, there are qualified patients who because of their home and/or living arrangements find it preferable to use medical marijuana at a dispensary, rather than at their own home. 3 Report to Regional Planning Commission Medical Marijuana Dispensaries If on-site dispensing of edibles is allowed, both the Business License Commission and the Department of Health Services would, in certain instances, may need to regulate it much like it does restaurants and public eating-places. Recommendation: Revise the draft ordinance to allow the distribution of edibles on-site in conformance with Business License Commission and Department of Health Services requirements. (See revised subsection 22.56,196 E.7 of revised draft ordinance.) 6. Prohibit minors from loitering at the site and from entering the dispensary. California Penal Code Section 647(e) defines loitering as any "wandering ... from place to place without apparent reason or business and refusing to identify oneself...[when] public safety demands such identification." Loitering laws are aimed at public safety; however, they are applicable to adults as well as minors. Therefore, it would be productive to reference State and local loitering laws in the draft ordinance's conditions of use as applicable to all persons frequenting dispensary sites, and to require dispensaries to display a sign that specifies a prohibition against loitering. Staff suggests that the required sign should also warn that marijuana can impair driving and machinery operation. With respect to prohibiting minors from entering dispensaries, this would not be advisable as minors may be qualified patients or may be assisting qualified patients. Recommendation: Revise the draft ordinance to add a condition to reference State and County laws prohibiting loitering as applicable to dispensary sites. (See revised subsections 22.56.196 E.2.e.iii, E.12 and E.14 of the revised draft ordinance.) 7. Require distribution of operator's emergency name and phone number to neighborhood residents. This is a good neighbor policy recommended by medical marijuana advocates. The requirement would help foster good relations between dispensary operators and the neighborhoods in which they are located. Therefore, the operator should be required to provide such information to anyone who requests it. Additionally, staff suggests that such information should be required to be included on the allowable wall or identification signs. Recommendation: Revise the draft ordinance to require the operator to distribute and display their name and phone number in the event of an emergency or if there are complaints or concerns regard!ng the operation of the dispensary. 4 Report to Regional Planning Commission Medical Marijuana Dispensaries (See revised subsection 22.56.196 E.2.d and 22.56.196 E.13 in revised draft ordinance.) B. Additional concerns raised during the hearing. 1. On-site consumption. Medical marijuana may be smoked, inhaled, consumed in edible forms, or taken as tinctures. Medical marijuana advocates testified that on-site consumption, which may or may not include smoking,should be allowed under certain conditions in order to provide a safe haven for patients who may not be able to consume medical marijuana at their residence. For example, a patient may have young children at home and may not want to expose children to marijuana smoke, or a patient may live in an apartment building or other densely populated building where there is greater potential for discovery, harassment, or other repercussions. Advocates say that without a safe haven, the only recourse for some of the patients may be to smoke or consume it on neighborhood streets. Staff believes that on-site consumption, including smoking, should be , allowed. Dispensaries that allow on-site consumption will be required to provide appropriate seating, restrooms, drinking water, ventilation, air purification system and patient supervision. Dispensaries that allow on-site consumption of medical marijuana may be subject to the requirements of the Business License Commission and/or the Department of Health Services. Recommendation: Revise the draft ordinance to allow on-site consumption, including smoking, but require dispensary operators to provide appropriate seating, restrooms, drinking water, adequate ventilation, and supervision for patients. (See revised subsection 22.56.196 E.8 in revised draft ordinance.) 2. Sales tax. In October 2005, the state Board of Equalization instituted a policy that allows medical marijuana dispensaries to obtain a sellers permit thus enabling the state to collect sales tax on medical marijuana sales. This issue is the purview of the State Board of Equalization. Recommendation: Do not revise the draft ordinance. i 3. Prohibit dispensaries in industrial zones. It was suggested that dispensaries be prohibited in industrial zones because they would lack community oversight and visibility in the evening, and, thus, be more prone to burglaries. This point is well taken; however, it has also been argued that residential neighborhoods and sensitive uses should be distanced and buffered from dispensaries, which supports the location of 5 Report to Regional Planning Commission Medical Marijuana Dispensaries dispensaries in industrial zones. Additionally, requirements for security guards and security systems would help to mitigate the dangers of locating dispensaries in industrial zones. Therefore, dispensaries should be accommodated in industrial zones with the cited required security conditions of use. Recommendation: Do not revise the draft ordinance to prohibit dispensaries in industrial zones. 4. Distribute medical marijuana through the County health clinics. It was suggested that if State law allows for the "safe and affordable" distribution" of medical marijuana, then the County should consider dispensing marijuana that has been seized by law enforcement agencies to qualified patients at County health clinics free of charge. Similar ideas have been proposed in Arizona and New York, but there is no practical application' of'such a proposal at this time that staff is aware of. One contributing cause for the lack of such a practice may be the Federal prohibition of possession and use of marijuana. For example, in October 2005, the Santa Cruz City Council voted to create a City department to, distribute medical marijuana. However, the City has decided that this plan should not be implemented unless and until Federal court decisions allow it to proceed because if the city were to open such an office now, it would be subject to Federal prosecution like any other organizations that provide medical marijuana under the State law. If the County were to distribute medical marijuana, it would be vulnerable to Federal sanctions as well. Accordingly, representatives of the Department of Health Services have informed staff that a County doctor could recommend medical marijuana, but could not dispenses it without facing Federal prosecution. Also, County pharmacy could not handle medical marijuana without endangering its license because the Federal government has designated it a controlled substance with no recognized medical value. Therefore, until Congress resolves the conflict between the State and Federal laws, such a program would not be appropriate for the County to implement. Recommendation: Do not revise draft ordinance. 5. The role of collectives and cooperatives, and the cultivation of marijuana. The state legislature enacted SB 420 in early 2003, One specified intent of the law was to "enhance the access of patients and caregivers to medical marijuana through collectives and cooperatives". Thus, California Health and Safety Code Section 11362.775 exempts from prosecution patients and caregivers who associate in order to collectively or cooperatively cultivate marijuana for medical purposes. One reason the State specified allowances for collective and cooperative cultivation is because such cultivation would be 6 Report to Regional Planning Commission Medical Marijuana Dispensaries undertaken locally, and thus be less likely to violate the interstate commerce clause of the U.S. Constitution. The term collective is not defined under the State law; however it is generally accepted to be an association of members who may cultivate marijuana for its members for medical purposes. In contrast, the term cooperative is defined under California Corporations Code Section 12200-12203. These sections provide that an entity must be incorporated pursuant to the Sections' requirements in order to be considered a cooperative. Under recent State court cases, a "dispensary" may be a collective or a cooperative, or it may be a proprietary retail dispensary. However, State law provides no guidance on the actual definition I of a dispensary. The distinction between the three dispensary types: collective, cooperative, and proprietary retail is important because State law provides for the cultivation of medical marijuana by collectives and cooperatives, and if the County were to define a medical marijuana dispensary as a collective or a cooperative, it would have to comply with,the state law and allow dispensaries to cultivate marijuana for medical purposes. The County has previously, in its temporary injunction against an existing dispensary, defined medical marijuana dispensaries as any facility or location where marijuana is made available, sold, transported, given, or otherwise provided to qualified individuals in accordance with Proposition 215. Consistent with this definition and consistent with the Board motion on medical marijuana dispensaries, staff recommends that this definition of dispensary, currently used in the draft ordinance, be retained, thus limiting the activity of a dispensary to the distribution of medical marijuana similar to a pharmacy operation, and prohibiting cultivation on dispensary sites. Recommendation: Revise the draft ordinance to specifically prohibit the cultivation of marijuana, and continue to limit the activity of a dispensary to the distribution of medical marijuana like a proprietary retail 'store' and not unlike a pharmacy. (See revised subsection 22.56.196 EA 1 of the revised draft ordinance.) 6. Illegal diversion of medical marijuana. The County Sheriffs Department and other law enforcement agencies in California have expressed concerns that some medical marijuana dispensaries, and qualified patients and/or primary caregivers have illegally diverted medical marijuana. This problem may be somewhat similar to persons who obtain prescription drugs from a pharmacy and illegally sell them to persons who are not authorized to have or use those drugs. In order to remind operators and patrons of dispensaries that it is illegal to divert medical marijuana to persons who are not authorized to have or use it, each dispensary should display a sign warning against such activity. This 7 Report to Regional Planning Commission Medical Marijuana bispensaries would be similar to signs in liquor stores or bars which contain warnings prohibiting the sale or consumption of alcohol by minors. The sign for this requirement could be combined with that prohibiting loitering and warning that use of marijuana can impair driving. Recommendation: Revise the draft ordinance to require such signs. (See revised subsection 22.56.196 E.2.e.i of revised draft ordinance.) C. Changes recommended by the Commission. The Commission has directed staff to make the following additional changes to the draft ordinance: 1. Specify that a warning and disclaimer be put on medical marijuana zoning application forms as follows: a warning that dispensary operators and their employees maybe subject to prosecution under Federal marijuana laws, and a disclaimer that the County will not accept any legal liability for the approval and operation of a dispensary. Revise the ordinance to include this wording. (See revised subsection 22.56.196 C.2 of the revised draft ordinance.),, 2. Change allowable operating hours from 8am-8pm to 7am-8pm. (See revised subsection 22.56.196 E.3 of the revised draft ordinance.) 3. Change graffiti removal requirements from every 72 hours to every 24 hours. (See subsection 22.56.196 E.5 in the revised draft ordinance.) D. Changes recommended by County Counsel. County Counsel has directed staff to amplify on the liability and indemnification provisions of the draft ordinance. Staff has revised the draft ordinance accordingly. (See revised subsections 22.56.190 E.17 and 18, and H.) The draft ordinance has been revised in accordance with these directives. Staff recommends that the Commission approve the changes contained in the attached revised draft ordinance and adopt the attached resolution. A motion for your use is also attached. Staff looks forward to your continued hearing of January 18, 2006, and we will be present at that time to answer any questions you may have. In the interim, if you have any questions about staffs recommendations or any other issue related to dispensaries, please contact me or Mi Kim of our staff at (213) 9I74-6432. LE:MK 8 Report to Regional Planning Commission Medical Marijuana Dispensaries Attachments Revised Draft Ordinance Suggested Regional Planning Commission Resolution Suggested RPC Motion Report back to RPC for 1-18-06-10 1/11/06 9 I ORDINANCE NO. Draft 2 An Ordinance amending Title 22 (Planning and Zoning) of the Los'Angeles 3 County Code to regulate the establishment of medical marijuana dispensaries. 4 The Board of Supervisors of the County of Los Angeles ordains as follows: 5 SECTION 1. Section 22.08.130 is hereby amended to add the definition of 6 Medical Marijuana Dispensary in alphabetical order as follows: 7 22.08.130 M. 8 ... 9 -- "Medical marijuana dispensary" means any facility or location which sells, 10 transmits, gives or otherwise provides medical marijuana to qualified 11 patients or primary caregivers in accordance with (California Health and 12 Safety Code Sections 11362.5 through Section 11362.83, inclusive—the 13 Compassionate Use Act of 1996 and related sections of Article 2.5 14 (Medical Mariivana Program) Chapter 6, Division 10.1 15 ... 16 SECTION 2. Subsections A of Sections 22.28.110, 22.28.160, 22.28.210 and 17 22.28.260 are hereby amended to add to the list of uses subject to permits in zones 18 C-1, C-2, C-3 and C-M in alphabetical order as follows: 19 ... 20 -- Medical marijuana dispensaries, subject to the requirements of Sections 21 22.56.085 and 22.56.196. 22 ... 23 SECTION 3. Subsection A of Section 22.32.130 and subsection AA of Section 24 22.32.190 are hereby amended to add to the list of uses subject to permits in Zones 25 M-1 %, M-2 and M-4 in alphabetical order as follows: I Note: New revisions are fitalic underlined with brackets). 1 i 2 - Medical marijuana dispensaries subject to the requirements of Sections 3 22.56.085 and 22.56.196. 4 ... 5 SECTION 4. Subsection A of Section 22,56.085 is hereby amended to add to 6 the list of uses subject to minor conditional use permits in alphabetical order as follows: 7 22.56.085 Grant or denial of minor conditional use permit by director. 8 A. Any person filing an application for a conditional use permit may request 9 the director to consider the application in accordance with this Section for the following 10 uses: 12 Medical marijuana dispensaries, subiect to the requirements of Section 13 22.56.196. 14 ... 15 SECTION 5. Section 22.56.196 is added to read as follows: 16 22.56.196 Medical marijuana dispensaries. 17 A. Purpose. This Section is established to regulate medical marijuana 18 dispensaries in a manner that is safe, that mitigates potential impacts dispensaries may 19 have on surrounding properties and persons, and that is in conformance with the 20 provisions of the (California Health and Safety Code Sections 11362.5 through Section 21 1'1362.83 inclusive—the Compassionate Use Act of 1996 and related sections of Arlicl 22 2.5 (Medical Marijuana Program), Chapter 6, Division 10.1 23 B. Minor conditional use permit required. The establishment and operation of 24 any medical marijuana dispensary requires a minor conditional use permit in 25 compliance with the requirements of Section 22.56.085 and this Section. Note: New revisions are !italic underlined with brackets). 2 1 C. Application procedure. 2 1 . (County Department Review.7 Iri addition to the application 3 procedures specified in Sections 22.56.020, 22.56.030, 22.56.040, 22.56.050 and 4 22.56.085 the director shall send a copy of the application.and related materials to 5 Departments of Health Services, Sheriff's Department, Business License Commission 6 and all other applicable County departments for their review and comment. 7 (2. Disclaimer, A warninq and disclaimer shall be put on medical 8 marijuana zoning application forms and shall include the following: 9 a. A warninq that dispensary operators and their employees 10 may be subject to prosecution under federal marijuana laws: and 11 b. A disclaimer that the County will not accept any legal liability 12 in connection with any approval and/or subsequent operation of a dispensary.] 13 D. Findings. In addition to the findings required in Section 22.56.090, 14 approval of a minor conditional use permit for a medical marijuana dispensary shall be 15 subject to the following findings: 16 1. That the requested use at the proposed location will not adversely 17 affect the economic welfare of the nearbV community; 18 2. That the requested use at the proposed location will not adversely 19 affect the use of any property used for a school, playground park, youth facility, child 20 care facility, religious facility or library; 21 3. That the requested use at the proposed location is sufficiently 22 buffered in relation to any residential area in the immediate vicinity so as not to 23 adversely affect said area; 1 24 4. That the exterior appearance of the structure will be consistent with 25 the exterior appearance of structures already constructed or under construction within Note: New revisions are [italic underlined with bracketsl. 3 . r 1 the immediate neighborhood, so as to prevent blight or deterioration, or substantial 2 diminishment or impairment of property values within the neighborhood. 3 E. Conditions of Use. The following standards and requirements shall apply 4 to all medical marijuana dispensaries unless a variance is granted pursuant to Part 2 of 5 Chapter 22.56: 6 1. Location. 7 a. Dispensaries shall not be located within a r9,000-footl radius i 8 of schools playgrounds, parks, libraries, places of religious worship, child care facilities, 9 and youth facilities including but not limited to youth hostels, youth camps, youth clubs, 10 etc., and other similar uses. 11 b. Dispensaries shall not be located within a 1 ,000-foot radius 12 of other dispensaries. 13 2. Signs. 14 a. Notwithstanding the wall sign standards specified in 15 subsection A of Section 22.52 880, dispensaries shall be limited to one wall sign not to 16 exceed 10 square feet in area. 17 b. Notwithstanding the building identification sign standards 18 ;specified in subsection A.3 of Section 22.52.930, dispensaries shall be limited to one 19 building identification sign not to exceed two square feet in area. 20 C. Notwithstanding the provisions of subsection E of Section 21 22.52.880 and subsection C of Section 22.52.930, dispensary wall and building 22 identification signs may riot be internally or externally lit. 23 (d. All dispensaries shall display on their wall sign or 24 identification siqn, the name and emergency contact phone number of the operator or 25 manager in letters of at least 2 inches in height. Note: New revisions are (italic underlined with bracketsl. 4 1 (e. Dispensaries shall post a legible indoor sign in a 2 conspicuous location with the following warnings: 3 L That the diversion of marijuana for non-medical 4 purposes is a violation of State law; 5 ii. That the use of medical mariivana may impair a 6 person's ability to drive a motor vehicle or operate machinery; and 7 iii. That loitering on and around the dispensary site is 8 prohibited by California Penal Code Section 647(e).1 9 3. Hours of Operation. Dispensary operation shall be limited to the 10 hours of n a.m.l to 8 p.m. 11 4. Lighting. 12 a. Lighting shall adequately illuminate the dispensary, its 13 immediate surrounding area, any accessory uses including storage areas, the parking 14 lot, the dispensary's front faQade and any adioWnq public sidewalk to the director's 15 satisfaction. 16 b. Lighting shall be hooded or oriented so as to deflect light 17 away from adjacent properties. 18 5. Graffiti. The owner(s) of the property on which a dispensary is 19 located shall remove graffiti from the premises within [247 hours of its occurrence. 20 6. Litter. The owner(s) of a propertv on which a dispensary is located 21 shall provide for removal of litter twice each day of operation from, and in front of the 22 premises. 23 U. Edibles. Medical marijuana may be provided by a dispensary in an 24 edible form provided that the edibles meet all applicable Department of Health Services 25 and all other County reguirements.7 Note: New revisions are [italic underlined with bracketsl. 5 o 1 L. On-site consumption. Medical mariivana maybe consumed on-site 2 only as follows: 3 a. The smoking of medical marijuana shall be allowed provided 4 that appropriate seating, restrooms drinking water, ventilation, air purification system 5 and patient supervision are provided in a separate room or enclosure: and 6 b. Consumption of edibles by ingestion shall be allowed subject 7 to applicable Department of Health Services, Business License Commission, and all i 8 other County-requirements.l --- - - -- - 9 f9. Devices for inhalation. Dispensaries may provide specific devices, 10 contrivances, instruments or paraphernalia necessary for inhaling medical marijuana, 11 including, but not limited to rolling papers and related tools, pipes, water pipes, and 12 vaporizers. The equipment may only-be provided to qualified patients, or primary 13 caregivers in accordance with California Health and Safety Code Section 11364.5.] 14 f10. Security. Dispensaries shall provide for security as follows: 15 a. An adequate and operable security system that includes 16 security cameras and alarms to the satisfaction of the director,- and 17 b. A licensed security guard present at all times during 18 business hours. All security guards must be licensed and possess a valid Department o_ 19 Consumer Affairs "Security Guard Card"at all times] 20 f11. Cultivation. Marijuana shall not be grown or cultivated on or within 21 the premises of medical marijuana dispensary.] 22 [12. Loitering. Dispensaries shall ensure the absence of loitering 23 consistent with California Penal Code Section 647(e).1 24 25 Note: New revisions are (italic underlined with brackets7. 6 I (13. Distribution of emergency phone number. Dispensaries shall 2 distribute the name and emergency contact phone number of the operator or manager 3 to anyone who requests it.l 4 [14. Minors. It shall be unlawful for any dispensary to provide medical 5 mariivana to any person under the aqe of 18 unless that person is a qualified patient or 6 is a primary caregiver with a valid identification card in accordance with California State 7 Health and Safety Code Section 11362.7.7 8 1"5----Compliance with other requirements. Dispensaries shall comply 9 with applicable provisions of the California Health and SafetV Code Sections 11362.5 10 through Section 11362.83, inclusive; and with the procedures and requirements of the 11 Los Angeles CountV Business License Commission. Department of Health Services. 12 fDeparlment of Public Worksl and Sheriffs Department, 13 16. Additional conditions. Prior to approval of any dispensary, the 14 director or the regional planning commission maV impose any other conditions deemed 15 necessary for compliance with the findings specified in subsection D above. 16 f17. Release the County from liability. The permittees shall agree to 17 forgo seeking to hold the County liable for any injuries, damages, etc. that results from 18 any arrest or prosecution of dispensary owners, employees, or clients for violation of 19 state or federal laws.) 20 f18. County indemnification. The owners and/or operators of the 21 dispensaries shall indemnify the County for any claims, damages or injuries brought by 22 +adjacent or nearby property owners due to the operations, and for any claims brought 23 by any of their clients for problems that may arise out of the distribution and/or on-site 24 use of medical marijuana.l 25 Note: New revisions are!italic underlined with brackets). 7 1 F. Revocation. The Regional Planning Commission or a hearing officer ay. 2 after conducting a public hearing, revoke a medical marijuana dispensary approval 3 granted pursuant to this section if the Commission or the hearing officer finds that the 4 conditions of approval or any other state or local laws or regulations have been violated, 5 or that the grant of approval has been exercised so as to be detrimental to the public 6 health or safety or so as to be a nuisance. 7 G. Previously existing dispensaries. Notwithstanding the provisions of Part 10 i 8 (Nonconforming Uses, Buildings and Structures) of Chapter 22.56, dispensaries 9 established prior to the May 31 , 2005 shall be brought into full compliance with the 10 provisions of this Section within one year of the effective date of the ordinance 11 establishing this section. 12 H. Liability. The provisions of this Section shall not be construed to protect 13 dispensary owners and operators, or their patients from prosecution pursuant to any 14 other laws that may prohibit the cultivation, sale, use or possession of controlled 15 _substances. [Moreover, cultivation, sale, possession, distribution and use of mariivana r 16 currently remain violations of federal law and this Section is not intended to, nor could it, 17 protect the permittees and its clients from federal arrest or prosecution under those 18 federal la ws. Permittees must assume any and all risk or any and all liability that may 19 arise or result under state and federal criminal laws from operations of a medical 20 mariivana dispensary.! Further, to the fullest extent permitted by law, any actions taken 21 under the provisions of this Section by any public officer or employee of the County of 22 Los Angeles or the County of Los Angeles itself, shall not become a personal liability of 23 such person or the liability of the County. 24 MMD Draft Ordinance-15 1111/06 25 Note: New revisions are [italic underlined with brackets], 8 RESOLUTION REGIONAL PLANNING COMMISSION COUNTY OF LOS ANGELES WHEREAS, the Regional Planning Commission of the County of Los 'Angeles conducted public hearings on December 21, 2005 and January 18, 2006 on the amendments to Title 22 (Planning and Zoning) of the Los Angeles County Code to add case processing and conditions of use for the establishment of medical. marijuana dispensaries. WHEREAS, the Commission finds as follows: 1. That in 1996, the voters of the State of California approved Proposition 215 (codified as California Health and Safety Code Section 11362.5 and known as the Compassionate Use Act) allowing persons to obtain and use marijuana for medical purposes. 2. That in 2003, the State legislature enacted Senate Bill 420 (codified as California Health and Safety Code Section 11362.7 et seq.)„ which clarifies and implements the Compassionate Use Act and allows local governments to adopt and enforce related rules and regulations. 3. That there are currently no provisions in the County Code regulating facilities that dispense medical marijuana to authorized patients. 4. That on May 31, 2005, the Board of Supervisors adopted an urgency ordinance (Ordinance No. 2005-0042U), which , placed a 45 day moratorium on the establishment of medical marijuana dispensaries. The Board subsequently extended the moratorium on July 15, 2005 (Ordinance No. 2005-0059U) for another 10 months and 15 days to allow the County to develop appropriate regulatory standards for medical marijuana dispensaries. 5. That the Board has expressed its intent to safeguard the health, safety and welfare of the public by regulating the location of and land use impacts related to medical marijuana dispensaries. 6. That the proposed ordinance amendments respond to the Board's concerns by establishing case processing procedures and conditions of use that would authorize appropriate dispensaries while limiting their effects on surrounding properties and persons. { 7. That the public health and .welfare will be further protected by requirements that dispensaries comply with the procedures and requirements of the Los Angeles County Business License Commission, Department of Health Services, and Sheriff's Department. 8. That the proposed regulation of the medical marijuana dispensaries is consistent with State laws that authorize the distribution of marijuana to qualified patients. 9. That the proposed amendments establishing a regulatory framework for medical marijuana dispensaries are compatible with and supportive of the policies of the Los Angeles County General Plan in that authorized dispensaries would provide needed services to the residents of unincorporated areas of the County. 10. That an Initial Study was prepared for this project in compliance with the California Environmental Quality Act (CEQA). The Initial Study showed that there is no substantial evidence that the project may have a significant effect on the environment. Based on the Initial Study, the Department of Regional Planning prepared a Negative Declaration for this project. The Commission finds that these proposed amendments to the County Code will not have a significant effect on the environment pursuant to CEQA, the State CEQA Guidelines and the Los Angeles County Environmental Document and Reporting Procedures and Guidelines: The Commission further finds that the project is de minimus in its effect on fish and wildlife resources and that the project is exempt from the payment of State Department of Fish and Game Fees pursuant to Section 711.2 of the California Fish and Game Code. THEREFORE, BE IT RESOLVED THAT the Regional Planning Commission recommends to the Board of. Supervisors of the County of Los Angeles as follows: 1. That the Board hold a public hearing to consider the proposed amendments to Title 22 of the Los Angeles County Code to establish new case processing procedures and conditions of use for medical marijuana dispensaries. 2. That the Board certify the attached Negative Declaration, and find that the proposed amendments to Title 22 will not have a significant effect on the environment; 3. That the Board find that the adoption of the proposed ordinance amendment is de minimus in its effect on fish and wildlife resources, and authorize the Director of Planning to complete and file, a Certificate of Fee Exemption for the project; and 2 iJ 1 J ' 4. That the Board adopt the draft ordinance as recommended by this Commission and amend Title 22 accordingly, and determine that the amendments are consistent with the goals•and policies of the Los Angeles County General Plan. I hereby certify that the foregoing resolution was adopted by the Regional Planning Commission of the County of Los Angeles on January 18, 2006. Rosie O. Ruiz, Secretary Regional Planning Commission County of Los Angeles MMD RPC Resolution-3 3 AF� 1� DO YOU KNOW THESE WHAP/SILIAPP� MARIJUANA FACTST �""P�°�J e °�see n The mission of the Marijuana ■ FACT: "Marijuana as medicine And-Pronlbiiiun irujec[ rs to _ engage the public and our elected works. -Dr. Dean Edell, MD., Nationally Syndicated Radio Talk Show officials in an open, informed Host&ABC TV Medical Advisor discussion on mar Juana, its safety, + its prohibition and methods to t remove itfrom the criminaijustice a FACT: An objective consideration of system. As with the end of alcohol marijuana shows that it is 1 ! prohibition, ending marijuana u responsible for less damage to prohibition would reduce crime, �0 � ! society and the individual than are violence and corruption, would , alcohol and cigarettes. provide medical patients with a -„ - California Research Advisory Panel- 2 �eBflll IOC�t10�lS Ill fie=1�/ad ����( safe low cost medicine, would give 1990 (government board ofpharma- ceutical experts&representatives of the fanners a significant new crop, Attonney General's office) and could provide government with sit Sunday each month at � p.rYl. a large new source of revenue. FACT: "Although over 112 million :ath -.`M ° CIt PubI•CirLlbra people die each year in the United y FOR MORE INFORMATION �3 520 Date Palrn Qr,OneblocKnortdp[DmahShoreaf a states from diseases associated comer orDafePaI a-Dave Kelly - - with alcohol and tobacco,there is v� Go to our website at not one recorded death in the www.marijuananews.org 2nd Vil�dneda each rnQnth ' medical literature from any disease OI C8tl �_ associated with marijuana. 7.30 Dr. Phillip Leveque D.O., Ph.D 760-799-2055 ■ p�; ■ Professor ofPhm•maeolog}; Georgetown Medical School& Ohio or send your name &address to: Joshua Tree ,Comrxlunity Center state University Medical School MAPP 6171' Sulnb,usfi St, In Joshua Tree PO Box 739 a = FACT: "Marijuana is not the. . . Palm Springs CA 92263 Learn ab011t,the health Ilellefit$ OF . "gateway"to illicit drug use.There is or send your email address to: # no conclusive evidence that the drug mappnow@hotmail.com I1LefIi¢aI I11arlJllana Op )QUr N Set, effects of marijuana are casually �`OmgSS1031 Eery Tuesday, FId1. & SatUrda - linked to the subsequent abuse of We will send material without any 1SS y y, „ „ donation, but we would appreciate other illicit drugs. There is little pp any het you can give. We receive p. warner. able evidence that decriminalization of Y help More email mappnow@hotmajl com marijuana use necessarily leads to a no governmen[funding. We rely Info7760-799�2'D55 matlPOBox339;PaImSpnngs;CA922§3 substantial increase in marijuana entirely on financial and in-kind PreseAtsd 6'y the use."-Dr. John Benson et al, donations made by our supporters. Find OS On the net 8t MwRIlIfANw A_MTI PROH161TIDN �`wltai er Maryuana& Medicine; Institute of Please send adonation-with your vYrw ma[g4ananews,Org AINERI,CAN HARM REDUCTION ASSOiIATION,_; _; Medicine, National Academy of help we can bring compassion and Science, March 1999 common sense to marijuana laws. LONG TERM MARIJUANA-USE STUDY No 111 Health Effects '" Less Prescribed Mods Needed In the first study of its kind, four recipients of federally provided medical t e eat e ects of their long-term cannabis use-and none showed any serious adverse effects. The Missoula Chronic Clinical Cannabis Use Study-headed by Montana neurologist Dr. Ethan Russo and Virginia nurse Mary Lynn Mathre, cofounder of Patients Out of Time-investigated "the therapeutic benefits and adverse effects" among patients receiving cannabis through the department of Health and Human Services' Compassionate Investigational New Drug program. That program was closed to new applicants in 1991, but continues to supply medical marijuana to seven patients. The four patients studied-one with glaucoma, one with chronic musculoskeletal pain, one with spasm and nausea, and one with spasticity from multiple sclerosis-were run through a battery of tests, including magnetic-resonance-imaging brain scans, chest X-rays, and neuropsychological, immunological and pulmonary-functions tests. The study provided the first opportunity to investigate the long-tern physical effects of cannabis-smoking on patients who used a "known dosage of a standardized, heat-sterilized, quality-controlled supply of low-grade marijuana for 10-19 years." The results, which will be published in the Journal of Cannabis Therapeutics in January 2002, showed "all four atients are stable with respect to their chronic conditions, and are taking many fewer standard harmaceuticals than previously.' Mild changes in pulmonary function were found in two of the: four, but no cancer cells were detected. No other negative functions were discovered. The study, conducted at St. Patrick's Hospital in Missoula, Montana, was sponsored by Patients Out of Time and funded by outside individuals. "This is a positive result using a poor-quality medicine. What could we expect using a better quality cannabis?" Al Byrne, Patients Out of Time's other cofounder, told HT. Asked whether he thought the study would result in a reopening of the Compassionate IND program, Byrne bristled. "No. I don't think it will, but it should. I think the study's effect on the government will be that they will no longer be able to say that long-term therapeutic cannabis use is bad for you. But will the federal government pay it any heed? Probably not." When asked why it took a nonprofit to organize the study rather than the government, Byrne noted "I suppose because they suspected the result of the study would be positive and the government does not want anything positive said about cannabis use as medicine. That's the bottom line." Note: The government says smoking pot is bad for your health,particularly in the long run. But four of the seven people it supplies have been looked at from every angle, and researchers conclude that their rnar�luana use hasn't hurt them a bit. Further because of their marijuana-use, they were able to signif cantly reduce the quantity of their prescribed, expensive and dangerous pharmaceutical medications. Printed by the MARIJUANA ANTI-PROHIBITION PROJECT, PO BOX 739, Palm Springs CA 92263 On the web at www.marijuananews.org —email: mappnow@hotmail.com MAPP meets the first Sunday of each month at 3 p.m. at the Cathedral City Public Library at 33520 Date Palm Dr. &the second Wednesday of each month at 7:30 p.m. at the Joshua Tree Community Center, 6171 Sunburst St, rScientific and Medical Research flooded by applications from AI patients, and the re- MARIJUANA & MEDICINE Support Medical Marijuana maining patients had to sue the fed ral goverrunent on the Numerous published studies demonstrate that marijuana basis_ " y"to retain a .,,'access to rhe;redi_ has medical value in treating patients with serious illnesses tiasis of necessitne. Today, eight surviving patients still receive medical FACT: "Most of us in the medical such as AIDS, glaucoma, cancer, multiple sclerosis, epi- marijuana from the federal govern ent.The most a single profession believe this decision (banning lepsy,and chronic pain.In 1999,the Institute of Medicine, patient receives from the federal gc vernment is 9 pounds a medical madjuana)'is politically motivated, in the most comprehensive study of medi ----- year.Despite this uccessful medical pro- Marijuana as medicine works." cal marijuana's efficacy, concluded that, gram, marijuana is still classified as a Dr. Dean Edell,M.D.;Syndicated Radio "Nausea,appetite loss,pain and anxiety. . Schedule I substa ice,defined as Show Host&ABC TV Medical Advisor ana. ow- all can be mitigated by marijuana."All having a high pot ntial for abuse .:= ing patients legal access to medical mari- and no medicinal value.Medical juana has been endorsed by numerous or- marijuana advoc ites have also ganizations, including the AIDS Action I pursued reform through the FACT: "Marijuana has been shown to be Council,American BarAssociation,Ameri- courts. In 1972, a petition was safe and effective, particularly for nausea, can Public Health Association, California submitted to the Bur of Nar- Nev.._Zz in people being treated for cancer,AIDS Medical Association, The New England cotics and Dangerous Drugs Journal of Medicine, and several state (now known as the Drug En- n' and other serious illnesses. forcemeat Administration, or 4L/. nurses associations. Marinol is touted by David Siegel, MD;Stephen Hulley, dID; the DEA as the legal means to obtain the DEA)to reschedule marijuana so Normal Hearst, MD;Michelle Berlin, MD; that it could be tte 12r"` benefits of marijuana. However, marinol scribed to pa- Stephen Stephen Hulley, MD;-Center for AIDS does not deliver the same therapeutic ben- tients. In 1988, tl e DEA's chief ' Prevention Studies, Univ. of Calif. at S.F. efits found in the natural herb.Matinol is a synthetic form administrative law judge,Francis&Young,ruled of THC, which is only ONE of the therapeutic elements that, "Marijuana,in its natural forr i,is one of the found in the cannabis plant.In isolation,THC cannot offer safest therapeutically active substai ices known... the same therapeutic value, and has an array of negative It would be unreasonable,arbitrary and capricious FACT: "This medicine does no harm to the side effects not found with cannabis. for the DEA to continue to stand between those patient and is effective in relieving pain and sufferers and the benefits of this s bstance . . ." without nausea." justification,the DEA refused to i plement this ruling and Feds Ignore Their Own Research continues to class' m Dr.Richard Cohen, Chief Oncologist, classify marijuana as Schedule I substance. When it comes to federal policy on marijuana, the right California Pacific Hospital hand doesn't know, or care, what the left hand is doing. Widespread Public Support; State For example, in 1978 the federal Referenda Passed government ere- Public opinion is clearly in favor oi ending the prohibition FACT: "The health professionals want ated the Investi j g o a CNN/Time Poll in Gloria Stone, 76 ga- of medical marijuana. According medical marijuana. BREAST CANCER tional New Drug November 2002,80%of American support medical mari- RepresentativeHenryWaxman, (IND) compas- juana. Since 1996, voters in eight states plus the District California, United States Congress "I'm 76 years old. I found sionate access re- of Columbia have passed favorable medical marijuana bal- using marijuana stimulated search program to lot initiatives.Currently,laws that eifectively remove state- my appetite and calmed my allow some pa- level criminal penalties for growing and/or possessing Alaska, Arizona, California, Colorado, the nausea from the chemo- tients to receive medical marijuana are in place inA aska,California,Colo- District Of Columbia, Hawaii, Maine, therapy. It also eased my medical marijuana rado, Hawaii, Maine, Nevada, Or gon, and Washington. pain." from the govern- Ten states have symbolic medical marijuana laws. (laws Nevada, Oregon and Washington by voter ment. The IND that support medical marijuana but do not provide patients initiative or legislative law allow seriously was closed in with legal protection under state 1.w). ill people to use marijuana for medicine. 1992 after it was STUDY: SMOKING MARIJUANA DOES NOT CAUSE LUNG CANCER AND MAY PROTECT AGAINST LUNG CANCER by Fred Gardner Counterpunch Magazine July 2 2005 Marijuana smoking -"even heavy longterm use"-does not cause cancer of the lung, upper airwaves, or esophagus, Donald Taslrkin reported at this year's meeting of the International Camiabinoid Research Society. Coming from Tashkin,this conclusion had extra significance for the assembled drug-company and university-based scientists (most of whom get funding from the U.S. National Institute on Drug Abuse). Over the years, Tashkin's lab at UCLA has produced irrefutable evidence of the damage that marijuana smoke wreaks on bronchial tissue. With NIDA's support, Tashkin and colleagues have identified the potent carcinogens in marijuana smoke, biopsied and made photomicrographs of pre- malignant cells, and studied the molecular changes occurring within them. It is Tashkin's research that the Drug Czar's office cites in ads linking marijuana to lung cancer. Taslikin himself has long believed in a causal relationship, despite a study in which Stephen Sidney examined the files of 64,000 Kaiser patients and found that marijuana users didn't develop lung cancer at a higher rate or die earlier than non-users. Of five smaller studies on the question, only two -involving a total of about 300 patients-concluded that marijuana smoking causes lung cancer. Tashkin decided to settle the question by conducting a large, prospectively designed, population-based, case-controlled study. "Our major hypothesis," he told the ICRS, "was that heavy, longterm use of marijuana will increase the risk of lung and upper-airwaves cancers." The Los Angeles County Cancer Surveillance program provided Tashkin's team with the names of 1,209 L.A. residents aged 59 or younger with cancer(611 lung, 403 oral/pharyngeal, 90 laryngeal, 108 esophageal). Interviewers collected extensive lifetime histories of marijuana, tobacco, alcohol and other drug use, and data on diet, occupational exposures, family history of cancer, and various "socio- demographic factors." Exposure to marijuana was measured in joint years (joints per day x 365). Controls were found based on age, gender and neighborhood. Among them, 46%had never used marijuana, 3 I% had used less than one joint year, 12%had used 10-30 j-yrs, 2%had used 30-60 j-yrs, and 3%had used for more than 60 j-yrs. Tashkin controlled for tobacco use and calculated the relative risk of marijuana use resulting in lung and upper airwaves cancers. All the odds ratios turned out to be less than one (one being equal to the control group's chances)! Compared with subjects who had used less than one joint year,the estimated odds ratios for lung cancer were .78; for I-10 j-yrs, .74; for 10-30 j-yrs, .85 for 30-60 j-yrs; and 0.81 for more than 60 j-yrs. The estimated odds ratios for oral/pharyngeal cancers were 0.92 for 1-10 j- yrs; 0.89 for 10-30 j-yrs; 0.81 for 30-60 j-yrs; and 1.0 for more than 60 j-yrs. "Similar, though less precise results were obtained for the other cancer sites," Tashkin reported. "We found absolutely no suggestion of a dose response." The data on tobacco use, as expected, revealed "a very potent effect and a clear dose- response relationship -a 21-fold greater risk of developing lung cancer if you smoke more than two packs a day." Similarly high odds obtained for oral/pharyngeal cancer, laryngeal cancer and esophageal cancer. "So, in summary" Tashkin concluded, "we failed to observe a positive association of marijuana use and other potential confounders." There was time for only one question, said the moderator, and San Francisco oncologist Donald Abrams, M.D., was already at the microphone: "You don't see any positive correlation, but in at least one category [marijuana-only smokers and lung cancer], it almost looked like there was a negative correlation, i.e., a protective effect. Could you comment on that?" "Yes," said Tashkin, "The odds ratios are less than one almost consistently, and in one category that relationship was significant, but I think that it would be difficult to extract from these data the conclusion that marijuana is protective against lung cancer. But that is not an unreasonable hypothesis." Abrams had results of his own to report at the ICRS meeting. He and his colleagues at San Francisco General Hospital had conducted a randomized, placebo-controlled study involving 50 patients with HIV- related peripheral neuropathy. Over the course of five days, patients recorded their pain levels in a diary after smoking either NIDA-supplied marijuana cigarettes or cigarettes from which the THC had been extracted. About 25%didn't know or guessed wrong as to whether they were smoking the placebos, which suggests that the blinding worked. Abrams requested that his results not be described in detail prior to publication in a peer-reviewed medical journal, but we can generalize: they exceeded expectations, and show marijuana providing pain relief comparable to Gabapentin,the most widely used treatment for a condition that afflicts some 30%of patients with HIV. To a questioner who bemoaned the difficulty of"separating the high from the clinical benefits," Abrams replied: "I'm an oncologist as well as an AIDS doctor and I don't think that a drug that creates euphoria in patients with terminal diseases is having an adverse effect." His study was funded by the University of California's Center for Medicinal Cannabis Research. The 15th annual meeting of the ICRS was held at the Clearwater, Florida,Hilton, June 24-27. Almost 300 scientists attended. R. Stephen Ellis, MD, of San Francisco, was the sole clinician from California. Los Angeles Fannacy operator Mike Onunaha and therapist/cultivator Pat Humphrey showed up to audit the proceedings... Some of the younger European scientists expressed consternation over the recent U.S. Supreme Court ruling and the vote in Congress re-enforcing the cannabis prohibition. "How can they dispute that it has medical effect?" an investigator working in Germany asked us earnestly. She had come to give a talk on "the role of different neuronal populations in the pharmacological actions of delta-9 THC." For most ICRS members,the holy grail is a legal synthetic drug that exerts the medicinal effects of the prohibited herb. To this end they study the mechanism of action by which the body's own cannabinoids are assembled, function, and get broken down. A drug that encourages production or delays dissolution,they figure, might achieve the desired effect without being subject to "abuse..." News on the scientific front included the likely identification of a third cannabinoid receptor expressed in tissues of the lung, brain, kidney, spleen and smaller branches of the mesenteric artery. Investigators from GlaxoSmithKline and AstraZeneca both reported finding the new receptor but had different versions of its pharmacology. It may have a role in regulating blood pressure. Several talks and posters described the safety and efficacy of Sativex, G.W. Pharmaceuticals'whole-plait extract containing high levels of THC and CBD (cannabidiol) formulated to spray in the mouth. G.W. director Geoffrey Guy seemed upbeat, despite the drubbing his company's stock took this spring when UK regulators withheld pernnission to market Sativex pending another clinical trial. Canada recently granted approval for doctors to prescribe Sativex, and five sales reps from Bayer(to whom G.W. sold the Canadian marketing rights) are promoting it to neurologists. Sativex was approved for the treatment of neuropathic pain in multiple sclerosis, but can be prescribed for other purposes as doctors see fit. Information provided by the MARIJUANA ANTImPROHIBITION PROJECT PO BOX 739, Palm Springs CA 92263 On the web at www.marijuananews.org - email: mappnow@hotmail.com Join us at one of our monthly meetings. First Sunday of each month at 3 p.m. Cathedral City Public Library at 33520 Date Palm Dr. and on the Second Wednesday of each month at 7:30 p.m. Joshua Tree Community Center, 6171 Sunburst St. MARIJUANA AND MEDICINE Assessing the Science Base Janet E. Joy, Stanley J. Watson, Jr., and John A. Benson, Jr., Editors Division of Neuroscience and Behavioral Health NATIONAL INSTITUTE OF MEDICINE March 1999 Executive Summary The full report can be accessed on the internet at: http://bob.nap.edu/books/0309071550/html/ Public opinion on the medical value of marijuana has been sharply divided. Some dismiss medical marijuana as a hoax that exploits our natural compassion for the sick; others claim it is a uniquely soothing medicine that has been withheld from patients through regulations based on false claims. Proponents of both views cite "scientific evidence" to support their views and have expressed those views at the ballot box in recent state elections. In January 1997, the White House Office of National Drug Control Policy (ONDCP) asked the Institute of Medicine (IOM) to conduct a review of the scientific evidence to assess the potential health benefits and risks of marijuana and its constituent cannabinoids (see the Statement of Task on page 9). That review began in August 1997 and culminates with this report. The ONDCP request came in the wake of state "medical marijuana" initiatives. In November 1996, voters in California and Arizona passed referenda designed to permit the use of marijuana as medicine. Although Arizona's referendum was invalidated five months later, the referenda galvanized a national response. In November 1998, voters in six states (Alaska, Arizona, Colorado, Nevada, Oregon, and Washington) passed ballot initiatives in support of medical marijuana. (The Colorado vote will not count, however, because after the vote was taken a court ruling determined there had not been enough valid signatures to place the initiative on the ballot.) Can marijuana relieve health problems? Is it safe for medical use? Those straightforward questions are embedded in a web of social concerns, most of which lie outside the scope of this report. Controversies concerning the nonmedical use of marijuana spill over into the medical marijuana debate and obscure the real state of scientific knowledge. In contrast with the many disagreements bearing on social issues, the study team found substantial consensus among experts in the relevant disciplines on the scientific evidence about potential medical uses of marijuana. This report summarizes and analyzes what is known about the medical use of marijuana; it emphasizes evidence-based medicine (derived from knowledge and experience informed by rigorous scientific analysis), as opposed to belief-based medicine (derived from judgment, intuition, and beliefs untested by rigorous science). Throughout this report, marytiana refers to unpurified plant substances, including leaves or flower tops whether consumed by ingestion or smoking. References to the "effects of marijuana" should be understood to include the composite effects of its various components; that is, the effects of tetrahydrocannabinol (THC), which is the primary psychoactive ingredient in marijuana, are included among its effects, but not all the effects of marijuana are necessarily due nd in the marijuana plant, in animals, or synthesized in chemistry laboratories. Three focal concerns in evaluating the medical use of marijuana are: 1. Evaluation of the effects of isolated cannabinoids; 2. Evaluation of the risks associated with the medical use of marijuana; and 3. Evaluation of the use of smoked marijuana. EFFECTS OF ISOLATED CANNABINOIDS Cannabinoid Biology Much has been learned since the 1982 IOM report MarUuana and Health. Although it was clear then that most of the effects of marijuana were due to its actions on the brain, there was little information about how THC acted on brain cells (neurons), which cells were affected by THC, or even what general areas of the brain were most affected by THC. In addition, too little was known about cannabinoid physiology to offer any scientific insights into the harmful or therapeutic effects of marijuana. That all changed with the identification and characterization of cannabinoid receptors in the 1980s and 1990s. During the past 16 years, science has advanced greatly and can tell us much more about the potential medical benefits of cannabinoids. Conclusion: At this point, our knowledge about the biology of marijuana and cannabinoids allows us to make some general conclusions: • Cannabinoids likely have a natural role in pain modulation, control of movement, and memory. • The natural role of cannabinoids in immune systems is likely multi-faceted and remains unclear. • The brain develops tolerance to cannabinoids. • Animal research demonstrates the potential for dependence, but this potential is observed under a narrower range of conditions than with benzodiazepines, opiates, cocaine, or nicotine. • Withdrawal symptoms can be observed in animals but appear to be mild compared to opiates or benzodiazepines, such as diazepam (Valium). Conclusion: The different cannabinoid receptor types found in the body appear to play different roles in normal human physiology. In addition, some effects of cannabinoids appear to be independent of those receptors. The variety of mechanisms through which cannabinoids can influence human physiology underlies the variety of potential therapeutic uses for drugs that might act selectively on different cannabinoid systems. Recommendation 1: Research should continue into the physiological effects of synthetic and plant-derived cannabinoids and the natural function of cannabinoids found in the body. Because different cannabinoids appear to have different effects, cannabinoid research should include, but not be restricted to, effects attributable to THC alone. Efficacy of Cannabinoid Drugs The accumulated data indicate a potential therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation. The therapeutic effects of cannabinoids are best established for THC, which is generally one of the 2 i i i two most abundant of the cannabinoids in marijuana. (Cannabidiol is generally the other most abundant cannabinoid.) i The effects of cannabinoids on the symptoms studied are generally modest, and in most cases there are more effective medications. However, people vary in their responses to medications, and there will likely always be a subpopulation of patients who do not respond well to other medications The combination of cannabinoid drug effects (anxiety reduction appetite stimulation, nausea reduction, and pain relief) suggests that cannabinoids would be moderately well suited for particular conditions, such as chemotherapy-induced nausea and vomiting and AIDS wasting. Defined substances, such as purified cannabinoid compounds, are preferable to plant products, which are of variable and uncertain composition. Use of defined cannabinoids permits a more precise evaluation of their effects, whether in combination or alone. Medications that can maximize the desired effects of cannabinoids and minimize the undesired effects can very likely be identified. Although most scientists who study cannabinoids agree that the pathways to cannabinoid drug development are clearly marked, there is no guarantee that the fruits of scientific research will be made available to the public for medical use. Cannabinoid-based drugs will only become available if public investment in cannabinoid drug research is sustained and if there is enough incentive for private enterprise to develop and market such drugs. Conclusion: Scientific data indicate the potential therapeutic value of cannabinoid drugs, primarily THC, for pain relief, control of nausea and vomiting, and appetite stimulation; smoked marijuana, however, is a crude THC delivery system that also delivers harmful substances. Recommendation 2: Clinical trials of cannabinoid drugs for symptom management should be conducted with the goal of developing rapid-onset, reliable, and safe delivery systems. Influence of Psychological Effects on Therapeutic Effects The psychological effects of THC and similar cannabinoids pose three issues for the therapeutic use of cannabinoid drugs. First, for some patients--particularly older patients with no previous marijuana experience--the psychological effects are disturbing. Those patients report experiencing unpleasant feelings and disorientation after being treated with THC, generally more severe for oral THC than for smoked marijuana. Second, for conditions such as movement disorders or nausea, in which anxiety exacerbates the symptoms, the antianxiety effects of cannabinoid drugs can influence symptoms indirectly. This can be beneficial or can create false impressions of the drug effect. Third, for cases in which symptoms are multifaceted, the combination of THC effects might provide a form of adjunctive therapy; for example, AIDS wasting patients would likely benefit from a medication that simultaneously reduces anxiety, pain, and nausea while stimulating appetite. Conclusion: The psychological effects of cannabinoids, such as anxiety reduction, sedation, and euphoria can influence their potential therapeutic value. Those effects are potentially undesirable for certain patients and situations and beneficial for others. In addition, psychological effects can complicate the interpretation of other aspects of the drug's effect. Recommendation 3: Psychological effects of cannabinoids such as anxiety reduction and sedation, which can influence medical benefits, should be evaluated in clinical trials. RISKS ASSOCIATED WITH MEDICAL USE OF MARIJUANA Physiological Risks Marijuana is not a completely benign substance. It is a powerful drug with a variety of effects. However, except for the harms associated with smoking, the adverse effects of marijuana use are within the range of effects tolerated for other medications. The harmful effects to individuals 3 1 I from the perspective of possible medical use of marijuana are not necessarily the same as the harmful physical effects of drug abuse. When interpreting studies purporting to show the harmful effects of marijuana, it is important to keep in mind that the majority of those studies are based on smoked marijuana, and cannabinoid effects cannot be separated from the effects of inhaling smoke from burning plant material and contaminants. imam+-adverse-effect-e€�aJe-tttarijuana use-is diminished p�yrhmm�rr,r performance. It is, therefore, inadvisable to operate any vehicle or potentially dangerous equipment while under the influence of marijuana, THC, or any cannabinoid drug with comparable effects. In addition, a minority of marijuana users experience dysphoria, or unpleasant feelings. Finally, the short-term immunosuppressive effects are not well established but, if they exist, are not likely great enough to preclude a legitimate medical use. The chronic effects of marijuana are of greater concern for medical use and fall into two categories: the effects of chronic smoking and the effects of THC. Marijuana smoking is associated with abnormalities of cells lining the'human respiratory tract. Marijuana smoke, like tobacco smoke, is associated with increased risk of cancer, lung damage, and poor pregnancy outcomes. Although cellular, genetic, and human studies all suggest that marijuana smoke is an important risk factor for the development of respiratory cancer, proof that habitual marijuana smoking does or does not cause cancer awaits the results of well-designed studies. Conclusion: Numerous studies suggest that marijuana smoke is an important risk factor in the development of respiratory disease. Recommendation 4: Studies to define the individual health risks of smoking marijuana should be conducted, particularly among populations in which marijuana use is prevalent. Marijuana Dependence and Withdrawal A second concern associated with chronic marijuana use is dependence on the psychoactive effects of THC. Although few marijuana users develop dependence, some do. Risk factors for marijuana dependence are similar to those for other forms of substance abuse. In particular, anti- social personality and conduct disorders are closely associated with substance abuse. Conclusion: A distinctive marijuana withdrawal syndrome has been identified, but it is mild and short lived. The syndrome includes restlessness, irritability, mild agitation, insomnia, sleep disturbance, nausea, and cramping. Marijuana as a "Gateway" Drug Patterns in progression of drug use from adolescence to adulthood are strikingly regular. Because it is the most widely used illicit drug, marijuana is predictably the first illicit drug most people encounter. Not surprisingly, most users of other illicit drugs have used marijuana first. In fact, most drug users begin with alcohol and nicotine before marijuana--usually before they are of legal age. In the sense that marijuana use typically precedes rather than follows initiation of other illicit drug use, it is indeed a "gateway" drug. But because underage smoking and alcohol use typically precede marijuana use, marijuana is not the most common, and is rarely the first, "gateway" to illicit drug use. There is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs. An important caution is that data on drug use progression cannot be assumed to apply to the use of drugs for medical purposes. It does not follow from those data that if marijuana were available by prescription for medical use, the pattern of drug use would remain the same as seen in illicit use. Finally, there is a broad social concern that sanctioning the medical use of marijuana might increase its use among the general population. At this point there are no convincing data to support this concern. The existing data are consistent with the idea that this would not be a 4 problem if the medical use of marijuana were as closely regulated as other medications with abuse potential. Conclusion: Present data on drug use progression neither support nor refute the suggestion that medical availability would increase drug abuse. However, this question is beyond the issues normally considered for medical uses of drugs and should not be a factor in evaluating the therapeutic potential of marijuana or cannabinoids. USE OF SMOKED MARIJUANA Because of the health risks associated with smoking, smoked marijuana should generally not be recommended for long-term medical use. Nonetheless, for certain patients, such as the terminally ill or those with debilitating symptoms, the long-term risks are not of great concern. Further, despite the legal, social, and health problems associated with smoking marijuana, it is widely used by certain patient groups. Recommendation 5: Clinical trials of marijuana use for medical purposes should be conducted under the following limited circumstances: trials should involve only short- term marijuana use (less than six months), should be conducted in patients with conditions for which there is reasonable expectation of efficacy, should be approved by institutional review boards, and should collect data about efficacy. The goal of clinical trials of smoked marijuana would not be to develop marijuana as a licensed drug but rather to serve as a first step toward the possible development of nonsmoked rapid-onset cannabinoid delivery systems. However, it will likely be many years before a safe and effective cannabinoid delivery system, such as an inhaler, is available for patients. In the meantime there are patients with debilitating symptoms for whom smoked marijuana might provide relief. The use of smoked marijuana for those patients should weigh both the expected efficacy of marijuana and ethical issues in patient care, including providing information about the known and suspected risks of smoked marijuana use. Recommendation 6: Short-term use of smoked marijuana (less than six months) for patients with debilitating symptoms (such as intractable pain or vomiting) must meet the following conditions: • failure of all approved medications to provide relief has been documented, • the symptoms can reasonably be expected to be relieved by rapid-onset cannabinoid drugs, • such treatment is administered under medical supervision in a manner that allows for assessment of treatment effectiveness, and • involves an oversight strategy comparable to an institutional review board process that could provide guidance within 24 hours of a submission by a physician to provide marijuana to a patient for a specified use. Until a nonsmoked rapid-onset cannabinoid drug delivery system becomes available, we acknowledge that there is no clear alternative for people suffering from chronic conditions that might be relieved by smoking marijuana, such as pain or AIDS wasting. One possible approach is to treat patients as n-of-I clinical trials (single-patient trials), in which patients are fully informed of their status as experimental subjects using a harmful drug delivery system and in which their condition is closely monitored and documented under medical supervision, thereby increasing the knowledge base of the risks and benefits of marijuana use under such conditions. 5 MARIJUANA AND MEDICI Assessing the Science Base TABLE OF CONTENTS Front Matter i-xviii Executive Surmnary 1-12 1 Introduction 13-32 2 Cannabinoids and Animal Physiology 33-82 3 First, Do No Hann: Consequences of Marijuana Use and 83-136 Abuse 4 The Medical Value of Marijuana and Related Substances 137-192 5 Development of Cannabinoid Drugs 193-222 Appendix A Individuals and Organizations That Spoke or 223-231 Wrote to the Institute of Medicine About Marijuana and Medicine Appendix B Workshop Agendas 232-239 Appendix C Scheduling Definitions 240-241 Appendix D Statement of Task 242-243 Appendix E Recommendations Made in Recent Reports on 244-255 the Medical Use of Marijuana Appendix F Rescheduling Criteria 256-258 Index 259-267 The full report can be accessed on the internet at: http://bob.ngp.edu/books/0309071550/html/ Printed and distributed in the Coachella Valley for public education purposes by MARIJUANA ANTI-PROHIBITION PROJECT PO Box 739, Palm Springs CA 92263 - 760-799-2055 On the web at www.marimuananews.org - email to; MAPPNOW@hotmail.com 6 A'A ;ki i.**w-j,14�,A 1414­11 "m Flo b VT I PIMA", kz, .01 P� I NIP, 14 SON ju 31 rct ;AX I Ua� till 4, 7,]a'W" Zi 9 J, 7 CANNABIS YIELDS AND DOSAGE CONTENTS Introduction Page i PART I: TIIE SCIENCE Federal Medical Marijuana Page 1 History and usage 2 Affect on the body 3 Systemic effect, symptomatic relief 4 Daily therapeutic dosages 6 Usable medical marijuana and conversions 7 Federal cannabis yield study 8 Garden adversity and how it affects yields 9 Indoor and outdoor gardens 10 Measuring canopy to estimate yield potential 11 PART II: STATE OF THE LAW Federal laws and rulings 12 California voter initiative Prop 215 and rulings 13 Senate Bill 420 basics of California statutory law 14 Patients, caregivers, cities and counties 15 Coops and collectives 16 Legal proceedings and challenges 17 PART III: Ti IIE POEICY Safe Access Now sample guidelines ordinance 18 PART IV: APPENDICES Medical marijuana laws outside of California 20 California statutory citations 20 Resources and reference material 21 About the author 21 More quotes Back cover CANNABIS YIELDS AND DOSAGE A Guide to the Production and Use of Medical Marijuana t � . CHRIS CONRAD Court-qualified cannabis expert Director, Safe Access Now Creative Xpressions PO Box 1716, El Cerrito CA 94530 • www.safeaccessnow.net ©2004, 2005 Chris Conrad.All rights reserved. i INTRODUCTION Since the 1996 passage of California's medical marl- This booklet explains the basics cif mr;dir,al iwnijuana. juana law, Proposition 215, counties have grappled Part I gives basic facts about dut7aqu and ylold:;. Part II with the key issue left unresolved in the measure: How is a Safe Access Now model ordin;mi:c! for rluidolines. much is a reasonable amount? Part III explains the legal settin(l, and Pod IV gives The federal government has decades of experience in excerpts from state law. We also In(Judo lolotonce producing and providing medical marijuana and has groups and websites for the readot. studied garden yields. Its IND medical marijuana pro- A common understanding of modinttl m:n'ijunna could dram has shown that more than six pounds of marijua- prevent needless arrests and prosocutiont:, froc op law ria per year is a safe and effective dosage. California enforcement to focus on seriotn; crinw, anti :atvo patients more typically use up to half that amount, or California's communities millions of rinlltw; th.0 rite: three pounds of cannabis bud per year. desperately needed for schools. Ilbrrario;; tout vil,il pro- What size garden is therefore appropriate?The answer grams. Reasonable guidelines are good fear a:vnt yuno, must consider several variables. Senate Bill 420, HS11362.7, set a rednlinom :�_dr 11r11- 1) Every garden is different. 2) Grown outdoors, plants bor from arrest at eight ounces of dry connabls bud can get large. An exceptional garden can yield many or conversion plus six mature or 12 Immature pounds of cannabis bud with just a few huge plants. plants, an inadequate amount for many p;dh nlr,. It 3) The common "Sea of Green" indoor garden uses does, however, empower doctors, citi(!a, onfinhw, mid scores or hundreds of very small plants to yield a few courts to protect caregivers and pairnt:• wh,l use pounds. 4) Different growers get different yields using more. This booklet shows how much camwhit: prdiunis the same techniques. can reasonably consume why and rlulrinhiw>; t:hntdd Data published in the federal Drug Enforcement be expanded. Safe Access Now prc'po:1r,;; ii -,cicntific compromise, based on canopy are Administration's Cannabis Yields, provides a scientific a, ilrt really woks. method to let patients grow indoors or out in any format You can help advance this process. Who0wi,a patient, they wish, yet makes it easy to gauge the output. That physician, policy maker, prosecutor, police offlcor, or is the essence of the Safe Access Now guidelines: concerned citizen, please take a stand let tho princi- allow a safe harbor per qualified patient of up to three pies of reason, compassion and the rulo of Iriw. pounds of bud and as many plants as fit within 100 For more information on what you can do, vl.;It the SAN square feet of garden canopy. Nothing is perfect, but website: www.safeaccessnow.net. Thank you. SAN guidelines can realistically protect most patients with a minimum of problems. Patients, doctors, district attorneys, courts and juries across the state have fol- lowed these model medical marijuana guidelines. This system is simple, yet it works. It eliminates the need to train police to assess complicated medical Chris Conrad needs, calculate yields, distinguish male from female NOTICE:This book is not a substitute for legal of medical or vegetative from flowering plants, determine what counsel. Laws and rulings cited are subject to change at any part of a crop is usable, or understand consumption, time.This booklet is current as of July, 2005. For updates,visit processing and storage. Counting plants is never us online at:www.chrisconrad.com or www.safeaccessnow.net. required. To check compliance, all a field officer needs Special thanks to attorneys David Nick, Omar Figueroa, is a scale and tape measure. Any excess may be con- William Logan, Robert Raich and Joe Elfoid for their editorial fiscated or spared, based on circumstances such as review of legal issues, and to the Marijuana Policy Project, Ralph Sherrow, Michael Baldwin,Andrew Lesure, Mikki Norris the presence of a physician's statement that they use and many others for their help in researching, preparing and more. publishing this document. Page i • Cannabis Yields and Dosage Part 1: The science FEDERAL MEDICAL MARIJUANA Cannabis: Legally grown and provided in daily smoked dosages Marijuana (Cannabis satit a) is a treatment for pain and other symptoms of many diseases; its medical use ' goes track some 5,000 years. Sometimes cannabis can halt the development of a condition. It is medicine with a safe and effective dosage demonstrated by United mks States government research. The National Institute on WOW pa an Drug Abuse provides by prescription a standard dose of smoked cannabis to patients in the Compassionate Investigational New Drug (IND) program. This is about two ounces per week — a half-pound per month mailed in canisters of 300 pre-rolled cigarettes con- sumed at a rate of 10 or more per day. nx41 "Marijuana, in its natural form, is one of the sGfest therapeutically active substances This six-inch diameter canister held 254.89 grams, about nine ounces, of federal medical marijuana for an IND patient.This known to man. " is a typical monthly supply mailed from the federal cannabis —DEA Administrative/,aw Judge Francis Young research garden in Oxford, Mississippi. Docker No. 86-22. 1988. the annual dose comes to between 5.6 and 7.23 pounds of cannabis. The documented federal single This long-term dosage has proven to be safe and effec- patient dosage averages 8.24 grams per day — that's tive, with no unacceptable side effects. As seen below more than 1/4 ounce per day, two ounces per week or in Table 1, from the ✓oul-na/of Cannabis Therapeutics, 6.63 pounds smoked per year. Table 1: Chronic cannabis IND* patient demographics 'The Investigational New Drug (IND) program is overseen by National Institute on Drug Abuse: NIDA Patient Age/ Qua/ifying IND Approval/ Daily Cannabis/ Current Status 0 Gender Condition Cannabis Usage THC Content A 62 Glaucoma 1988 8 grams (0.28 oz) Disabled operator/singer/ F 25 years 3.80% activist/vision stable B 52 Nail-Patella 1989 7 grams (0.25 oz) Disabled laborer/ M Syndrome 27 years 3.75% factotum/ambulatory C 48 Multiple 1982 9 grams (0.32 oz) Full time stockbroker/ M Congenital 26 years 2.75% disabled sailor/ambulatory Cartilaginous Exostoses D 45 Multiple 1991 9 grams (0.32 oz) Disabled clothier/visual F Sclerosis 11 years 3.5% impairment/ambulatory aids Source: Russo, Mathre, Byrne,Velin, Bach,Sanchez-Ramos and Kirlin. ✓ournalofCannabis Therapeutics,Vol.2(1)2002.p. 9 Cannabis Yields and Dosage• Page 1 LONG HISTORY, MANY THC RECEPTORS IN THE BRAIN THERAPEUTIC USES AFFECT MOOD, MOVEMENT, PAIN Cannabis brings relief to a wide Cerebral cortex: variety of body systems and ills Memory, pain, For over 3,500 years, various strains of the green herb perception, higher thinking, Cannabis sativa, or true hemp, have been among the emotions most widely used of medicinal plants.This includes civ- ilizations in China, India, Europe, Africa and the Middle East. Cannabis was used in the USA from 1850 to 1937 to treat more than 100 distinct diseases or conditions. Hippocampus: The Journal of the American MedicalAssociation ran a ,V Memory 1995 commentary supporting the medical use of mari- juana and calling for increased research. Soon there- after, the National Academy of Science / Institute of Basal ganglia: Medicine reported to the Office of National Drug Control Movement, Cerebellum: Policy that "The accumulated data indicate a potential coordination Movement therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation" (Mar#uana and the condition being treated. Furthermore, hemp seeds Medicine. National Academy Press, 1999. p. 3). Today, are nutritious and work as a gentle laxative. scientists hold annual medical conferences to discuss recent research and study naturally occurring human In general, cannabis is used to treat symptoms rather endocannabinoids.Tens of thousands of patients in ten than to cure disease. Since many health problems states use cannabis with state-level legal protections cause similar symptoms, however, this means that peo- for approved medicinal use. pie with a wide variety of diseases, injuries and congen- Modern medical uses of cannabis include conjunctive ital maladies all benefit at a basic level: Relief from treatments for physical and mental illness (see list in physical or mental suffering. The intensity and duration box). Symptoms of numerous ills can be controlled, of the symptom often dictates the pattern of use. bringing effective relief and significantly improving the Of course, no drug works equally well for all people in quality of life and functionality. It is also a stress reduc- all circumstances. For some people cannabis is like a er, an expectorant, and a topical antibiotic. It can be a miracle drug, while for others it may offer no benefit. safe and effective alternative to pharmaceuticals such Effectiveness is linked to dosage. Some patients find as Demoral, Valium and morphine. Herbal cannabis that small amounts suffice, while others need heavy, and its derivatives are eaten, smoked or used as tinc- ongoing dosages to function. tures, topical salves and herbal packs, depending on Cannabis bud has a combination of special compounds called cannabinoids that affect various body systems Partial list of health conditions for simultaneously at allopathic and homeopathic doses. Not all strains work equally well in treating specific which medical marijuana is used problems. For example, a variety that reduces nausea Cannabis resin and its derivatives have long been and stimulates appetite may not be as effective at con- used to treat symptoms of many health conditions trolling aches, pains or insomnia. Only certain strains of or to synergize or control the side effects of other cannabis plants produce THC at sufficient levels to be drugs, particularly in chemotherapy. used for medical marijuana. Among these maladies are: Hempseed has no drug effect. It is a nut-like fruit that contains eight proteins in excellent nutritional balance ADD /ADHD, AIDS, anorexia, anxiety, arthritis, plus essential fatty acids that bolster the immune sys- asthma, ataxia, bipolar, cachexia, cancer, chronic tem and may even reduce "bad" cholesterol levels. fatigue, chronic pain, cramps, Crohn's, depression, There are many ways to prepare hempseed, especially epilepsy, fever, glaucoma (progressive blindness), now that it is available in a dehulled form. Its oil is used HIV, insomnia, migraine, MS, nausea, neuralgia, in many foods, salves, lotions, hygiene, health and neuropathy, PMS, PTSD, rheumatism, sickle cell body care and other products that are already on the anemia, spasms, spinal injury, stress, vomiting, commercial market. wasting syndrome. Page 2 • Cannabis Yields and Dosage SUMMARY MEDICAL EFFECTS OF RESINOUS CANNABIS HEMP (MEDICAL MAR iuANA) 1. Cannabinoids stimulate special receptor sites on the brain that affect body systems, triggering a chain of temporary psychological and physiological effects. Initially it has a stimulant effect, followed by relaxation and overall reduction in stress. Analgesic effect. Blocks migraine or seizures. Helps mitigate or control symptoms of multiple sclerosis (MS), spinal injury, epilepsy. Enhances sense of humor and of well-being. Cannabis has synergistic effects with opiates and other drugs. Not all cannabis has the same potency or effect. May cause drowsiness, distraction, paranoia or anxiety. 2. Cannabis reddens and dehydrates the eyes, lowers intra-ocular pressure. 3. Stills ringing in ears (tinnitus). 4. Dehydrates the mouth, stimulates appetite, enhances flavors and taste. 5. Smoked or vaporized, cannabis has anti-phlegmatic and expectorant effects to clear the throat and lungs. Its bronchodilator effect improves oxygen intake for asthma. Smoke can irritate the mouth, throat and respiratory system, but vaporization, oral ingestion and other precautions can mitigate this. 6. Accelerates heart beat and pulse. Dilates bronchia, alveoli and blood vessels. When cannabinoids are inhaled, the lungs and cardiovascular system add them to the bloodstream flowing directly to the brain. This is an extremely fast and effective delivery system. 7. Stimulates appetite. Settles the gastrointestinal tract. Calms stomach. Reduces nausea and vomiting (antiemetic). Soothes motion sickness and various side effects of radiation and chemotherapy. 8. Little or no effect on reproductive system. Cannabinoids cross the placenta without mutagenic effect. Used as a mild aphrodisiac and to enhance the sensual experience. 9. Soothes joints. Analgesic effect reduces pain. Anti-inflammatory, helps arthritis and rheumatism when taken orally or applied topically. 10. Relaxes muscles. Reduces muscle cramps, convulsions, spasms, ataxia and other neurological or movement disorders. 11. Vasodilation carries blood more quickly from the extremities, lowering overall body temperature. Helps reduce fever. 12. The body's fatty tissues collect inert cannabinoids for harmless disposal through urine or feces. Cannabis Yields and Dosage• Page 3 SYSTEMIC EFFECTS FOR "; CARDIOVASCULAR . " SYMPTOMATIC RELIEF R,ESPONSE �� Cannabis stimulates the The cannabinoids attach to special receptor sites in the cardiovascular system, like brain and other parts of the body. While much is known mild exercise, or falling in love. about how they affect the body in general, some of the mechanisms remain unknown, and their effect on the individual can vary greatly. The general scope of effect Stimulates heart 9; on body systems and symptom mitigations make rate, dilates blood „i t cannabis therapeutics beneficial for many diseases, vessels throughout some of which are specified in state laws. California circulatory system. allows its use for listed health problems plus "any other condition" that a physician approves. Cools the extremities. Helps bring down fevers. Personal research with the approval of a physician is Sometimes lowers blood pressure. the safest way for any given patient to determine its potential. How does one know where to start? First look at what specific symptoms need to be treated,then see Here are some common uses for medical marijuana: if there are any negative effects that contraindicate its CANCER, AIDS / HIV: Cannabis reduces the gut- use. That will help a patient to identify the appropriate wrenching nausea caused by chemotherapy(and radi- form, dosage and means of ingestion. Cannabis is ation therapy), while it stimulates the appetite to help exceptionally safe, physically. Not one single death due patients eat and combat excessive weight loss (the to cannabis overdose has ever been reliably reported wasting syndrome) and cachexia. It reduces pain and in medical history. Its smoke does not cause cancer, helps cancer patients sleep and rest. It often raises the but patients with emphysema, lung cancer or personal patients' spirits and mood, improving their will to live preference may choose a different means of ingestion. and chance of recovery. Direct application of THC in vitro shows promise as a tumor-killing or reducing RESPIRATORY EFFECTS OF agent and also kills the herpes virus. not only b consuming PAIN: Pain control is possibley y g CANNABIS SMOKE / VAPOR cannabis flowers, but possibly even the leaves, because, along with THC, cannabidiol (CBD) seems to Dries mucus membrane Causes dry mouth have a major analgesic (pain lowering) effect. Not all and nasal passages.` (oral dehydration). pain responds to cannabinoids, but some of the most troublesome ones do. Neuropathy and neuralgia both Cardio- respond well, while acute injury pain gets less immedi- ate relief but eventually feels diminished. Cannabis has pulmonary synergistic effects with th opiates and other drugs,sopa in exchange Smoke e their dosages of prescription drugs patients can reduce transfers irritates large P 9 P P 9 that have adverse side effects. cannabinoids air passage to blood of lung,' frequently MIGRAINE: Cannabis is fre uentl used to treat light then brain. throat, and migraine headaches. It helps reduce g ht sensitivit y, P wind iP e.t nausea,vomiting, and pain, and can be consumed reg- ularly to prevent attacks from occurring or to as need- ed to reduce the severity of an acute headache. Stress- induced headaches can also be mitigated. MS: Multiple Sclerosis is characterized by increasing Relaxes neuropathic pain and degenerative loss of muscle con- and dilates trol in two forms: involuntary movements (spasms) and bronchi the inability to move (ataxia). Cannabis helps improve and alveoli. movement affected by each of these, while reducing or stopping the pain and related depression. GLAUCOMA: Most sufferers of glaucoma, one of the Possible health risks caused by long-term dehydration world's leading causes of tunnel vision and blindness, and buildup of smoke residues not yet fully assessed could benefit from cannabis, which reduces pressure in t Minor bronchitis risk, no cancer or emphysema link. Page 4• Cannabis Yields al7d Dosage the eye caused by ocular fluid buildup. Its exact mech- anism is unknown. Surgery poses severe risk to the REDUCING EYE PRESSURE eyes and pharmaceuticals hold dangerous side effects, IOP = Intra Ocular Pressure. such as liver damage. Regular cannabis use can often halt this painful progressive vision loss by lowering the Glaucoma The blockage leads to fluid fluid pressure within the eye. When symptoms appear, blockage buildup and high IOP. smoking can stop an acute attack. occurs at Nk EPILEPSY / SEIZURES: Cannabis can calm down the sites overactive nerves, alleviating seizures that may be of eye's caused by a deficiency of natural endocannabinoids. fluid drainage. "One of marihuana's greatest advantages as a medicine is its remarkable safety. It has little . i effect on major pliysiological functions. There is no known case of a lethal overdose; ... Lyt! annabis dries Marihuana is also far less addictive and far es, to lower 1. High ocular damages o a safe level. the ocular nerve less subject to abuse than many drugs now used as muscle relaxants, hypnotics, and analgesics. lends a sense of humor. It can lower blood pressure. ... The ostensible indifference of physicians Contraindication: When fast heartbeat poses risk. should no longer be used as a justification for ARTHRITIS: Eating or smoking cannabis helps control keeping this medicine in the shadows." joint pain, reduce inflammation and improve mobility. A —Journalof the Ameiican Medical Association traditional treatment for rheumatism and arthritis is to June 21, 1995. Commentary.p. 1874-1875 soak cannabis leaves in rubbing alcohol and wrap them around the sore joints to reduce swelling and pain, and ease movement. A general use topical antibiotic is ANXIETY, HEART DISEASE:As a major contributor to made by straining the plant matter out and using the heart disease, anxiety-induced stress may be the num- cannabinoids suspended in alcohol. ber one killer in America. Cannabis promotes relax- MENTAL HEALTH: Cannabis enhances sensory expe- ation, reduces mental agitation, anger and anxiety and riences such as enjoyment of music and art, and has long been regarded as a mild aphrodisiac. It can stimu- late inspiration and critical thinking, increase motivation GASTROINTESTINAL BENEFITS' and reduce malaise such as chronic fatigue syndrome. OF MARIJUANA & HEMPSEED It is anti-depressant and helps people with attention deficit (ADD/ADHD) to better focus and concentrate. It can stabilize bipolar mood swings and may also help Marijuana ^'_ Prevents with memory, such as with Alzheimer's and senility. stimulates "' nausea, Studies on veterans show it helps reduce nightmares the appetite, reduces and rage caused by PTSD. Contraindication: Possibly makes food vomiting schizophrenia. May cause paranoia or panic attack. taste better ABLE-BODIED YOUNG MAN SYNDROME: When an apparently able-bodied young person has a doctor's / note, people may assume that they don't use cannabis as medicine and "just want to get high." However: Sax q Hempsee EFA •A person does not have to look sick to be sick. d improves "�� • You can't see pain, and patients may try to hide it. nutrition and d,� Eating . Mental illness is not visible to the naked eye. hempseed immune support; i oil soften • If cannabis is working, a patient may appear healthy; edestin helps fir.> . . in fact, one should hope that they feel well as can be. digestion & stools and gastric facilitates For these and other reasons, it is up to the patient to absorption. defecation make the determination with a physician as to whether cannabis is the right medicine for them. Cannabis Yields and Dosage• Page 5 DAILY THERAPEUTIC USE Effect of Smoked vs. Eaten Cannabis .r t00 too Potency& duration of effect m a� a e•. Titratin medical marijuana dosages C/inica/andPhaim. g 1 g o Therapeutics.28:3. 1980 Most people are familiar with the use of smoked mari- y 10 Smoked 10 Eaten juana for symptomatic relief of chronic and acute health disorders, but there is much more to know about this o traditional herbal remedy. U N "Its margin of safety is immense and under- 0 t t. scores the lack of any meaningful danger in c Smoked cannabis: Eaten cannabis: using not only daily doses in the .3.,5 — 9 gram o fast peak, rapid drop slow build,long effect range, but also considerably higher doses. Tiiil O t 60—David Bearman, M.D. 120 180 240 80 120 18 (k D 240 300 36 Duration of effect: Expressed in minutes Physician, researcher, court-qualified cannabis expert The phrase "medical marijuana," as commonly used, Chronic pain patients tend to use larger amounts, while refers to the cured, mature female flowers of high- acute and terminal patients may use less. Conditions potency strains of cannabis or a conversion thereof. like glaucoma or MS may require continuous use to Since cannabis is an annual plant, it is logical to meas- prevent attacks. Health conditions may periodically or ure its use as an annual dosage. Many patients need cyclically improve or get worse, causing usage to fall or three pounds of bud or more per year. A smaller num- rise. Some require daily and multiple-daily dosages. ber of daily use patients smoke six, nine, 12 pounds or The means of ingestion also affects patient dosage. more per year for chronic conditions, but dosage varies Smoked cannabis provides rapid and efficient delivery. with each person and how they consume it. Most patients consume it this way, but some wish to Potency is one factor, but other concerns affect titra- avoid the smoke. "Vaporizing" it (heat without combus- tion, as well. "Whether a one gram marihuana cigarette tion) may require twice as much. NIDA estimates that contains 2% or 8%THC, the cigarette will generally be eating requires three to five times the smoked dosage. smoked so as to deliver the smoker's desired cannabi- This means that a patient who smokes a pound per noid dose," NIDA researcher Dr. Reese Jones noted in year needs about four pounds for the same effect if the UC San Francisco CME class syllabus Cannabis they eat it, although often they prefer a combination of Therapy(June 10, 2000, p. 315). the two. When eaten, cannabis' effects are spread out over a longer period of time (see graph). This may be Table 2 Dail Smoked D particularly good for sleep or situations where smoking v Dosages g is impractical or impossible, but due to its delayed A single cigarette per day weighing less onset and varied metabolic activity, eaten is hard to than one gram equates to roughly one titrate. Consumable goods spoil over time, there is a learning curve to prepare recipes, and not every ounce per month, or 12 ounces per year. attempt produces usable medicine. Making kef, hash, The national average weight of a cannabis cigarette ranges tinctures, oil, extracts, topical salves and liniment all from 0.5 to one gram each, according to NIDA,the federal require ample amounts of cannabis. Patients need an National Institute on Drug Abuse. accurate scale to measure, track and titrate their own Some patients consume small cigarettes to conserve their personal dosage and supply of cannabis. medicine, but for a patient who consumes one gram cigarettes,an ounce (28.3 grams) offers less than one ciga- All patients have the need to obtain and possess an rette per day for a month. Furthermore, stem and possibly adequate supply for some period of future need. Since seeds must be cleaned out of cannabis before it is used.A patients can't simply go to the pharmacy to get this patient who gets 24 cleaned grams per ounce can roll 30 ciga- medicine,they are forced to stockpile. From three to six rettes at 0.8 grams each, one per day for a month. However, many patients must smoke cannabis throughout the day. pounds is reasonable as a personal supply. Potency diminishes with age, but cannabis can be stored in a Three to five average-size cannabis cool, dry, dark place for years on end without significant cigarettes per day comes to about one loss of effect. ounce a week, or 3.25 pounds in a year. Page 6• Cannabis Vie/ds anal Dosage USABLE MEDICAL MARIJUANA & CONVERSIONS Plant, tend, harvest, prepare and store Cannabis takes root as either seedlings or cuttings (clones). Later, male plants are cut out of the garden to r„ prevent pollination. Female plants grow to full maturity before being cut and harvested.About 75%of the fresh weight is moisture that is lost in the drying process. [T]he quantity possessed by the patient or the primary caregiver, and the form and ? lr manner in which it is possessed, should be reasonably related to the patient's current medical needs. — California Court of Appeals, People v. Trippet(1997) Almost half of the dried plant matter is stem; only about a quarl'er (18% to 28%) remains after the herb is cured Mature female cannabis plants, like the one shown above, pro- duce buds with the concentrated medicinal compounds. and manicured into medical-grade bud. This bud por- Male plants are unusable, and so are promptly removed and tion of the plant has a coating of resin glands that con- destroyed unless pollen is desired for seeds.After the first tain eannabinoids, the active compounds. appearance of their flowers, it typically takes months for female bud to fully mature.According to the federal Cannabis Since different kinds of cannabis have distinct medici- K/Ndsstudy, only about 7% of the freshly cut mature plant nal benefits, genetics are critical. Breeding is preferably weight becomes dried, manicured medical-grade bud. done through selection from among very large numbers — hundreds or even thousands — of individual plants. <" The list below shows just a few of the ways cannabis is prepared or converted and utilized by patients, care- givers, collectives and cooperatives. Inhaled cannabis: smoked, vaporized, converted s Bud:the dried, manicured mature female cannabis flower 4`` Sinsemilla:seedless cannabis bud Kef: (keif, kif, kief): powdery resin glands (trichome) Hashish: compressed resin glands "Only the dried mature processed flowers of female cannabis Oil: (Hash or grass) liquefied resin glands plant or the plant conversion shall be considered when deter- mining allowable quantities of marijuana under this section." Eaten: OYaI ingestion —California Health and Safety Code 11362.77(d) All the various forms listed above can be heated and eaten Buffer: used for cooking or baking edibles _ Tinctures: ethyl alcohol (liquor)-based, by the dropper Food: Pastries, candies, sauce using any of the above Mari-pills: encapsulated cannabis in oil Marinol: Dronabinol, synthetic THC sold by prescription Topicall use: external, transdermal application j Salve:cream or oil-based compounds or suspensions Tincture:ethyl alcohol(liquor)-based suspensions ":. Liniment: isopropyl (rubbing) alcohol-based or DMSO-based suspensions J ;fit- ;, Pending means of ingestion Sativex:cannabinoid inhalers(similar to asthma inhalers) GW Pharmaceuticals product(not available in USA) Patients often roll cigarettes well over 1.0 grams. In this case, a single dosage unit weighed 1.6 grains. Cannabis Yields and Dosage• Page 7 FEDERAL CANNABIS GARDEN AND YIELD STUDY The canopy size predicts yield Table 3: Average leaf plus flower yields The US Drug Enforcement Administration (DEA) at maturity for high planting densities conducted scientific research with the National Institute on Drug Abuse(NIDA) at the University of Sponsor Year Density Yield* Seed Stock Mississippi, published in the 1992 DOJ report, Cannabis Yields. Both seeded and sinsemilla Univ of MS 1985 9 ft. sq. 222 grams Mexico plants of several seed varieties were measured. Univ of MS 1986 9 ft. sq. 274 grams Mexico Canopy is a term used in agriculture to describe DEA 1990 18 ft. sq. 233 grams Colombia the foliage of growing plants. The area shaded by foliage is called the canopy cover.The data on this DEA 1991 9 ft. sq. 215 grams Mexico page are based on the higher yielding, more potent seedless buds, sinsemilla.The federal field on 'Yield: Oven dry weight of usable leaf and data show that, on average, each square foot of bud from mature 120 day or older plants. mature, female outdoor canopy yields less than a Source: Cannabis Yields US Department of Justice(DOJ), half-ounce of dried and manicured bud (Table 4), Drug Enforcement Administration (DEA), 1992.Table 1, page 3. consistent with growers' reports and gardens seized by police as evidence and later weighed and examined. All other things being equal, a large garden canopy will always CANNA1315 YIELD,' /o BUD yield more than a small one, no 4$ e matter how many plants it con- Medical grade tains. This is true for skilled or Source: DEA unskilled gardener alike. Restric- ting the canopy will limit any gar- den's total bud yield, no matter Ratio of sinsemilla which growing technique is used bud to leaf, excluding or how many plants make up the stems and branches. combined canopy cover. Table 4: Sinsemilla bud yields per square foot of garden canopy Dry Sinsemilla Cannabis (Oven dry. calculated from the DEA data above.) Components 222 grams x 0.48 = 106.56 g cs Source: Cannabis Yie/ds A � (3.76 oz) , 9 square feet = 0.41 ounce US DOJ/DEA. 1992. 274 grams x 0.48 = 131.52 g Figure 2, page 5. �. ` (4.64 oz) - 9 square feet = 0.51 ounce LEAF 30% � ( 233 grams x 0.48 = 111.84 g (3.95 oz) - 18 square feet = 0.21 ounce BUD 28% 215 grams x 0.48 = 103.2 g (3.64 oz) -9 square feet= 0.40 ounce STEM l Average plant canopy size: 11.25 square feet 3Ragd19CNES, 42% Average oven-dry bud yield per plant: 4 ounces Percent oven dry weight for 90 day or older Average oven-dry bud per square foot: 0.38 ounce plants which did not have any seed development Average air-dry bud per square foot: 0.41 ounce (*Adds 10%moisture, per the IND suggestion) Page 8• Cannabis Yields and Dosage GARDEN ADVERSITY DRY SEEDED CANNABIS Bt9�1 'P$�/o COMPONENTS Dry weight for - LEAF 16% 120 day or older Pollen pests and plant problems plants with seeds p p p SEED 23% Contrary to cannabis' reputation as a weed, it is not so S T!2PWBGR ANn_HES 43% Source: Cannabis Yields, page 5 easy to grow quality medicine. Not all gardens have ideal conditions and few patients are trained botanists. Only mature female plants were considered in the The NIDA field data has a solid scientific basis, but it study. Male plants were removed before NIDA made its does not reflect all the realities a patient or caregiver calculations. Statistically, half of all cannabis plants faces in obtaining medical-grade cannabis. It is reliable grown from seed are males with no medical value. for a mature female garden grown in optimum condi- • Only healthy plants were considered. Plants that tions, but several key factors must be clarified: were sick or died were excluded from the study, but in • The NIDA Mississippi garden was grown in ideal a real garden this can be a very serious problem. conditions with full sunlight and fertile, loose, well- NIDA had no loss to theft, pests or law enforcement. drained soil. Many patient gardens are partially shaded or rely on soils of uncertain pH and quality. • Unreliable police estimates were listed in the back. • Trained scientists maintain the NIDA garden. Most Some gardens yield less than average. Some patients patients and caregivers are self-taught from books, may need to grow or store more than a year supply at a time overlook serious problems until too late, and seldom for security issues or as a hedge against crop failure. have access to expert advice when needed. When seedless (sinsemilla) cannabis goes to seed, the quality drops and net yield of bud goes down by a third (see chart). Female plants may suddenly Table 5: Big plants can have reduced canopy yields become hermaphrodite and grow Source: Cannabis Yields. US DOJ/DEA. 1992.Table 2, page 3 male flowers. Deer, rodents and Average Cannabis Yields at Maturity for Low Planting Densities snails snack on young plants and Sponsor Year Density Grass Yield` Seed Stock can destroy entire garden. White fly, spider mites, mealy DEA-A 1990 81 ft.sq. 777 grams (27.3 ounces) Mexico bugs, thrips, aphids and scores of DEA-B 1990 81 ft.sq. 936 grams (32.8 ounces) Mexico other insects feed on cannabis. A DEA-C 1990 81 ft.sq. 640 grams (22.5 ounces) Mexico power failure can wipe out an DEA 1991 72 ft.sq. 1015 grams (35.6 ounces) Mexico indoor crop light cycle. Molds,fun- DEA 1991 36,ft.sq. 860 grams (30.2 ounces) Mexico gus and mildew may attack a crop at any time, but are most common Yield = Dry usable leaf and bud from mature 120 day or older plants. just before harvest and can make an entire crop unusable. Floods, Calculations using the DEA canopy yield formulae* frost and other bad weather can *Whereas 48% of gross sinsennilla yield is bud, only 32% of seeded yield is bud. destroy an entire garden. NIDA 19afplus bud yields Sinsemilla bud net Clean seeded bud Table 5 on the left, using data A: 27.3 ounces foliage x 0.48 = 13.1 oz x 0.32 = 8.7oz net from the DEA study, shows that even big plants may produce less B: 32.8 ounces foliage x 0.48 = 15.7oz x 0.32 = 10.4oz net than an eighth of an ounce per C: 22.5 ounces foliage x 0.48 = 10.8oz x 0.32 = 7.2oz net square foot. After you remove DEA: 35.6 ounces x 0.48 = 17.Ooz x 0.32 = 11.4oz net seeds, that leaves a tenth of an DEA: 30.2 ounces x 0.48 = 14.5oz x 0.32 = 9.7oz net ounce - 1/5 as much as its pro- jected yield, and requiring 500 Cannabis bud yields per square foot based on low density field data square feet to obtain three N/DA loaf andbudyields Sinsemilla bud not Clean seeded bud pounds of bud and 1000 square 27.3 -- 81 sq' = 0.34oz/sq' x 0.48 = 0.16oz/sq.ft. x 0.32 =0.11 oz/sq.ft. feet for six pounds. 32.8 - 81 sq' = 0.40oz/sq' x 0.48 = 0.19oz/sq.ft. x 0.32 =0.13oz/sq.ft. Despite its shortcomings, the best 22.5 - 81 sq' = 0.27oz/sq' x 0.48 =0.13oz/sq.ft. x 0.32 =0.09oz/sq.ft. way to estimate crop yields is still 35.6 _ 72 sq' = 0.49oz/sq' x 0.48 =0.24oz/sq.ft. x 0.32 =0.16oz/sq.ft. measured by the acre-or, in this case, by the square foot. 30.2 - 36 sq' = 0.83oz/sq' x 0.48 = 0.40oz/sq.ft, x 0.32 = 0.27oz/sq.ft. Cannabis Yields and Dosage-Page 9 I INDOOR AND OUTDOOR GARDEN ISSUES Different methods, similar yields Depending on their interest and abilities, individuals may plant a medicine garden outdoors or inside, under �r .a electric lamps. Most patients have difficulty gaugingl"�., their future yield, so barring clear evidence of sales or diversion, even seemingly large gardens may be hon- est efforts t0 comply. California Narcotics Officers More harvests of smaller plants: Indoor gardens often involve many small plants rather than a few large ones.This dry, mature Association trainer and Bureau of Narcotics Enforce- female plant weighed only nine grams including bud,stem, leaf ment expert Earl "Mick" Mollica, testified on December and roots. It yielded less than three grams manicured and fin- 15, 2000 (People v. Urzlceanu, Sacramento), "I have shed bud—about 1/10 ounce. It would take 80 plants this size seen plants that produce a quarter gram per plant, 900 to yield eight ounces of finished smsemilla bud. of them" (900 plants times 0.25 grams equals 225 grams, just less than eight ounces.) ounces per square feet. While the DEA data show an Some harvests are better or worse for each grower. oven-dried average of 0.38 ounces per square foot, b 9 P q Y Some growers get better yields than others, but most using better genetics, a good grower often harvest a fall in the middle, so using the average is the most rea- half-ounce of air-cured bud per square foot outdoors. sonable basis to make projections. Outdoor plants typ- Indoors:A personal indoor garden typically fits into one ically yield more bud at one harvest per year. Indoor or two average size rooms using electric lamps, fans plants each yield less, but allow multiple harvests. Y P and basic garden supplies While an indoor gard en is Either way' it takes about 200 square feet of garden typically harvested three times a year, its annual yield is canopy toobt ain six pounds of bud per year. often about the same as outdoors. a o s Only part of an indoor garden is used for flowering at OUTDOORS: ALL MATURE TOGETHER any given time.The rest is nursery and vegetative area Plants grow together throughout the season, that does not produce bud. Cannabis is light sensitive, When lams ow together the male plants are destroyed. so a barrier must separate vegetative from flowering 100 square feet of mature female canopy.from seed areas. If half ti 100 square foot area is used obtain or clone is harvested at one time with a total ield of flowers three times a year, a total of 150 squarere feet of y bud canopy is harvested. The typical indoor yield range ±50 ounces (3.1 pounds) of bud to last the entire year. is 0.25 to 0.5 ounces per square foot, averaging 0.38 ounces, so those 150 square feet should yield 56.25 Outdoors: With a typical growing season that lasts ounces (3.5 pounds), just over one ounce per week. from March or April into September or October, outdoor Once a patient has an adequate supply, they can peri- plants have a long time to grow and usually much more odically shut down an indoor flowering area but keep space to spread out, so they tend to be larger. the nursery going for future use.Any supply of cannabis Half the plants grown from cannabis seed are mates or garden canopy that is larger than the local guidelines or statewide default amounts should be accom anied that are worthless for marijuana. That's why outdoor P canopy should not be evaluated until flowering is fully by a physician's written authorization whenever possi- underway, usually in August.After that, males are elim- ble. This allows fora small buffer against adversity and crop loss and lets law enforcement know that the sup- inated, leaving gaps in the canopy and giving a better sense of the useable canopy size. Plant canopy need Ply is legitimate for the patient's current needs. not be continuous. A backyard garden often has plants CAUTION: Electric overloads and lamp heat can cause of different sizes scattered over a wide area. Measure fires. Be sure your system is up to code. Most homes and calculate each plant's individual canopy then add can support no more than 3500 extra watts or less. the total to find the actual area of a garden; e.g., 11 round plants each having a 42"diameter(9 square feet) INDOORS: TWO CYCLES OF GROWTH totals 99 square feet of canopy cover. About half of the area is used for flowering females and, The remaining plants are killed with only one harvest harvested three times per year, for a total of 56.25.ounces. per year.To obtain three pounds of sinsemilla bud from 100 square feet of canopy requires a yield of 0.48 The othermothers, - plants that are used to refill the flowering area as needed. Page 10• Cannabis Ylalo's and Dosage MEASURING CANOPY Outdoor Example Aerial view, looking down at a plant A single plant with - - rounded canopy .,t Larger gardens give bigger yields 30"in diameter o, covers almost Some people can grow bushy plants outdoors, others 5 square feet ` First, measure need to grow small "Sea of Green" gardens with tiny of area plant diameter plants indoors. Safe Access Now garden guidelines are r °- (e.g.,30") easy to use and follow for either circumstance. All you need is a tape measure to calculate the canopy size. �t�,t , Consider the overall plant and garden configuration, layout and density, then do the math: example: Plant diameter 30" 1)If a garden is rectangular and densely filled-in(no gaps or open Area=rz(pi) radius squared areas), measure the length and width and multiply to find square Find radius:30 , 2= 15" Short cut: footage.Some examples:4'x8'bed=32 square feet.4'x25'=100 Area=rz (pi)x(15 x 15) Area=diameter sq.x 0.7854 sq. ft. 8'x12.5'= 100 sq.ft. A=3.14 x 226=706.5 sq. in. Diameter sq.=30 x 30=900 2)If a garden is rectangular and mostly filled-in,but has pathways 706.5_144 sq. in*=4.9 sq.ft 900 x 0.7854=706.86 sq. in. or gaps between plants, calculate the overall area in square feet Result:Canopy=4.9 sq.ft. 706.86 a 144*=4.9 sq.ft. then subtract open spaces to find the garden's net square *1 square foot=144 square inches footage. Example: 12'x12'greenhouse = 144 sq. ft minus 44 sq. ft open space= 100 sq.ft actual canopy area. 3) If a garden is irregular in shape or isolated plants are scattered Many small plants or a few big ones throughout an open area, measure individual plant canopies or patches of filled-in area that the plants occupy, not the open The following reference chart shows how many rounded space between them. Calculate for each plant or patch and plants of similar size can fit within 100 square feet of total repeat; add to find the garden total. garden canopy: /ndiuidua/p/ant size Remember that indoors or out, only the mature flower- 1 plant at 9-11'diameter each 64 to 95 sq' ing area provides usable cannabis bud. After they are 2 at 7-8'diameter 33 to 50 sq' ripe, the plants must still be cut, dried, manicured, 3 at 6'diameter 28 sq' cured and processed before they are ready to use. 5 at 5'diameter 20 sq' 7 at 4'diameter 12.6 sq' Indoor Example 14 at 3'diameter(typical outdoor girth) 7 sq' � `-- 33 plants at 2'diameter 3 sq' 8 + 24 -F 32 + 32 = 96 sq. ft. T 99 plants at 1.25'diameter 1 sq' _ $ 125 plants at V diameter. 0.7854 sq' q Most gardens naturally produce an assortment of plants of different sizes. A typical mature out- door garden might hold two plants at 4'diameter, six at 3',four at 2'and 12 at 1'diameter for a total of 24 plants in 92 square feet. A typical indoor garden might include 12 flowering plants in 32 sq'area, 24 vegetative in 32 sq', 4 mothers in 24 Nursery: Starter plants Vegetative plants in a sq', and 48 starters in 8 sq', for a garden total of (seedlings or clones) in a 4'x8'tray=32 square feet 88 plants in 96 square feet. 4'x2'tray= 8 square feet Flowering female plants in a How many are too many? It depends. Since a 4'x8'tray=32 square feet few large cannabis plants can out-produce hun- Mother plants growing in a dreds of small ones, the number of plants in a 6'x4'area=24 square feet garden cannot accurately predict yield. Canopy indicates a garden's likely yield without counting plants, knowing if they are seedlings or clones, .fi etc.A 99-plant cap is below the federal five year mandatory sentence for 100 plants and ensures that state jurisdiction applies. The California default guidelines in SIB 420 protect from arrest only eight ounces of bud and six mature or 12 immature cannabis plants per patient. Cannabis Yields and Dosage• Page 11 *\ � �art 11: State of the law FF EDERAL LAW Under the Commerce Clause of the Constitution, the federal Controlled Substances Act of 1970 set up five schedules to establish varying degrees of control over classified drugs. Marino% synthetic THC in gel cap- sules, is in Schedule III and available by prescription; but the DEA still bans the natural plant and its deriva- Left to Right: David Michael, Diane Monson, Randy Barnett, tives. Marijuana is in Schedule I, prohibited. Therefore, Angel McClary Raich,and Robert Raich, at the Ninth Circuit doctors can not oreseribenatural cannabis in any form. Court of Appeals in San Francisco, CA, on the day they argued However, they are allowed to speak with patients and or medical rights. October 7, 2003. recommend or approve its use, as long as they don't help supply the patient. The law remains in a state of necessity" does not afford medical marijuana providers flux, with both High Court rulings and legislation. a defense against federal charges of distribution, even Conant,'Doctors can recommend it within state borders to seriously [[I patients who have tried all other alternatives and suffer imminent harm The Ninth Circuit spoke loud and clear in its 2002 deci- without it. It did not rule on individual necessity. slon affirming a physician's First Amendment right to In the case of the Controlled Substances Act,the statute I I speak freely to a patient without fear of arrest. Conant reflects a determination that marijuana has no medical benefits v. Walters was appealed, but the US Supreme Court worthy of an exception (outside the confines of a Government- denied cent, thereby confirming its validity, approved research project). This is an appeal from a permanent injunction entered to pro- — US v. OCBC,532 U.S. 483, 491 (2001). tect First Amendment rights.The order enjoins the federal gov- Ra/Ch:Fed can prosecute patients ernment from either revoking a physician's license to prescribe controlled substances or conducting an investigation of a phy- The Ninth Circuit rose to the occasion. In its historic sician that might lead to such revocation,where the basis for Raich v. Ashcroft ruling, it held that there are limits on the government's action is solely the physician's professional federal power — i.e., the Interstate Commerce clause 'recommendation'of the use of medical marijuana. ...The gov- ' ernment has not provided any empirical evidence to demon- does not apply to patients who Use non-Commercial strate that this injunction interferes with or threatens to interfere cannabis and solely within a state where it is legal. with any legitimate law enforcement activities. Nor is there any Appellants argue that the Commerce Clause cannot support the evidence that the similarly phrased preliminary injunction that exercise of federal authority over the appellants'activities.The preceded this injunction, Conant v McCaffrey,which the gov- Supreme Court expressly reserved this issue in its recent deci- ernment did not appeal, interfered with law enforcement.The sion, US v Oak/and CannabisBuyers'Coop... We find that the district court, on the other hand, explained convincingly when it CSA, as applied to the appellants, is likely unconstitutional. ... entered both the earlier preliminary injunction and this perma- nent injunction, flow the governments professed enforcement (9th Cir. Dec. 16, 2003) policy threatens to interfere with expression protected by the First Amendment. We therefore affirm. The US Supreme Court heard Raich on appeal and on — Conant v Walters(9th Cir 2002) 309 Fad 629, June 6, 2005 it issued a 6-3 ruling against patients and Cert denied Oct. 14, 2003 States Rights, despite the "troubling facts" of the case. OCSC:Sales subject to federal ban It did not address issues of substantive due process or medical necessity. The Court's majority noted that In US v. Oakland Cannabis Buyers' Coop., the US there are other avenues of relief available without sep- Supreme Court decided that the doctrine of "medical arating out medical marijuana or overturning the CSA. The authority to grant permission whenever the doctor deter- mines that a patient is afflicted with 'any other illness for which Controlled Substances Act of 1970 marijuana provides relief,'Cal. Health &Safety Code Ann. §11362.5(b)(1)(A) is broad enough to allow even the most Criteria for the highest [prohibited] drug schedule in scrupulous doctor to conclude that some recreational uses US Code Title 21 Section 812(b): would be therapeutic. ... (1]he[CSA]statute authorizes proce- dures for the reclassification of Schedule I Drugs. Perhaps even more important than these legal avenues is the democratic A. The drug or other substance has a high potential for process, in which the voices of voters allied with these respon- abuse. dents may one day be heard in the halls of Congress. B. The drug or other substance has no currently accepted Under the present state of the law, however,the judgment of medical use in treatment in the United States,AND the Court of Appeals must be vacated. C. There is a lack of accepted safety for use of the drug or — Gonzales v Raich, 125 S.Ct. 2195 (2005) other substance under medical supervision. Page 12 • Cannabis Yields and Dosage CALIFORNIA VOTERS CA Supreme Court Mower Decision PASSED AN INITIATIVE While not immune from arrest, a •= - qualified patient should not be Proposition 215: The law of the land indicted. Once an approval is In the California Constitution, when a state law conflicts shown, the burden shifts to the 1' with federal statute, state officials must enforce and fol- prosecutor to prove that any - low state law and leave federal law to federal agencies. cannabis so cultivated or pc7 sessed is beyond the scope of An administrative agency,including an administrative agency cre- Proposition 215. ated by the Constitution or an initiative statute, has no power: ... (c) To declare a statute unenforceable, or to refuse to enforce a [A]defendant moving to set aside an Patient Myron Mower statute on the basis that federal law or federal regulations prohib- indictment or information prior to trial took his case to the it the enforcement of such statute unless an appellate court has based on his or her status as a quali- California Supreme made a determination that the enforcement of such statute is pro- fied patient or primary caregiver may Court—and won. hibited by federal law or federal regulations. proceed under Penal Code section 995. ... Of course, in the absence of — California State Constitution Amendment III, Section 3.5 reasonable or probable cause to believe that a defendant is State Attorney BIII Lockyer announced that the Raich guilty of possession or cultivation of marijuana, in view of his or "ruling does not overturn California law permitting the her status as a qualified patient or primary caregiver,the grand use of medical marijuana, but It does uphold a federal jury or the magistrate should not indict or commit the defendant in the first place, but instead should bring the prosecution to an regulatory scheme that contradicts the will of California end at that point. ... We agree that, in light of its language and voters and limits the right of states to provide appropri- purpose, section 11362.5(d) must be interpreted to allow a ate medical care for its citizens. ... [S]tate and federal defense at trial. ... laws are no different today than they were yesterday." As a result of the enactment of section 11362.5(d),the posses- sion and cultivation of marijuana is no more criminal—so long Qualified patients and caregivers as its conditions are satisfied—than the possession and acqui- have aright to use and cultivate sition of any prescription drug with a physician's prescription. ... the provision renders possession and cultivation of marijuana Proposition 215, The Compassionate Use Act of 1996,, noncriminal under the conditions specified. passed by more than 56% of the vote, creating broad —California Supreme Court, People v Mcwer(2002) protections for doctors, patients and primary caregivers 28Cal.4th 457. who may use or cultivate marijuana legally. It did not Appeals Court TrippetDeeision legalize sales of cannabis."Stop arresting patients"was a campaign theme, but it has not since been the case. Benefits of legislative reform are retroactive and Prop The measure does not limit personal amounts of can- 215 may cover transportation of cannabis; however, nabis that can be grown or possessed, nor did it author- any amount of cannabis cultivated, possessed or trans- ize the legislature or any other entity to set such a limit. ported must be reasonably related to current use. On this page are some key elements of this law and As the Attorney General concedes, absent contrary indicia, 'the court decisions, OY case law, that apply to cannabis use Legislature is presumed to have extended to defendants whose appeals are pending the benefits of intervening statutory am- within the state. Two sections merit our notice here: endments which decriminalize formerly illicit conduct[citation], HS 11362.5(c): Notwithstanding any other provision of law, no or reduce the punishment for acts which remain unlawful.' ... physician in this state shall be punished, or denied any right or The rule should be that the quantity possessed by the patient or privilege,for having recommended marijuana to a patient for the primary caregiver, and the form and manner in which it is medical purposes. possessed, should be reasonably related to the patient's current (d)Section 11357, relating to the possession of marijuana, and medical needs. ... [T]ransportation may be allowed if quantity Section 11358, relating to the cultivation of marijuana,_shall not transported and method,time and distance of transportation are apply to a patient,or to a patient's primary caregiver, who pos- reasonably related to patient's current medical needs. sesses or cultivates marijuana for the personal medical purpos- —CA Court of Appeals, People v Tlppet(1997) es of the patient upon the written or oral recommendation or 56 Cal.App.4th 1532, 57 Cal.App.4th 754A approval of a physician. — Califomia Health and Safety Code n, ' ;,._n Appeals Court Sp,?Airdecision A qualified individual charged with any amount .HwcoTPeMPHaeT The doctor's medical opinion is not on trial. of cannabis can file a demurrer or seek a 995 — A physician's determination on this medical issue is ..,,,. or Mower hearing to get charges dismissed. `-�a< - 'f � not to be second-guessed by jurors who might not They can also assert an affirmative defense in deem the patient's condition to be sufficiently"seri- ous."court to have charges dropped at a preliminary hearing or win acquittal by a jury. rvo0E41it 0996 —CA Court of Appeals, People v Spark(2004) C.A _ 5th 08-02-2004 F042331. Cite 04 C.D.O.S. 6972 .% - ~ T� Cannabis Yelds and Dosage• Page 13 SUBSEQUENT STATUTORY , Local implementation is mandatory LAYY IN CALIFORNIA To ensure that qualified patients, caregivers and collec- tives are protected all over the state, every county has been required to take steps to accommodate and SB 420: State legislators implement the voluntary card system. provlde new protections HS 11362.71.(b) Every county health department, or the coun- p ty's designee, shall do all of the following: Despite the law and rulings, patients (1) Provide applications upon request to individuals seeking to continue to be arrested and prosecuted, join the identification card program. even for small amounts. Senator John (2) Receive and process completed applications in accordance Vasconcellos and Assemblyman Mark with section 11362.72. Leno introduced California SB 420 in (3) Maintain records of identification card programs. Authors:John (4) Utilize protocols developed by the department pursuant to Vasconcellos 2003, passed and signed Into law as paragraph (1) of subdivision (d). Health and Safety Code 11362.7, et seq. (5) Issue identification cards developed by the department to Mark Lane It expands the scope of activities pro- approved applicants and designated primary caregivers. tected under medical marijuana and for- (c)The county board of supervisors may designate another malizes the role of patient collectives. It health-related governmental or non-governmental entity or also created a voluntary identification organization to perform the functions described in subdivision card system to protect against arrest but (b), except for an entity or organization that cultivates or distrib- at the last minute they inserted low and utes marijuana. non-scientific guideline amounts as a Creates limited immunity for sales, safe harbor from arrest. They explained the writing process in an open letter. transportation and intent to distribute Fully appreciating that Proposition 215 cannot be amended by One of the most powerful aspects of SB 420 is its inclu- the Legislature,we have resisted all efforts to make the new sion of sections authorizing activities not included in identification card system created by SB 420 mandatory—at Prop 215, such as intent to distribute, transportation, least two times our SB 420 contains specific language declaring our intent that the program is wholly voluntary. ... processing, sales and maintaining a place where We tried to incorporate NIDA guidelines, but learned that they cannabis is used or produced. do not really exist in any form we could incorporate into SB 420; 11362.765. (a) Subject to the requirements of this article,the ...We chose guidelines we believe best meet our search for individuals specified in subdivision (b)shall not be subject, on balance between patient's needs and pwoticaiiesutts in getting that sole basis,to criminal liability under Section 11357, 11358, SB 420 signedinto law,(emphasis added) 11359, 11360, 11366, 11366.5, or 11570. However, nothing in In addition we allow localities with higher possession or this section shall authorize the individual to smoke or otherwise cultivation amounts to retain them, and other localities to estab- consume marijuana unless otherwise authorized by this article, lish new guidelines which exceed what is set forth in this bill. No nor shall anything in this section authorize any individual or jurisdiction may establish guidelines lower than those set forth group to cultivate or distribute marijuana for profit. in SB 420; (b) Subdivision (a)shall apply to all of the following: In addition we provided individuals the option to get in excess of (1)A qualified patient or a person with an identification card who the guidelines upon a doctor's recommendation for amounts transports or processes marijuana for his or her own personal exceeding the cultivation and possession guidelines set in this medical use. bill. Our letter in the Assembly and Senate Journals expresses (2)A designated primary caregiver who transports, processes, legislative intent that these guidelines are intended to be the administers, delivers,or gives away marijuana for medical pur- threshold, and not a ceiling. ... poses, in amounts not exceeding those established in subdivi- -Sen. John Vasconcellos, sion (a) of Section 11362.77, only to the qualified patient of the Assemblyman Mark Leno, authors of SB 420, primary caregiver, or to the person with an identification card who has designated the individual as a primary caregiver. Some points made above were put into the introduction (3)Any individual who provides assistance to a qualified patient to SB 420 but are not in the resulting legal code. or a person with an identification card, or his or her designated SB 420 SECTION 1. (b) It is the intent of the Legislature, there- primary caregiver, in administering medical marijuana to the fore, to do all of the following: qualified patient or person or acquiring the skills necessary to (1) Clarify the scope of the application of the act and facilitate cultivate or administer marijuana for medical purposes to the the prompt identification of qualified patients and their designat- qualified patient or person. ed primary caregivers in order to avoid unnecessary arrest and (c)A primary caregiver who receives compensation for actual prosecution of these individuals and provide needed guidance expenses, including reasonable compensation incurred for serv- to law enforcement officers. ices provided to an eligible qualified patient or person with an (2) Promote uniform and consistent application of the act among identification card to enable that person to use marijuana under the counties within the state. this article, or for payment for out-of-pocket expenses incurred (3) Enhance the access of patients and caregivers to medical in providing those services, or both, shall not, on the sole basis of that fact, be subject to prosecution or punishment under marijuana through collective, cooperative cultivation projects. Section 11359 or 11360. Page 14• Cannabis YieidsandDosage PATIENTS, CAREGIVERS All state law enforcement officers AND CARDHOLDERS must respect the voluntary ID cards The problem of police continuing to arrest innocent patients is addressed, but only for cardholders and only SB 420 preserves all Prop 215 rights up to the floor amounts in SB 420 unless a local juris- and protects cardholders from arrest diction allows larger amounts, or the patient has a physician's note exempting them from the guidelines. Proposition 215 was a California voter Initiative creating 11362.78.A state or local law enforcement agency or officer our state medical marijuana law, HS 11362.5, so the shall not refuse to accept an identification card issued by the legislature cannot modify it directly. department unless the state or local law enforcement agency or Article 2 Section 10(c)The Legislature. . . May amend or repeal officer has reasonable cause to believe that the information Con- an initiative statute by another statute that becomes effective tained in the card is false or fraudulent,or the card is being only when approved by the electors unless the initiative statute used fraudulently. permits amendment or repeal without their approval. ID card Is a voluntary contract that —California State Constitution,Art. 2 sec 10(c) couples protections with limitations Senate Bill 420 is statutory law that created HS 11362.7 and 11362.8, subject to future modification by the legis- Prop 215 did not protect people from arrest, and it did lature, for example to increase the guidelines in 2005 at not set any limits on gardens or dosages. The courts the suggestion of the Attorney General. It established a have held this to mean any reasonable amount accept- voluntary and confidential patient ID card program ed by a judge or jury. A person with a valid ID card, on administered by the Department of Health Services but the other hand, is immune from arrest — but only for not yet implemented.Among other things, this new law: these very small amounts of medicine: eight ounces of dry, mature bud or conversion and a garden with no • Defines medical marijuana as dry mature female more than six mature plants. For many patients, this is cannabis buds or conversion not enough, and the more cannabis a patient needs, • Creates two legal categories: "qualified patients" pro- the more vulnerable they are to arrest and prosecution. tected by Prop 215 and "persons with an identification There are two immediate remedies to this problem. card"with distinct rights and responsibilities Doctor,s exemption protects dosage • Sets criminal penalties for abuse of the card system • Allows cardholder-caregivers to have more than one First, a physician may authorize unspecified amounts patient in their home county, but only one patient from greater than the state and local guidelines. out of county HIS 11362.77(b) If a qualified patient or primary caregiver has a doctor's recommendation that this quantity does not meet the Sets a default guideline of six mature plants and eight qualified patient's medical needs,the qualified patient or primary ounces of bud or conversion as a safe harbor from caregiver may possess an amount of marijuana consistent with arrest for patients and caregivers with valid cards: the patient's needs. HS 11362.71(e) No person or designated primary caregiver in Cities and Counties are empowered possession of a valid identification card shall be subject to arrest for possession,transportation, delivery, or cultivation of Another provision protects the integrity of local medical medical marijuana in an amount established pursuant to this marijuana guidelines around the state, which allowed article, unless there is reasonable cause to believe that the up to three pounds and 100 square feet of canopy as in information contained in the card is false or falsified,the card Sonoma and Humboldt Counties. Localities are has been obtained by means of fraud, or the person is other- wise in violation of the provisions of this article. empowered to adopt new guidelines, as long as the (f) It shall not be necessary for a person to obtain an identifica- amounts are no lower than the state floor. tion card in order to claim the protections of Section 11362.5. HIS 11362.77(c) Counties and cities may retain or enact medical HIS 11362.77. (a)A qualified patient or primary caregiver may marijuana guidelines allowing qualified patients or primary care- possess no more than eight ounces of dried marijuana per qual- givers to exceed the state limits set forth in subdivision (a). ified patient. In addition, a qualified patient or primary caregiver Why should any locality enact guidelines greater than may also maintain no more than six mature or 12 immature the SB 420 floor? Because to do so is a cost effective, marijuana plants per qualified patient. reasonable and compassionate. A cost effective policy saves on law enforcement and court resources and expense.A reasonable review shows that the specified floor amount is neither scientific nor adequate for many patients. A compassionate policy would stop arresting patients, leave them their medicine and not ruin them y financially by causing prohibitive legal costs. " ' Cannabis YYe/ds and Dosage• Page 15 HS 11362.766. (a) Subject to the requirements of this article, CANNABIS COOPS the individuals specified in subdivision (b) shall not be subject, on that sole basis,to criminal liability under Section 11357, AND COLLECTIVES 11358, 11359, 11360, 11366, 11366.5, or 11570. However, noth- ing in this section shall authorize the individual to smoke or oth- erwise consume marijuana unless otherwise authorized by this Where to get California's medicine: article, nor shall anything in this section authorize any individual The Appeals Court Peron Decision or group to cultivate or distribute marijuana for profit. ... (b) ... (c)A primary caregiver who receives compensation for actual Obtaining cannabis is one thing, but sales are a differ- expenses, including reasonable compensation incurred for serv- ent matter. The problem has to do with receiving pay- ices provided to an eligible qualified patient or person with an meat for cannabis. Shortly after passage of Prop 215, identification card to enable that person to use marijuana under this article, or for payment for out-of-pocket expenses incurred an Appeals Court decided a case in which the initia- in providing those services, or both,shall not, on the sole basis tive's chief proponent, Dennis Peron, argued that he of that fact, be subject to prosecution or punishment under had a right to sell at his San Francisco dispensary. Section 11359 or 11360. ... Although the sale and distribution of marijuana remain as crimi- HS 11362.775. Qualified patients, persons with valid identifica- nal offenses under section 11360, bona fide primary caregivers tion cards, and the designated primary caregivers of qualified for section 11362.5 patients should not be precluded from patients and persons with identification cards,who associate receiving bona fide reimbursement for their actual expense of within the State of California in order collectively or cooperative- cultivating and furnishing marijuana for the ly to cultivate marijuana for medical purposes, shall not solely - - patient's approved medical treatment. ... on the basis of that fact be subject to state criminal sanctions - Assuming responsibility for housing, health, or under§ 11357, 11358, 11359, 11360, 11366, 11366.5, or 11570. _ safety does not preclude the caregiver from Organizing a collective or coop charging the patient[59 Cal.App.4th 1400]for those services.A primary caregiver who cons[s- After Prop 215 passed, patient cooperatives and collec- tently grows and supplies physician-approved tives took root around the state, as noted above. There or-prescribed medicinal marijuana for a section 11362.5 patient is serving a health need of the is no clear definition in the law as to what that means, patient,and may seek reimbursement... . but Courts and communities are recognizing a broad Dennis Peron We find no support in section 11362.5 for array of arrangements. In general terms it constitutes a respondents'argument that sales of marijuana group of individual bona fide patients and caregivers on an allegedly nonprofit basis do not violate working within a mutually agreed relationship as prop- state laws against marijuana sales. No provision in section erty holder, workers and patients who obtain cannabis. 11362.5 so states. Sections 11359 and 11360 explicitly forbid In some groups everything is voluntary, some have both the sale and the"giv[ing] away"of marijuana. Section 11362.5(d) exempts"a patient"and"a patient's primary caregiv- mandatory participation in the garden itself, and some er"from prosecution for two specific offenses only: possession have paid support staff. All require that the physician's of marijuana (§ 11357)and cultivation of marijuana(§ 11358). It authorization be verified. Most require written, rather does not preclude prosecution under sections 11359 (posses- than oral, approvals and keep documents on at the gar- sion of marijuana for sale) or 11360(a), which makes it a crime den and supply sites. Some seek the approval of a gov- for anyone to"sell furnish, administer, orgive away"marijuana ernment agency, but many prefer to "fly under the (italics added).—(1997)59 Cal.App.4th 1383, 70 Cal.Rptr.2d 20 radar" and provide information only as an affirmative [No.A077630. First Dist., Div. Five. Dec 12, 1997.1 defense after the fact. The"right to obtain"marijuana is, of course, meaningless if it Every qualified patient or arrangement thereof has a cannot legally be satisfied. ... Local governments in California right to argue any quantity or arrangement under state are now exploring ways in which to responsibly implement the law, but they still might lose in court. Those with valid new law(as, for example,through licensing ordinances) so as identification cards are protected to the minimal extent to relieve those medically in need of marijuana but unable to cultivate it from the need to do so. I do not think we should in HS 11362.77(a) eight ounces, 12 immature or six make gratuitous blanket determinations which might premature- mature plants per patient, (b) a physician's exemption ly interfere with those efforts. (Concurring opinion, Ibid.) or (c) a local policy. In theory that means no arrest and Based on that decision, cities like West Hollywood, San no destruction of medicine. Collectives might follow pro- Francisco, and Arcata have allowed caregiver- and rata amounts, like 36 mature plants for six cardholders. patient-run dispensaries to operate within their jurisdic- Unfortunately, the same records that may prove helpful tions, although this has not prevented federal or state in defending a collective under state law add greater law enforcement raids. Oakland City Council has risk under federal law. authorized four dispensaries to operate. The WAMM cooperative in Santa Cruz is pursuing an injunction Zoning, permits and taxes against federal DEA raids at the time of this writing. Some cities have zoning and permitting laws that affect HS 11362.7 is even more clear in authorizing certain dispensaries. Cannabis is an over-the-counter medica- kinds of production, sales and distribution. tion, so the Board of Equalization requires sales tax. Page 16• Cannabis YiefdsandDosage NAVIGATING THE Consider getting an investigator or an expert witness. If your case involves more than a very small amount of cannabis, their participation can make a big difference.An expert can con- LECTAL PROCESS sult with your attorney, analyze evidence, prepare reports and testify on your behalf at a hearing or a trial. If you can't afford to pay for one, ask your attorney to file an Evidence Code section Living within acceptable risks 730 extoan'o motion for the court to pay the cost. This booklet is not a substitute for legal counsel. The Plea negotiations occur when your attorney and the DA argue between getting your charges dismissed or altered and them issues discussed in it are either factual or subject throwing the book at you. If you can have them talking before to legal interpretation and changes in law. charges are filed,so much the better. It's never too soon to Before undertaking the cultivation or provi- bring in legal counsel to resolve the issues. sion of medicinal cannabis, it is always a Reading of charges and bail hearing.An opportunity good idea to spend the time and money to make a record that it was legal medical marijuana, to talk with a knowledgeable attorney. ask for dismissal of charges, return of property and Even if What a person Is doing is legal release on your own recognizance, known as"O.R." under state law, these is risk.A patient can Arraignment is the defendant's first hearing, to enter the plea.A demurrer is an alternative to entering a plea. still be prosecuted in state court. Primary Continue the arraignment and tell the judge you need to caregivers are especially at risk because sup- review the police reports and may be filing a demurrer. plying medicine may be charged as distribution. Any- Preparations. During the discovery process,you learn the pros- one should be aware how serious the offense could be, ecutor's evidence against you and glean what areas need to be how likely they are to be held criminal, and whether addressed.You may wish to consult with an expert witness or they can handle its consequences. In any "drug" case, investigator. Plea bargaining, phase two:Ask the DA to recon- sider and dismiss,think about what they want you to plead guilty to and all the consequences of your plea. Can you comply and increase sentences. If a case goes federal, a five- with the requirements,or is it creating future problems for you? year mandatory sentence begins at 100 plants, and 10- Mower Hearing, a PC 995 hearing or common law(speaking) years at 1000 plants, so it is important to balance legal motion to dismiss, is a proceeding before a judge prior to trial in rights against the ability to endure persecution. which a person gets to wage a medical defense with the burden In the end, you make the choice and take the risks. of proof beyond reasonable doubt placed upon the prosecution. Williamson Hearing is a PC section 1000 pre-trial process for Many layers of legal process growers who are not medical users or whose approvals are invalid, allowing them to refute charges of commercial intent What follows is not a comprehensive listing, but serves and get diversion based on a preponderance of the evidence. merely as a general outline of what might occur at some Preliminary Hearing is where a prosecution presents to a point if you are involved with medical marijuana. Not judge witnesses and other evidence of guilt, and the defendant everything here applies to every circumstance. is able to present a defense and attempt to win a dismissal.The court only requires the prosecutor to show probable cause.This It may never happen, but here is a glimpse of the entan- means something gives the court a strong suspicion of guilt, so glements that may await. it usually holds the accused over for trial.This is an opportunity Talk to a knowledgeable attorney. If you don't already have to hear the government's case and have the option of whether an attorney, ask some questions. What do they offer? Do they or not to respond. If the judge dismisses the charges, a prose- know about the sections of law in this booklet?What is it going cutor may be able to refile them, anyway. to cost?You need to balance money against freedom. Remem- Evidentiary Hearing is for a judge to decide what evidence to ber you can also educate your lawyer, but you have much more admit and what to suppress. Sometimes the decisions help the on the line than they do—so choose well and be ready to do defense, other times they hurt it. In any case,these decisions some of your own leg work. If you can't afford an attorney, after shape the case and can form the basis for an appeal in case of arraignment you are entitled to a public defender. conviction. Contact with law enforcement is often triggered by some Jury Trial is when a jury of 12 (plus several alternates) hears minor incident, such as an officer thinking they smell cannabis evidence,testimony and arguments,then renders a verdict of during a routine traffic pullover or cannabis left out in plain sight. either guilty or not-proved-guilty-beyond-reasonable-doubt.At This is the time to exercise your right to remain silent(until you this point the burden of proof again favors the defendant and have an attorney on hand) other than to refuse to consent to a the defense goal is full acquittal.There may also be a hung jury, search. If the officer locates medicine,the defense should be meaning that it cannot come to a unanimous decision and the asserted immediately, such as to say"that medicine is legal charges may or may not be retried. If there is a conviction,there under Health and Safety Code 11362.5"and showing a medical may be basis for an appeal. approval or card.This is not the time to make spontaneous Return of Property Hearing after dismissal or acquittal seeks statements or argue your case.What you say might be different to clarify that your legal property is not contraband and have the than what the officers hear or write down.The police are not court order the return of medicine, equipment, etc. there to help you,they are there to build a case against you and Sentencing is after a conviction when evidence is considered send you to prison if possible.Ask if you are under arrest or if and points argued to determine your sentence. Mitigating cir- you can leave. If you can leave, do so. If you are under arrest, cumstances are considered in both state and federal courts. ask to see an attorney at once,then be silent. Booking is when the police transport and process a suspect after an arrest and put them in a holding cell. Cannabis Yields and Dosage• Page 17 • Safe Access Now recommends this model ordinance for local medical marijuana guidelines: BOARD OF SUPERVISORS COUNTY OF ORDINANCE NO. 2004 - AN ORDINANCE ENACTING MEDICAL MARIJUANA GUIDELINES FOR THE IMPLEMENTATION OF PROPOSITION 215 [HS 11362.51 AND SIB 420 [HS 11362.71 WHEREAS, in 1996 the voters of the State of California approved Proposition 215, also known as the Compassionate Use Act of 1996, creating Health and Safety Code 11362.5; and WHEREAS, HS 11362.5(d) states, "Section 11357, relating to the possession of marijuana [cannabis], and Section 11358, relating to the cultivation of marijuana, shall not apply to a patient, or to a patient's pri- mary 1 Pp y P P p nary caregiver, who possesses or cultivates marijuana for the personal medical purposes of the patient upon the written or oral recommendation or approval of a physician"; and WHEREAS, since the 1970s, medical marijuana patients in the federal IND program have received and smoked approximately 6.5 pounds of dried cannabis per year, thereby establishing a safe and effective dosage for a chronic daily use patient to possess and consume; and WHEREAS, some patients require more than that amount of cannabis bud per year, especially when it is eaten, used in tincture, used topically or by methods other than being smoked; and WHEREAS, 3 pounds of dried cannabis bud per year is a reasonable compromise safe harbor amount that allows most compliant individuals to cultivate, possess and consume their medicine; and WHEREAS, a 100 square foot canopy of mature female cannabis plants, typically will yield 3 pounds of dried and processed cannabis bud per year outdoor; regardless of the number of plants; and WHEREAS, successful propagation, breeding and cultivation of cannabis may require large numbers of plants in various stages of growth, especially when grown in the indoor"Sea of Green" method which typ- ically produces lower yields than outdoor gardens but affords multiple harvests per year; and I' WHEREAS, in 2003, Senate Bill 420 created HS 11362.7 that, among other things, sets forth in HS 11362.77(a) an impractical default threshold for immunity from arrest at 8 ounces of dried female cannabis flowers in addition to 6 mature or 12 immature plants per qualified patient; and WHEREAS, HS 11362.77(c) empowers this jurisdiction when it states that"Counties and cities may retain or enact medical marijuana guidelines allowing qualified patients or primary caregivers to exceed the state limits set forth in subdivision (a)"; and WHEREAS, other counties and cities throughout the State of California have enacted or retained guide- lines for the implementation and enforcement of HS 11362.5 in amounts that are significantly greater than the threshold amounts set forth in HS 11362.77(a); and WHEREAS,failure to enact a community standard for presumed compliance with HS 11362.77 may effec- tively limit local patients and caregivers to the arbitrary and unreasonable amounts as set forth in HS 11362.77(a), thereby causing undue pain, suffering and legal risks; and Page 18• Cannabis Ke/dsano'Dosage HS 11362.5 AND HS 11362.77 GUIDELINES IMPLEMENTATION ORDINANCE — PAGE 2 WHEREAS, pursuant to HS 11362.775, qualified patients and caregivers "who associate within the State of California in order collectively or cooperatively to cultivate marijuana for medical purposes, shall not solely on the basis of that fact be subject to state criminal sanctions under Section 11357, 11358, 11359, 11360, 11366, 11366.5, or 11570"; and WHEREAS, law enforcement officers require a simple, reasonable and efficient guideline to use in eval- uating individual and collective patient medical marijuana gardens and on-hand supplies; and WHEREAS, this resolution does not address the enforcement of federal law. THEREFORE, BE IT NOW RESOLVED that this County Board of Supervisors does hereby enact the fol- lowing medical marijuana guidelines within its jurisdiction per HS 11362.77(c): A) A qualified patient, a person holding a valid identification card, or the designated primary care- giver of that qualified patient or person may possess and cultivate any amount of marijuana con- sistent with the patient's current medical needs. B) Possession of up to 3 pounds of dried cannabis bud or conversion per patient shall not consti- tute probable cause for arrest or prosecution of any person listed in (A). C) To obtain that amount, any person listed in (A) may also cultivate any number of cannabis plants per patient with up to 100 square feet of total garden canopy, measured by the combined vegetative growth area. Gardens that are consistent with this provision shall not constitute proba- ble cause for arrest or prosecution. D) Qualified patients, caregivers and providers who collectively or cooperatively cultivate marijua- na for medical purposes shall not exceed the standards set forth in (B) and (C). E) Any person listed in (A) and having a physician's assent that this guideline is not adequate for the qualified patient's medical needs may possess and cultivate an amount of cannabis up to six Pounds of bud or conversion and up to 200 square feet of canopy. F) As defined in HS 11362.5, "Primary caregiver means the individual designated by the person exempted under this act that has consistently assumed responsibility for the housing, health or safety of that person." For purposes of this policy, a primary caregiver shall include any adult des- ignated as such in writing by a qualified or card-holding patient, in the interests of their personal health and safety. G) For purposes of identification, such designation shall be posted at the garden site or in the pos- session of the caregiver, along with a copy of the physician's document. H) Law enforcement shall not arrest persons who are compliant with these provisions, and shall leave them, their medical marijuana supply and their garden unmolested. Amounts in excess of those above shall be preserved in usable form in case it need be returned. PASSED AND ADOPTED This th day of 200 at a regular meeting of the County Board of Supervisors by the following vote: Cannabis Ke/dsandDosage• Page 19 ` Appendices , hating symptoms. Patients with cachexia;cancer; chronic pain;epilepsy and other disorders characterized by seizures; glaucoma, HIV or AIDS; multiple sclerosis and other disorders characterized by muscle spastici- tSUMMELRIZED STATE LAws ty; and nausea. Other conditions may be added by the Dept of Human Resources,which last year added agitation due to Alzheimer's. Patients Alaska: Measure 8 protects patients diagnosed with cachexia; cancer; (or caregivers) may possess no more than three ounces of usable chronic pain; epilepsy and other disorders characterized by seizures; cannabis, and cultivate no more than seven plants, no more than three glaucoma;HIV or AIDS;multiple sclerosis and other disorders character- mature.A confidential state-run registry issues patient ID cards.Patients ized by muscle spasticity; and nausea. Other conditions subject to who do not register or who possess amounts greater than allowed may approval by the Department of Health and Social Services. Patients(or argue "affirmative defense of medical necessity." House Bill 3052 limits caregivers) may possess no more than one ounce of usable cannabis patients(or caregivers)to cultivate in only one location,requires patients and cultivate no more than six plants,no more than three mature.Senate be diagnosed by their physician at least 12 months prior to arrest for the Bill 94 mandates that all patients must enroll the confidential state-run "affirmative defense"and states that law enforcement officials who seize registry and possess a valid ID card or they cannot argue "affirmative cannabis do not have to keep plants alive.In 2001,administrators added defense of medical necessity." temporary procedures defining the attending physician as "a physician Arizona:Prop.200 attempted to allow doctors to"prescribe"schedule 1 who has established a physician/patient relationship with the patient; ... controlled drugs.However,federal law forbids physicians from"prescrib- is primarily responsible for the care and treatment of the patients; ...has ing"cannabis,so this statute offers no legal benefits whatsoever. reviewed a patient's medical records at the patient's request, has con- Colorado: Amendment 20 protects.patients with cachexia; cancer; ducted a thorough physical examination of the patient, has provided a chronic pain; chronic nervous system disorders;epilepsy and other dis- treatment plan and/or follow-up care, and has documented these activi- orders characterized by seizures;glaucoma;HIV or AIDS; multiple scle- ties in a patient file."(New legislation under discussion.) rosis and other disorders characterized by muscle spasticity; and nau- Vermont:Senate Bill 76 protects patients diagnosed with a"debilitating sea.Other conditions may be approved by the Board of Health. Patients medical condition"including HIV or AIDS,cancer and Multiple Sclerosis. (or caregivers)may have no more than two ounces of cannabis and cul- Patients(or caregivers)may possess no more than two ounces of usable tivate no more than six plants.A confidential state-run registry issues ID cannabis, and cultivate no more than three plants, only one mature. A cards to patients. Patients must possess documentation prior to arrest. mandatory,confidential registry issues ID cards. Patients who do not join the registry or who possess greater amounts Washington: Measure 692 protects patients with authorization from may argue"affirmative defense of medical necessity." their physician for cachexia; cancer, HIV or AIDS; epilepsy; glaucoma; Hawaii:Senate BIII 862 protects patients having a statement from their intractable pain (defined as pain unrelieved by standard treatment or physician affirming a debilitating condition and that"potential benefits of medications);and multiple sclerosis.Other conditions subject to approval medical use of marijuana would likely outweigh the health risks." It cov- by the Board of Health. Patients(or caregivers) may legally possess or ers cachexia;cancer;chronic pain;Crohn's disease;epilepsy and other cultivate no more than a 60-day supply of marijuana.No state-run patient disorders characterized by seizures; glaucoma; HIV or AIDS; multiple registry.The Medical Quality Assurance Commission added Crohn's dis- sclerosis and other disorders characterized by muscle spasticity; and ease, Hepatitis C,and"any disease,including anorexia,which results in nausea. Other conditions approved by the Dept of Health. Patients (or nausea, vomiting, wasting, appetite loss, cramping, seizures, muscle caregivers) may possess no more than one ounce of usable cannabis, spasms,and/or spasticity,when these symptoms are unrelieved by stan- and cultivate no more than seven plants, no more than three mature.A dard treatments." mandatory,confidential state-run registry issues ID cards. Maine:Question 2 protects patients with an oral or written"professional CALIFORNIA LEGAL CODE opinion"from their physician authorizing cannabis for epilepsy and other disorders characterized by seizures; glaucoma; multiple sclerosis and Slate laws may change during the legislative session or at any time in the courts. other disorders characterized by muscle spasticity;and nausea or vomit- For the full text of any California statutory law or status of pending state legislation ing as a result of AIDS or cancer chemotherapy.Patients(or caregivers) see:http://www.leginfo.ca.govl may possess no more than two and one-half ounces of usable cannabis Health & Safety Code 11018: Marijuana means all parts of the plant (Senate Bill 611), and cultivate no more than six plants, no more than Cannabis sativa L.,whether growing or not;the seeds thereof;the resin three mature. Patients with greater amounts have a"simple defense"to extracted from any part of the plant;and every compound, manufacture, a possession charge.No state-run patient registry. salt,derivative,mixture,or preparation of the plant, its seeds,or resin.It Maryland:The affirmative defense law requires the court to consider a does not include the mature stalks of the plant,fiber produced from the defendant's medical use of cannabis as a factor in marijuana prosecu- stalks,oil or cake made from the seeds of the plant,any other compound, lions. If the patient successfully makes the medical necessity case at manufacture,salt,derivative,mixture,or preparation of the mature stalks trial, the maximum penalty would be a$100 fine. (except the resin extracted therefrom),fiber,oil,or cake,or the sterilized seed of the plant which is incapable of germination. Montana: Initiative 148 protects patients with then physician's written HIS 11006.5: Concentrated cannabis means the separated resin, authorization for cachexia or wasting syndrome;severe or chronic pain; whether crude or purified,obtained from marijuana. severe nausea;seizures,including but not limited to seizures caused by epilepsy; or severe or persistent muscle spasms, including but not limit- HIS 11362.77(d): Only the dried mature processed flowers of female ed to spasms caused by multiple sclerosis or Crohn's disease. Patients cannabis plant or the plant conversion shall be considered when deter- (or primary caregivers)may possess no more than six plants.A confiden- mining allowable quantities of[medical]marijuana under this section. tial state-run patient registry issues ID cards. Transportation of Cannabis; (Also see HS 11360, transportation of Nevada Question 9 protects patients with their physician's written more than one ounce.)Vehicle Code 23222.(b)Except as authorized by authorization for AIDS; cancer; glaucoma; and any medical condition or law,every person who possesses,while driving a motor vehicle upon a treatment to a medical condition that produces cachexia,persistent mus- highway or on lands, as described in subdivision (b) of Section 23220, cle spasms or seizures,severe nausea or pain.Other conditions may be not more than one avoirdupois ounce of marijuana, other than concen- approved by the Dept of Human Resources.Patients(or caregivers)may trated cannabis as defined by Section 11006.5 of the Health and Safety possess no more than one ounce of usable marijuana, and cultivate no Code,is guilty of a misdemeanor and shall be punished by a fine of not more than seven marijuana plants, no more than three mature.A confi- more than one hundred dollars($100). dential registry issues patient ID cards. Patients who do not join the reg- Possession of Cannabis: Health&Safety Code 11357(a) Except istry or who possess greater amounts than allowed may argue"affirma- as authorized by law, every person who possesses any concentrated tive defense of medical necessity" cannabis shall be punished by imprisonment in the county jail for a peri- Oregon: Measure 67 protects patients with a signed recommendation od of not more than one year or by a fine of not more than five hundred from their physician stating that cannabis"may mitigate"his or her debil- dollars($500), or by both such fine and imprisonment, or shall be pun- Page 20• Cannabis Yields and Dosage ished by imprisonment in the state prison. (b)Except as authorized by law,every person who possesses not more (c) Notwithstanding any other provision of law, no physician in this state than 28.5 grams of marijuana,other than concentrated cannabis,is guilty shall be punished, or denied any right or privilege, for having recom- of a misdemeanor and shall be punished by a fine of not more than one mended marijuana to a patient for medical purposes, hundred dollars ($100). Notwithstanding other provisions of law, if such (d)Section 11357, relating to the possession of marijuana, and Section person has been previously convicted three or more times of an offense 11358,relating to the cultivation of marijuana,shall not apply to a patient, described in this subdivision during the two-year period immediately pre- or to a patient's primary caregiver,who possesses or cultivates marijua- ceding the date of commission of the violation to be charged, the previ- na for the personal medical purposes of the patient upon the written or ous convictions shall also be charged in the accusatory pleading and, if oral recommendation or approval of a physician. found to be true by the jury upon a jury trial or by the court upon a court (e) For purposes of this section, Primary caregiver means the individual trial or if admitted by the person,the provisions of Sections 1000.1 and designated by the person exempted under this act who has consistently 1000.2 of the Penal Code shall be applicable to him,and the court shall assumed responsibility for the housing,health or safety of that person. divert and refer him for education,treatment,or rehabilitation, without a Voluntary ID card: SB 420,HS 11362.715(a)A person who seeks an court hearing or determination or the concurrence of the district attorney, identification card shall pay the flee, as provided in Section 11362 755, to an appropriate community program which will accept him.If the person and provide all of the following to the county health department or the is so diverted and referred he shall not subject to the fine specified in county's designee on a form developed and provided by the department: this subdivision. If no community program will accept him, the person shall be subject to the fine specified in this subdivision. In any case in (1)The name of the person,and proof of his or her residency within the which a person is arrested for a violation of this subdivision and does not county. demand to be taken before a magistrate,such person shall be released (2) Written documentation by the attending physician in the person' s by the arresting officer upon presentation of satisfactory evidence of iden- medical records stating that the person has been diagnosed with a seri- tity and giving his written promise to appear in court, as provided in ous medical condition and that medical use of marijuana is appropriate. Section 853.6 of the Penal Code,and shall not be subjected to booking. (3) The name, office address, office telephone number, and California (c)Except as authorized by law,every person who possesses more than medical license number of the person's attending physician. 28 5 grams of marijuana,other than concentrated cannabis,shall be pun- (4)The name and the duties of the primary caregiver. ished by imprisonment in the county jail for a period of not more than six (5)A government-issued photo identification card of the person and of the months or by a fine of not more than five hundred dollars ($500), or by designated primary caregiver,if any.If the applicant is a person under 18 both such fine and imprisonment. ... years of age,a certified copy of a birth certificate shall be deemed suffi- Cultivation of Cannabis: Health &Safety Code 11358. Every per- cient proof of identity. son who plants, cultivates, harvests, dries, or processes any marijuana HS 11362.74.(a)The county health department or the county's designee or any part thereof, except as otherwise provided by law, shall be pun- may deny an application only for any of the following reasons: ished by imprisonment in the state prison. (1) The applicant did not provide the information required by Section Possession for sales: HS 11359. Every person who possesses for 11362.715,and upon notice of the deficiency pursuant to subdivision(d) sale any marijuana, except as otherwise provided by law, shall be pun- of Section 11362.72,did not provide the information within 30 days ished by imprisonment in the state prison. (2)The county health department or the county's designee determines Processing,transportation and sales:HS 11360.(a)Except as oth- that the information provided was false. erwise provided by this section ores authorized by law,every person who (3)The applicant does not meet the criteria set forth in this article. transports, imports into this state, sells, furnishes, administers, or gives (b)Any person whose application has been denied pursuant to subdlvi- away,or offers to transport,import into this state,sell,furnish,administer, sion(a)may not reapply for six months from the date of denial unless oth- or give away, or attempts to import into this state or transport any marl- erwise authorized by the county health department or the county's juana shall be punished by imprisonment in the state prison for a period designee or by a court of competent jurisdiction. of two,three or four years. (c)Any person whose application has been denied pursuant to subdiv{- (b) Except as authorized by law,every person who gives away,offers to sion (a) may appeal that decision to the department.The county health give away, transports, offers to transport, or attempts to transport not department or the county's designee shall make available a telephone more than 28.5 grams of marijuana,other than concentrated cannabis,is number or address to which the denied applicant can direct an appeal. guilty of a misdemeanor and shall be punished by a fine of not more than HS 11362.745.(a)An ID card shall be valid for a period of one year.... one hundred dollars($100).In any case in which a person is arrested for a violation of this subdivision and does not demand to be,taken before a HS 11362.76 (a)A person who possesses an identification card shall: magistrate, such person shall be released by the arresting officer upon (1)Within seven days, notify the county health department or the coun- presentation of satisfactory evidence of identity and giving his written ty's designee of any change in the person's attending physician or desig- promise to appear in court, as provided in Section 853.6 of the Penal nated primary caregiver,if any. Code,and shall not be subjected to booking. (2) Annually submit to the county health department or the county' s Medical marijuana: Prop 215, HS 11362.5(a)This section shall be designee the following: known and may be cited as the Compassionate Use Act of 1996. (A) Updated written documentation of the person's serious medical con- (b)(1)The people of the State of California hereby find and declare that dition. the purposes of the Compassionate Use Act of 1996 are as follows: (8)The name and duties of the person's designated primary caregiver,if (A) To ensure that seriously ill Californians have the right to obtain and any,for the forthcoming year, use marijuana for medical purposes where that medical use is deemed (b) If a person who possesses an identification card fails to comply with appropriate and has been recommended by a physician who has deter- this section, the card shall be deemed expired If an identification card mined that the persons health would benefit from the use of marijuana in expires,the identification card of any designated primary caregiver of the the treatment of cancer,anorexia,AIDS,chronic pain,spasticity,glauco- person shall also expire. ma,arthritis, migraine or any other illness for which marijuana provides (c) If the designated primary caregiver has been changed,the previous relief. primary caregiver shall return his or her identification card to the depart- (B)To ensure that patients and their primary caregivers who obtain and ment or to the county health department or the county's designee. use marijuana for medical purposes upon the recommendation of a (d)If the owner or operator or an employee of the owner or operator of a physician are not subject to criminal prosecution or sanction. provider has been designated as a primary caregiver pursuant to para- (C)To encourage the federal and state governments to implement a plan graph(1) of subdivision (d) of§ 11362.7, of the qualified patient or per- for the safe and affordable distribution of marijuana to all patients in med- son with an identification card, the owner or operator shall notify the ical need of marijuana. county health department or the county's designee, pursuant to § (2)Nothing in this act shall be construed to supersede legislation prohibit- 11362.715,if a change in designated primary caregiver has occurred. ing persons from engaging in conduct that endangers others,nor to con- done the diversion of marijuana for non-medical purposes. Cannabis Yields and Dosage• Page 21 Health &Safety Code 11362.765. (a) Subject to the requirements of HE 11362.785. (a)Nothing in this article shall require any accommoda- this article,the individuals specified in subdivision(b)shall not be subject, ' tion of any medical use of marijuana on the property or premises of any on that sole basis, to criminal liability under § 11357, 11358, 11359, place of employment or during the hours of employment or on the prop- 11360, 11366, 11366.5, or 11570. However, nothing in this section shall arty or premises of any jail, correctional facility, or other type of penal authorize the individual to smoke or otherwise consume marijuana unless institution in which prisoners reside or persons under arrest are detained. otherwise authorized by this article, nor shall anything in this section (b) Notwithstanding subdivision (a), a person shall not be prohibited or authorize any individual or group to cultivate or distribute marijuana for prevented from obtaining and submitting the written information and doc- profit. umentation necessary to apply for an ID card on the basis that the per- (b)Subdivision(a)shall apply to all of the following: son is incarcerated in a jail,correctional facility,or other penal institution (1)A qualified patient or a person with an identification card who trans- in which prisoners reside or persons under arrest are detained. ports or processes marijuana for his or her own personal medical use. (c)Nothing in this article shall prohibit a jail,correctional facility, or other (2)A designated primary caregiver who transports, processes, adminis- penal institution in which prisoners reside or persons under arrest are ters,delivers,or gives away marijuana for medical purposes,in amounts detained,from permitting a prisoner or a person under arrest who has an not exceeding those established in subdivision (a) of Section 11362.77, identification card,to use marijuana for medical purposes under circum- only to the qualified patient of the primary caregiver,or to the person with stances that will not endanger the health or safety of other prisoners or an identification card who has designated the individual as a primary the security of the facility. caregiver. (d) Nothing in this article shall require a governmental, private, or any (3)Any individual who provides assistance to a qualified patient or a per- other health insurance provider or health care service plan to be liable for son with an identification card,or his or her designated primary caregiv- any claim for reimbursement for the medical use of marijuana. er, in administering medical marijuana to the qualified patient or person HE 11362.79.Nothing in this article shall authorize a qualified patient or or acquiring the skills necessary to cultivate or administer marijuana for person with an identification card to engage in the smoking of medical medical purposes to the qualified patient or person. marijuana under any of the following circumstances: (c)A primary caregiver who receives compensation for actual expenses, (a) In any place where smoking is prohibited by law. including reasonable compensation incurred for services provided to an (b)In or within 1,000 feet of the grounds of a school,recreation center,or eligible qualified patient or person with an identification card to enable youth center,unless the medical use occurs within a residence. that person to use marijuana under this article,or for payment for out-of- (c)On a schoolbus. pocket expenses incurred in providing those services, or both,shall not, on the sole basis of that fact, be subject to prosecution or punishment (d)While in a motor vehicle that is being operated. under Section 11359 or 11360. (a)While operating a boat. H8; 11362.77. (a)A qualified patient or primary caregiver may possess HS 11362.795.(a)(1)Any criminal defendant who is eligible to use mar- no more than eight ounces of dried marijuana per qualified patient. In tjuana pursuant to Section 11362.5 may request that the court confirm addition, a qualified patient or primary caregiver may also maintain no that he or she is allowed to use medical marijuana while he or she is on more than six mature or 12 immature marijuana plants per qualified probation or released on bail. paiient. (2)The court's decision and the reasons for the decision shall be stated (b)If a qualified patient or primary caregiver has a doctor's recommenda- on the record and an entry stating those reasons shall be made in the tion that this quantity does not meet the qualified patient' s medical minutes of the court. needs,the qualified patient or primary caregiver may possess an amount (3)During the period of probation or release on bail,if a physician recom- of marijuana consistent with the patient's needs. mends that the probationer or defendant use medical marijuana,the pro- (c)Counties and cities may retain or enact medical marijuana guidelines bationer or defendant may request a modification of the conditions of pro- allowing qualified patients or primary caregivers to exceed the state lim- bation or bail to authorize the use of medical marijuana. its set forth in subdivision(a). (4) The court's consideration of the modification request authorized by (d)Only the dried mature processed flowers of female cannabis plant or this subdivision shall comply with the requirements of this section. the plant conversion shall be considered when determining allowable (b) (1) Any person who is to be released on parole from a jail, state quantities of marijuana under this section, prison, school, road camp, or other state or local institution of confine- (e)The Attorney General may recommend modifications to the posses- ment and who is eligible to use medical marijuana pursuant to Section sion or cultivation limits set forth in this section These recommendations, 11362.5 may request that he or she be allowed to use medical marijua- if any, shall be made to the Legislature no later than Dec. 1, 2005 and na during the period he or she is released on parole.A parolee's written may be made only after public comment and consultation with interested conditions of parole shall reflect whether or not a request for a modifica- organizations, including, but not limited to, patients, health care proles- tion of the conditions of his or her parole to use medical marijuana was sionals, researchers,law enforcement, and local governments.Any rec- made, and whether the request was granted or denied. ommended modification shall be consistent with the intent of this article (2) During the period of parole,where a physician recommends that the and shall be based on currently available scientific research. parolee use medical marijuana, parolee may request a modification of (f)A qualified patient or a person holding a valid identification card,or the the conditions of the parole to authorize the use of medical marijuana. designated primary caregiver of that qualified patient or person,may pos- (3)Any parolee whose request to use medical marijuana while on parole sess amounts of marijuana consistent with this article. was denied may pursue an administrative appeal of the decision. Any HE;11362.775.Qualified patients,persons with valid identification cards, decision on the appeal shall be in writing and shall reflect the reasons for and the designated primary caregivers of qualified patients and persons the decision. with identification cards, who associate within the State of California in (4) The administrative consideration of modification request authorized order collectively or cooperatively to cultivate marijuana for medical our- by this subdivision shall comply with the requirements of this section. poses, shall not solely on the basis of that fact be subject to state crimi- HS 11362.8.No professional licensing board may impose a civil penalty nal sanctions under Section 11357, 11358, 11359, 11360, 11366, or take other disciplinary action against a licensee based solely on the 11366.5,or 11570. fact that the licensee has performed acts that are necessary or appropri- H5 11362.78.A state or local law enforcement agency or officer shall not ate to carry out the licensee's role as a designated primary caregiver to refuse to accept an identification card issued by the department unless a person who is a qualified patient or who possesses a lawful identifica- the state or local law enforcement agency or officer has reasonable tion card issued pursuant to Section 11362.72. However, this section cause to believe that the information contained in the card is false or shall not apply to acts performed by a physician relating to the discussion fraudulent,or the card is being used fraudulently. or recommendation of the medical use of marijuana to a patient.These discussions or recommendations,or both,shall be governed by Section 11362.5. Page 22 • Cannabis Yields and Dosage RESOURCES References Russo, Mathre, Byrne, Velin, Bach, Sanchez-Ramos, Kirin. ✓ouinalofCannabls Therapeutics,Vol. 2(1), 2002, p. 9 British Medical Association. Therapeutic Uses of Cannabis. BMA Board of Science and Education. 1997 Sidney, Beck, Tekawa, Quesenberry and Friedman. Marijuana Use and Mortality. American✓ourna/of Public Chart and Pierri (U of Chicago). Some physical characteris- Health Vol 87:4, pp 585-590 tics of NIDA marijuana cigarettes. ✓ournalofAddlctive Behaviors Vol. 14, 1989, pp 61-67 Starks, M. Marjuana Chemistry.Genetics, Processing and Conrad, Chris. Hemp forHea/th. Healing Arts Press. 1997 Potency. Ronin Publishing. 1977, 1990 US Department of Justice, NIDA and Drug Enforcement DEA Administrative Law Judge Francis Young ruling. ACTv Administration (DEA). Cannabis Yields, 1992 DEA, Dochet/tlo. 8622, 1988 UC San Francisco, CMA accredited Continuing Medical Fairbairn, Liebmann and Rowan.The stability of cannabis Education syllabus. Cannabis Therapy,June 10, 2000 and its preparations on storage (U of London). ✓ouinalof PharmacologyandPharrnaceutica/s. V 28, 1976, pp 1-7 Grinspoon, Bakalar. Marihuana as Medicine:A Plea for For more information online Reconsideration (Commentary). ✓AMA, ✓oulnalofthe American Medfca/Association. Vol. 273:23. June 1995, http://www.safeaccessnow.net/Safe Access Now pp. 1874-1875 http://www.chrisconrad.com/Homepage Herningi, Hooker and Jones.THC content and differences in marijuana smoking behavior. Psychopharmacology 90:160-162, 1996 Other useful websites Iversen, Leslie. The Science ofMar�uana. Oxford University http://www.leginfo.ca.gov/California laws and bills Press, 2000. www.gpoaccess.gov/uscode/browse.htmi Federal laws National Academy of Science, Institute of Medicine (IOM). www4.law.cornell.edu/uscode/Federal laws Mai�uanaandMedicine:AssessingtheScienceBase,1999 wwwcanorml.org/CaliforniaNORML NAS, IOM. Mal-pana andHeelth:Report ofa Studyby www.drugpolicy.org/Drug Policy Alliance a Gommfttee ofthe/nstitute of Medicine. www.medicalcannabis.com/Patients Out of Time National Academy Press, 1982. www.mpp.org/Marijuana Policy Project National Institute on Drug Abuse. www.norml.org/ NIDA Notes. Vol. 11:2, March-April 1996, p 15 National Organization for the Reform of Marijuana Laws NIDA. Al ar�uana Research Findings: 19,90. www.letfreedomgrow.org/ Research Monograph 31, US GPO, June 1980 American Alliance for Medical Cannabis Ohlsson, Lindgren, et al. Plasma A-9 THC concentrations www.safeaccessnow.org/Americans for Safe Access and clinical effects after oral and intravenous administra- tion and smoking. Clinlca/Pharmacology and Therapeutics. Vol. 28:3, Sept. 1980, pp 409-416 Chris Conrad evaluates an authorized medical marijuana garden,2005 '`,p ABOUT THE AUTHOR �M " ' Chris Conrad is director of Safe Access Now. He is author 4 - of Hemp.,Lifeline to the Future and Hemp for Health and cura- tor of the Hash-Marijuana-Hemp Museum (Amsterdam). He has qualified as a cannabis expert more than 100 times in the California Superior and federal US courts. His r '4` " recognized cannabis expertise includes issues of hemp, v +4 �,.•: personal use, medical use, dosage, consumption, religious use, cultivation, yields, preparations, pricing, sales and intent. tw � His curriculum vitae is available online as a downloadable PDF file at www.chrisconrad.com. q,,,- Telephone: 510-215-8326 t'�, 4�- il 4 u Jj -A6,'p,q T-h �'.&O"Adw ' 11 awl014W I-E 41 AP Awo-'��M-�i M4..ik- 71 f, ..."WAW OL* I I'M 'A I mwggfm�i laf�g ... ........... .....I -to ...... ...... . W*' W,W. w lz.A &JN" +1 IM t I" Cl 63 kao" I WIA I -4 0 :::............... 'MPA"TiW vgl� 4 M lg� iirgra t .... ......... gr, Ui ll "i"AW u �pQ7ALM SAP iy V V ** HC{109I.tEO ape %k °a<.FORN�P CITY COUNCIL STAFF REPORT DATE: March 29, 2006 :)UBJECT: INTERIM URGENCY ORDINANCE RE MEDICAL MARIJUANA DISPENSARIES FROM: David H. Ready, City Manager BY: Douglas Holland, City Attorney SUMMARY The proposed Interim Urgency Ordinance is an urgency measure proposed by the City's Police Department, Community Development, and the City Attorney's Office to establish a temporary moratorium' on the establishment and operation of medical marijuana dispensaries within the City for a period of 45 days. The Ordinance would prohibit the issuance of permits for medical marijuana dispensary uses during this interim period and pending the completion of a written report describing the measures taken to alleviate the condition which led to the adoption of the Ordinance. It is anticipated that the report will include a discussion of potential code amendments to the City's land use regulations that are needed or desireable to address appropriate regulations for the establishment and operation of medical marijuana dispensaries in the City. [RECOMMENDATION: Staff recommends the City Council adopt the proposed Interim Urgency Ordinance. [A four-fifths vote is required for adoption.] STAFF ANALYSIS: The City currently has one medical marijuana dispensary operating in the City. This facility opened without receiving any approvals from the City. Staff has recently received one application to operate an additional medical marijuana dispensary within the City and has received an inquiry regarding a third such establishment. Existing City codes, including the Zoning Ordinance, do not specifically address or regulate the location or operation of medical marijuana dispensaries and thus, the Planning Director has recently concluded that these facilities can not be established or operated until the (Planning Commission or the City Council makes a determination regarding the appropriate zone district for such establishments. There is a concern that the City's central and accessible location, and its unique downtown commercial district, could make the City attractive for such businesses. To determine how to deal with the medical marijuana dispensaries and the potential negative effects on the public heath, Item 3.A. City Council Staff Report March 29, 2006 -- Page 2 INTERIM URGENCY ORDINANCE RE MEDICAL MARIJUANA DISPENSARIES safety, and welfare, could be caused by allowing a proliferation of unregulated marijuana establishments, staff recommends that the Council adopt the interim urgency ordinance and direct Staff to study the issue further. The interim urgency ordinance allows the Council time to determine an appropriate course of action. Synopsis of Relevant Legislation and Court Cases The Controlled Substance Act of 1970 Under the Controlled Substances Act, enacted by Congress in 1970, marijuana is classified as a schedule one controlled substance. Generally, this classification is based on a determination that marijuana: has a high potential for abuse; has no currently accepted use for medical treatment; and, is not accepted as safe, even when used under medical supervision. This federal law makes it illegal to import, manufacture, distribute, possess, or use marijuana in the United States. Proposition 215, the Compassionate Use Act of 1996 In 1996, California voters passed Proposition 215, the Compassionate Use Act, with the stated intent of ensuring that seriously ill individuals have the right to obtain and use marijuana for medical purposes when recommended by a physician. This voter initiative Exempts patients and their primary caregivers from prosecution under state laws that otherwise prohibit the cultivation or possession of marijuana. Senate Bill 420 -The Medical Marijuana Program In 2003, the State Legislature passed Senate Bill (SB) 420, which established the Medical Marijuana Program. This legislation created a voluntary system for qualified patients and their caregivers to obtain identification cards that would protect them from arrest for violations of State law relating to marijuana. When approving SB 420, the Legislature made findings that included the statement that the legislation is intended to "enhance the access of patients and caregivers to medical marijuana through collective, cooperative cultivation projects." However, the Bill does not expressly authorize the establishment of medical marijuana dispensaries. United States Supreme Court Decision in Gonzales v. Raich (2005) More recently, the conflict between the Federal Controlled Substances Act and California's Compassionate Use Act led to the Untied States Supreme Court decision in Gonzales v. Raich (2005) 125 S.Ct 2201. In the Raich case, Federal agents seized and destroyed marijuana plants that were being grown for personal medical use. The plaintiff sued to prohibit enforcement of the Controlled Substances Act to the extent that it interfered with the medical use of marijuana as permitted under California law. The Ninth Circuit Court of Appeals held that Federal law enforcement authorities could not enforce the Controlled Substances Act against the plaintiffs because it exceeded the scope of Congressional authority under the Commerce Clause of the U.S. Constitution. City Council Staff Report March 29, 2006 -- Page 3 INTERIM URGENCY ORDINANCE RE MEDICAL MARIJUANA DISPENSARIES The Supreme Court reversed, holding that the Commerce Clause allows Congress to prohibit cultivation or use of marijuana for medical purposes authorized by California law. Although the Supreme Court's analysis focused narrowly on the scope of Congressional authority under the Commerce Clause, the practical significance of this decision is that Federal law enforcement officers may continue to enforce Federal drug laws against Californians who cultivate or use medical marijuana. However, the case (lid not expressly rule on the question whether Proposition 215 and SB 420 are preempted by Federal law. Shortly after the Raich decision, the State Department of Health Services (DHS) briefly stopped issuing medical marijuana identification cards due to concern that issuing such cards might subject its employees to prosecution for aiding and abetting the possession or cultivation of marijuana in violation of Federal law. DHS requested the State Attorney General to provide legal advice on this issue. The Attorney General responded with a letter advising DHS that its employees were not in danger of federal prosecution and were still obliged to continue carrying out their statutory duties related to implementation of the medical marijuana identification card program. Other Communities Several California cities that have marijuana dispensaries in their jurisdictions claim that they have experienced an increase in crime associated with the dispensaries. Such crime ranges from the resale of medical marijuana to individuals who do not have physician recommendations to robberies of the dispensaries themselves. Of particular concern is the fact that crime is not being consistently reported by dispensaries and users because they do not want to jeopardize the status of the dispensaries. The City's Police Department has indicated that the City has endured similar experiences associated with the current dispensary in the City. Based on this experience as well as the claimed experiences of other cities, the staff is concerned that marijuana dispensaries may have the significant negative secondary effects that adversely affect the neighborhood in which these establishments may be located. The Proposed Interim Ordinance Adoption of the proposed Interim Urgency Ordinance would establish a temporary moratorium on the establishment and operation of medical marijuana dispensaries within the City for a period of 45 days pending the completion of a written report describing the measures taken to alleviate the condition which led to the adoption of the Ordinance. Staff will include in the study a discussion of potential code amendments to the City's land use regulations that may be needed to reasonably allow the establishment and operation of medical marijuana dispensaries in the City and reduce the potential for adverse secondary effects. Detailed findings in support of the adoption of the proposed Interim Urgency Ordinance sire included within the Ordinance. In part, staff is recommending that the Council address the issue now because: There is a current facility operating in the City and staff has received requests to operate additional medical marijuana dispensaries and there are no City Council Staff Report March 29, 2006 -- Page 4 INTERIM URGENCY ORDINANCE RE MEDICAL MARIJUANA DISPENSARIES standards in place that address the establishment or operation of such facilities; Other jurisdictions have passed ordinances prohibiting medical marijuana dispensaries, increasing the likelihood that Palm Springs may be an attractive location for such businesses; the U.S. Supreme Court in Raich v. Ashcroft determined that the possession and distribution of marijuana, even for medical purposes, is unlawful under the Federal Controlled Substances Act; and, law enforcement agencies with medical marijuana dispensaries in their jurisdictions have claimed that they have endured adverse secondary impacts from the dispensaries. It is reasonable to conclude that similar negative effects on the public health, safety, and welfare will occur in Palm Springs due to the establishment and operation of unregulated medical marijuana dispensaries. The City Attorney's office prepared the ordinance and has approved the form and content of the proposed Interim Urgency Ordinance. ENVIRONMENTAL: The proposed Interim Urgency Ordinance is not subject to the California Environmental Quality Act ("CEQA") pursuant to Title 14, California Code of Regulations, Sections 15060(c)(2) (the activity will not result in a direct or reasonably foreseeable indirect physical change in the environment) and 15060(c)(3) (the activity is not a project as defined in Section 15378) because it has no potential for resulting in physical change to the environment, directly or indirectly; it prevents changes in the environment pending the completion of the written report described above. FISCAL IMPACT: IFinance Director Review: The proposed Interim Urgency Ordinance is a City-initiated project. There is no direct fiscal impact associated with the proposed Ordinance. Douglas Holland, City Attorney Assistant City Manager David H. Ready, City r Attachments: Draft Ordinance ORDINANCE NO. AN INTERIM URGENCY ORDINANCE OF THE CITY OF PALM SPRINGS, CALIFORNIA, ESTABLISHING A TEMPORARY MORATORIUM ON THE LEGAL ESTABLISHMENT AND OPERATION OF MEDICAL MARIJUANA DISPENSARIES WITHIN THE CITY OF PALM SPRINGS FOR A PERIOD OF 45 DAYS PENDING A STUDY OF ZONING REGULATIONS THAT ARE NEEDED TO ALLEVIATE A CURRENT AND ACTUAL THREAT TO THE PUBLIC HEALTH, SAFETY, AND WELFARE. (4/5THS VOTE REQUIRED.) The City Council of the City of Palm Springs, California, ordains: SECTION 1. This interim urgency ordinance is adopted pursuant to Section E35858 of the California Government Code. SECTION 2. The City Council hereby finds, determines and declares that this interim urgency ordinance is necessary because: A. In 1996 the voters of the state of California approved Proposition 215 (codified as Health and Safety Code Section 11362.5 et. seq. and entitled "The Compassionate Use Act of 1996"). B. The intent of Proposition 215 was to enable seriously ill Californians to legally possess, use, and cultivate marijuana for medical use under state law. C. As a result of Proposition 215, individuals have established medical marijuana dispensaries in various cities. D. Other California cities, which have permitted the establishment of medical marijuana dispensaries, have claimed that they have experienced an increase in crime, such as burglary, robbery, loitering around the dispensaries, increased pedestrian and vehicular traffic and noise, and the sale of illegal drugs in the areas immediately surrounding such medical marijuana dispensaries. E. One medical marijuana dispensary has previously opened in the City and the Police Department has observed an increase in adverse secondary effects in the vicinity of the establishment, including loitering and the sale of illegal drugs in areas immediately adjoining the current establishment. F. On March 20, 2006, the City's Police Department and Building Department learned that an additional medical marijuana dispensary had taken steps to open to the public and has commenced advertising its future opening on the internet and through the dissemination of leaflets and brochures. The Police Department has received reliable information that a third medical marijuana dispensary is planning on opening in the City in the near future. 210569.1 1 G. The City has not adopted appropriate rules and regulations specifically applicable to the location and operation of medical marijuana dispensaries and the lack of such controls may lead to a proliferation of such establishments and the inability to egulate such establishments in a manner that will protect the general public, homes and businesses adjacent and near such businesses, and the patients or clients of such establishments. H. Based on the claimed experience of other cities and the experience of the City's Police Department, it is reasonable to conclude that similar negative effects on the public health, safety, and welfare will occur in Palm Springs as a result of the proliferation of medical marijuana dispensaries and the lack of appropriate regulations governing the establishment and operation of such establishments.. I. On June 6, 2005, the United States Supreme Court decided Gonzales v. Raich, 125 S. Ct. 2195 (2005). The Court found there to be no legally recognizable medical necessity exception under Federal Law to the prohibition of possession, use, manufacture or distribution of marijuana under federal law. SECTION 3. For purposes of this ordinance, "medical marijuana dispensary" rneans any for profit or not-for-profit facility or location, whether permanent or temporary, where the owner(s) or operator(s) intends to or does possess and distribute marijuana for any commercial purpose. A "medical marijuana dispensary" includes a rnarijuana club as described in People v. Peron (1997) 59 Cal.App.41h 1383. A "medical rnarijuana dispensary" shall not include the following uses, as long as the location of such uses are otherwise regulated by the City's Municipal Code: a "collective" as defined in Health and Safety Code Section 11362.775; a clinic licensed pursuant to Chapter 1 of Division 2 of the Health & Safety Code; a health care facility licensed pursuant to Chapter 2 of Division 2 of the Health & Safety Code; a residential care facility for persons with chronic life-threatening illness licensed pursuant to Chapter 3.01 of Division 2 of the Health & Safety Code; a residential care facility for the elderly licensed pursuant to Chapter 3.2 of Division 2 of the Health & Safety Code, a residential hospice; or a home health agency licensed pursuant to Chapter 8 of the Health & Safety Code, as long as any such use complies strictly with applicable law including, but not limited to, Health & Safety Code Section 11362.5 et sue. SECTION 4. A medical marijuana dispensary currently is not an expressly permitted use in any zoning district in the City of Palm Springs. However, such establishments may seek to locate in any zoning district disguised as a permitted use, or may seek to legalize this use. SECTION 5. The establishment of, or the issuance or approval of any permit, certificate of use and occupancy, or other entitlement for the legal establishment of a medical marijuana dispensary in the City may result in a threat to public health, safety and welfare in that the Palm Springs Municipal Code does not currently regulate the location and operation of medical marijuana dispensaries, and the claimed experience of other cities as well as the experience of the City's Police Department with such dispensaries shows that negative effects on the public health, safety, and welfare occur in the vicinity of such uses. In addition, the dispensing of marijuana for any reason, including medical reasons, is illegal under Federal Law. glossal 2 SECTION 6. For the period of this ordinance, or any extension thereof, a medical rnarijuana dispensary shall be considered a prohibited use in any zoning district of the City, even if located within an otherwise permitted use, and neither the City Council nor City Staff shall approve any use interpretation, permit, certificate of use and occupancy, or Zoning Code or General Plan amendment allowing the establishment or operation of a medical marijuana dispensary. SECTION 7. The City Council finds that this ordinance is not subject to the California Environmental Quality Act ("CEQA") pursuant to CEQA Guidelines Sections '15060(c)(2) (the activity will not result in a direct or reasonably foreseeable indirect physical change in the environment) and 15060(c)(3) (the activity is not a project as defined in Section 15378) (Title 14, of the California Code of Regulations) because if has no potential for resulting in physical change to the environment, directly or indirectly; it prevents changes in the environment pending the completion of the contemplated Municipal Code review. SECTION 8. The City Manager shall review and consider options for the regulation of medical marijuana dispensaries in the City, including, but not limited to the development of appropriate rules and regulations governing the location and operation such establishments in the City and shall file a written report describing the measures which the City has taken to address the conditions which led to the adoption of this ordinance with the City Council ten (10) days prior to the expiration of this interim urgency ordinance, and an extension thereof, and such report shall be made available to the public. SECTION 9. This interim urgency ordinance shall take effect immediately upon its :adoption by a four-fifths (4/5) vote of the City Council. This interim urgency ordinance shall continue in effect for forty-five (45) days from the date of its adoption and shall thereafter be of no further force and effect unless, after notice pursuant to California Government Code Section 65090 and a public hearing, the City Council extends this interim urgency ordinance for an additional period of time pursuant to California Government Code Section 65858. SECTION 10. During the initial forty-five day period of this interim urgency ordinance, the City's code enforcement officers shall not initiate any action or proceeding against the existing medical marijuana dispensary located at 333 N. Palm Canyon, Suite 18, Palm Springs, California, on the grounds that such establishment has not been expressly authorized to operate at its current location pursuant to the City's Zoning Ordinance. Except as provided herein, nothing in this ordinance shall be construed as authorizing or approving the operation of such medical marijuana dispensary or authorizing or condoning in any way the violation of any city, state, or federal law. SECTION 11. If any section, subsection, subdivision, paragraph, sentence, clause or phrase in this Ordinance or any part thereof is for any reason, held to be unconstitutional or invalid, or ineffective by any court of competent jurisdiction such decision shall not affect the validity of effectiveness of the remaining portions of this Ordinance or any part thereof. The City Council hereby declares that it would have passed this Ordinance and each section, subsection, subdivision, sentence, clause and 210569.1 3 phrase thereof, irrespective of the fact that any one or more sections, subsections, :subdivisions, sentences, clauses or phrases be declared unconstitutional. PASSED, APPROVED, AND ADOPTED this day of 2005. AYES: NOES: ABSENT: RON ODEN, MAYOR ATTEST: JAMES THOMPSON, CITY CLERK STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss CITY OF PALM SPRINGS ) I, JAMES THOMPSON, City Clerk of the City of Palm Springs, California, DO HEREBY CERTIFY that the foregoing Ordinance No. was duly introduced, adopted, and passed AS AN URGENCY ORDINANCE at a Regular Meeting of the City Council held on the_ day of 2006, by the following vote, to wit: AYES: NOES: ABSENT: ABSTAIN: (SEAL) JAMES THOMSPSON, CITY CLERK 21➢569 1 4