The complexities of “medical” cannabis

The California model of for-profit pot stores may not be long for this world.

In Los Angeles County, where there are reportedly more pot dispensaries  than Starbucks, the District Attorney doubts that the state law really permits storefront sales and threatens prosecution.   I share his doubts; on the other hand, an opinion by the California Attorney General raises enough doubt so I can’t see how a prosecution could get past the void-for-vagueness test, especially when the state has been collecting sale s tax from some dispensaries.   Wouldn’t it be more appropriate to proceed by seeking injunctions rather than by issuing indictments?  That way the question of what the law is can be resolved without the overlay of a criminal prosecution.

In other states, the situation is even more confused. It seems as if the Department of Homeland Security and the Justice Department need to get their signals straight.

It seems clear to me that true consumer co-ops, with employees rather than owners, would be a better model that for-profit retailers, and that if retail sale is allowed then the retailers ought to produce their own product rather than buying it from (strictly illegal) growers, and ought to be required to test it for chemical content and share that information with their consumer-members.   The deeper problem of physicians writing “recommendations” to all comers is harder to deal with.

The only reasonable solution in terms of making cannabis available to actual patients  is to stop stalling medical research, get a strain or blend of whole cannabis with a reproducible chemical profile through the usual FDA new drug approval process, and make whole cannabis a medicine like other medicines, available by prescription rather than “recommendation.”

I wouldn’t oppose making cannabis available on the same terms for non-medical use; but in most cases honesty is preferable to subterfuge.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact:

5 thoughts on “The complexities of “medical” cannabis”

  1. The article you linked to mentioned that the Santa Fe Institute offers two strains, one energizing and the other sedating. I have a very limited understanding of mj on a chemical level, but one could imagine that you might or probably already see the kind of variety of product that you see in various alcohol industries and the tobacco industry as well. Would there be such a thing as too much innovation? Trying to stifle innovation by placing too many restrictions on production might open up the black market again as illegal producers would be able to get you the stuff you can't get in stores. If we were to have mass commercially driven availability then how would prescriptions factor into all of this? Would a doctor just recommend a certain brand and strength of mj like doctors already recommend products like Advil and Tylenol?

    None of this even deals with the issue of taxation. I wonder what an accurate tax rate for mj would like (accurate in the sense of trying to capture monetarily how much damage to society is done by overall mj use and distributing the weight of this damage evenly onto users, without discriminating between heavy vs casual users). We might end up being better off undertaxing mj like we do alcohol if it means preventing the recreation of the black market.

  2. I am not convinced that putting some stabilized strain of cannabis through the IND process is going to happen any time soon. I'd like to hear Mark's reflections on the (in)compatibility of volatized plant matter as prescription medicine under the US system. And what kind of pharmaceutical industry is not allowed to operate for profit? Let's ask the same of GlaxoSmithKlineWellcomeEtc. Speaking of taxes, the tax rates accepted by cannabis sellers in Oakland are ridiculous: I don't think anyone deludes themselves into thinking that these taxes are somehow supposed to offset the "damage to society" of cannabis; the retailers are happy to pay them because they want the city and the state to get used to the revenue stream. I'd like to see individuals allowed to grow their own, plus a system that regulates cannabis as an herbal supplement.

  3. Let me throw in the Scandinavian model (well, Swedish and Norwegian) of state liquor monopolies. The ethos being Nordic Lutheran, the high prices and brown-paper-bag disapproval are accompanied by thoroughgoing professionalism, so the Bordeaux say is chosen by real experts.

  4. Karlos, the idea that the black market in cannabis is gone is demonstrably false. While it is certainly true that the dispensaries get much of their product illegally, most of it doesn't come from gangs, but from local farmers in NoCal (this is based on personal knowledge and endless conversations with LEOs on the front lines, not reports from the DA's office.) Even so, I can state with absolute certainty that most of the pot consumed in LA doesn't come from dispensaries: most of the recreational cannabis is not consumed by the middle class, after all, and prices are MUCH higher at the stores than on the street. To my mind, the best thing about the stores (and by extension the doctors who prescribe to all and everyone, according to Mark, though again, from personal experience I disagree) is that they keep many people legal, who would otherwise be seeking med mari from gangs, even if they did not realize that this is actually what they are doing. The dispensaries mostly function as outlets for recreational growers (some larger and some smaller), not narco-criminals, though there will always be some crossover. If there were 100 times as many dispensaries in LA as there are now (I think about 800?), it still would not account for the vast amount of pot grown, imported and used. People, I have seen parties of 50-60 people where close to a pound of pot was consumed in under 2 hours. At store prices in LA, that would be at LEAST $3000 worth ($200/oz, discounted, for non-premium pot; could go to $400/oz for excellent buds), and the people involved would have had no way to spend that sort of money. And this wasn't an unusual event. Therefor they are not getting their pot from the same sources, as even at 100% markups, the cost is simply out of reach.

    Matthew, in California, the prescription allows an individual to grow a small number of plants for his/her own use. However, most people, my wife included, simply have neither the skill nor the physical ability to grow a consistent supply. I do agree with you about the purpose of the retail agreement with local taxes.

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