10^th Anniversary of Prop. 215

California Leads, Feds Still Lag on Medical Marijuana

November 6^th* marks the tenth anniversary of California's landmark medical marijuana initiative, Prop. 215, approved by 56% of the voters in 1996. The past decade has seen remarkable progress in cannabis medicine both in California and worldwide. While opposition from the federal government has frustrated 215's stated goal of implementing a fully legal, "safe and affordable" distribution system, a growing network of dispensaries, clinics, and patients groups have made medical marijuana increasingly available to Californians.

The years since passage of Prop. 215 have seen growing acceptance of medical marijuana. An ever-growing population of physicians and patients are finding marijuana useful for a wide range of conditions, including chronic pain and spasticity due to injury or disease, nausea and appetite loss from HIV and cancer therapy, migraines, arthritis, post-traumatic stress, and as a harm reduction substitute for more dangerous prescription drugs. Their experiences have been confirmed by a growing body of scientific studies, which have found that marijuana and its constituents may be effective for an ever-widening list of conditions, including spinal cord injuries, multiple sclerosis, Tourette's syndrome, hepatitis C, intestinal disorders, peripheral neuropathy from HIV or diabetes, and possibly even Alzheimers. Thousands of physicians are now recommending marijuana as medicine to a patient population that is estimated between 200,000 and 350,000. Medical marijuana has come to be legally recognized in eleven states plus Canada and the Netherlands. Fully 80% of Americans support medical marijuana, according to a Time/CNN poll.

Experience of the past decade have refuted the prediction of Prop. 215 opponents that medical marijuana would send a bad message to kids. In fact, usage of marijuana by adolescents in California has declined significantly since Prop. 215 was passed. According to the California Student Survey of Drug, Alcohol and Tobacco Use, past-month marijuana use by 11^th graders declined from 42% in 1997-1998 to 30% in 2005-6; from 33% to 19% among 9^th graders; from 11% to 7% among 7^th graders).

Experience has likewise belied opponents' prediction that Prop. 215 would effectively legalize marijuana. In fact, the number of marijuana arrests in California has scarcely changed since Prop. 215 passed. While the number of marijuana prisoners has declined somewhat from its all-time peak of 1,900 in 1997 to 1,400 today, it still remains ten times higher than in the early 1980s.

Despite this record, the federal government has consistently opposed Prop. 215 as counter to federal law. Rather than adjusting federal regulations to accommodate medical marijuana, it has used federal law to undermine Prop. 215, first by threatening doctors, and then (after being blocked from doing so by a court injunction) by arresting, prosecuting and raiding growers and suppliers of medical marijuana, scores of whom have been arrested on federal charges. While the government has claimed that more FDA studies are needed to determine whether medical marijuana is truly safe and effective, it has deliberately obstructed FDA approved studies and blocked access to marijuana for research purposes. Federal restrictions on research have also made it impossible for patients or providers to test the quality, purity, safety and potency of marijuana used as medicine. More importantly, the threat of federal arrest has made it impossible to establish a legal production and distribution system, forcing producers underground into an unregulated, cash economy.

In the absence of a legal distribution system, patients have turned to a growing network of semi-licit patient's coops, collectives, dispensaries, and delivery services. Despite the federal prohibition, California's medical cannabis market has become increasingly sophisticated, with vendors specializing in extracts, tinctures, edible preparations, clones and growing equipment for home cultivators, and new smokeless vaporizers that eliminate the respiratory hazards of marijuana smoking. In addition, numerous clinics and doctors have begun to specialize in cannabis medicine, affording access to patients who would otherwise lack recommendations. There are now over 250 dispensaries, coops and delivery supplying medical marijuana to Prop 215 patients. Many operate like other legal businesses, offering health insurance, unemployment insurance and other benefits to their employees, and paying sales, business, and payroll taxes to the state. Because the legality of dispensaries remains unsettled under state law, they are regulated by local government. Some jurisdictions, such as San Francisco, Oakland and LA County, have enacted ordinances to license and regulate dispensaries. Others, such as San Diego, have sought to prohibit them, claiming that they are against state and federal law

Opponents have alleged that dispensaries attract problems. The most common are minor nuisance complaints such as parking, loitering, public smoking or odors, which can be addressed by local zoning and nuisance ordinances. In addition, police have complained that dispensaries attract robberies - a problem aggravated by their reliance on cash due to their continued illegality under federal law ≠ but this problem can be suitably controlled by security guards.

A more fundamental objection to dispensaries, and to Prop. 215 in general, is that their clientele appears to be increasingly dominated by a population with less than severe illnesses. Critics note that dispensary patrons are more apt to resemble able-bodied young males than proverbial grannies in wheelchairs. In fact, many patients obtain recommendations for relatively minor and everyday complaints, including anxiety, insomnia, lower back pain, depression, PMS, minor injuries, etc. Critics have charged that doctors are abusing Prop 215 by writing recommendations indiscriminately for trivial or unsubstantiated complaints.

Yet it is far from obvious what advantage there is in cracking down on legal access to medical marijuana. A crackdown will hardly reduce crime, since users will be driven back into the hands of criminal traffickers. On the other hand, the public benefits of the legal market are substantial. In Oakland, the city reported over $25 million in revenues from cannabis business in 2003-4, representing an estimated $2 million in sales taxes alone (Oakland's revenues later plummeted following the city council's closure of the popular Oaksterdam district, prompting the city's voters to pass an initiative, Measure Z, calling for adult use to be "taxed and regulated"). Elsewhere in California, medical cannabis business has soared, to the point where total revenues can be reasonably estimated at half a billion dollars. This in turn represents just a fraction of the state's total marijuana market, which encompasses two million users.

Ten years later, the shockwave of Prop. 215 is still spreading. It remains to be seen how far it will go before the federal ban on medical marijuana is finally lifted. If marijuana is eventually made available in licensed pharmacies like other prescription pharmaceuticals, the dispensaries and clubs may become obsolete. On the other hand, the dispensaries may well prove to be a stepping stone to a wider regime of legal adult access.

Given its uncommon pharmaceutical safety, a strong case can be made for making marijuana available as an over-the-counter drug for all adults. This November 7th, three California cities ≠ Santa Barbara, Santa Cruz, and Santa Monica - will be voting on initiatives like Oakland's Measure Z, aimed at eliminating penalties against adult use of cannabis. In addition, two states, Nevada and Colorado, will be voting on proposals to legalize adult marijuana use entirely. Ten years after Prop 215, a second marijuana reform shockwave may be in the making.

Dale Gieringer, co-sponsor, Prop 215 - Nov 2, 2006

The election was on Nov. 5th, 1996; Prop 215 became effective that midnight. Nov. 5th also marks the 15th anniversary of the day when San Francisco voters approved the nation's first medical marijuana initiative, Proposition P.