The State of the Medical Cannabis Union in California

This article written by Dr. Sean Breen. We at Green Relief largely agree with it’s message. Enjoy the read.

It is with sadness and regret that I say that the State of the Medical Cannabis Union is not strong. In the past 12 months we have seen DEA (Drug Enforcement Agency), local law enforcement and city councils decimate what is left of the medical marijuana industry here in California. Landlords, facing forfeiture of properties, have been forced to evict otherwise lawful medical marijuana dispensaries. Dispensary owners have had assets, product and bank accounts seized in what is known as “robbery with a badge.” However not all is lost. There are still excellent doctors who will recommend medical marijuana to patients, there are excellent collective that will deliver high quality medicine to their patients and there is a ground roots movement to truly change this industry.

With all that said, the medical marijuana industry has a tough hill to climb to get to the peak of the mountain which is regulations and guidelines for dispensaries to legally operate within the state of California. I would like to outline what I feel is the best way to fix the medical marijuana “industry”. I am basing these recommendations on my observations after working full time for the past 5 years evaluating patients who qualify to use medical marijuana per California’s proposition 215 which passed in 1996.

Some of my observations will be obvious and some less obvious.

1) The medical cannabis industry has to be for-profit. Under current law, all dispensaries have to operate as not-for-profit businesses. The problem with requiring dispensaries to operate as not-for-profit is that it attracts individuals who are willing to launder money and run the risk of not getting audited by the IRS. Running a dispensary is a full time job that requires owner/operators to be there all the time. Is not unlike the bar industry where owners have to worry about inventory, employee theft and making sure employees are following the law (i.e.. not selling 4 pounds out the back door to people who will sell it on the street). Ask yourself this question? Would you invest $100,000 into a business that you have to run and market just like any other business if you could not make a profit? It is obviously a rhetorical question.

What happened is that this business model attracted way too many people who were willing to put cash under the mattress and roll the dice that they won’t get caught. If you were a legitimate businessman and looked at the risk/reward ratio you would just apply for a liquor license and open a bar or any other business for that matter.

By allowing the medical marijuana industry to operate for profit, you would attract some of the best and brightest minds who would run it correctly. They would pay their employees on the books, they would charge and pay state taxes and they wouldn’t have to hid a few hundred thousand dollars from the IRS come April 15th each year.

2) Tighten up the process of getting a medical marijuana card. The doctors are truly the gate keepers to this industry. Without a recommendation patients can not enter a dispensary. Too many doctors are handing out recommendations without doing exams, without requiring medical records and without documenting a qualifying diagnosis. I just took care of a patient who went to a doctor last year for knee pain but the doctor he visited (over skype) kept on saying “OK you have insomnia and that’s why you use marijuana.” Each time he said he didn’t have insomnia the doctor would say “Yes I think you do have insomnia.” The doctor then gave him a recommendation to use marijuana for “insomnia”. I suspect the reason is because he couldn’t examine the guys knee and needed another reason.

The medical board should implement the following. 1. All patients must be evaluated for their condition within 12 months of receiving a medical marijuana recommendation and must provide written documentation of their diagnosis and workup at the time of their recommendation. This would eliminate 90% of the patients who walk into a medical marijuana clinic and say “I have anxiety and can’t sleep” and leave 5 minutes later with a recommendation. Doctors would have to insure that this patient had a complete physical with any necessary tests to rule out organic disease causing their symptoms. It would also eliminate any doctor doing this over skype or using “Telemedicine”. Their are legitimate reasons why doctors use telemedicine but in the medical marijuana industry it is highly abused. 2. Create a training program to qualify doctors who want to recommend cannabis to patients. Not necessarily a medical training program but to educate them on the requirements, the laws of co-habitating with dispensaries and the punishments if they do not follow the law. I can’t tell you how many doctors are working in clinics owned by non-doctors. This is called the corporate practice of medicine and doctors can and do lose their license for this frequently. It is one of the things that has killed the medical marijuana industry in California. Dispensaries pay doctors cash to sit in their office and rubber stamp cannabis recommendations for patients to walk next door and buy medical marijuana. The rate of malingering quadruples in these types of business arrangements because the doctor is given incentives for the amount of patients that “qualify.”

3) State the obvious: the state needs to set clear guidelines on how dispensaries can operate. Their needs to be licensed growers who can openly grow and provide quality medicine to dispensaries. This would eliminate the amateurs who have sub-par grows in their house from supplying un-tested marijuana to dispensaries. Patients need safe organic medicine that has been tested for impurities and cannabinoid content. Under the current system it is cost prohibitive to test your plants for cannabinoid concentration. The dispensaries that do not test just charge less and the ones that do can not compete. This hurts the patients ultimately.

4) Dispensaries should have specific software that is developed to track everything from seed to purchase. This software should be uniform across the state so that cities can easily track inventory, revenue and make sure that taxes are being paid. I recently spoke to an individual who had this entire software built out and ready to implement it. The cities ultimately rejected it for “who knows why.”

5) Someone needs to allow more medical studies. I have taken care of over 15,000 patients who benefit from using medical marijuana. The problem is that medicine needs to be evidenced based and not 90% anecdotal. Until we can get more papers published concluding that cannabinoids work for many different medical conditions it is difficult to get it re-classified a non-scheduled drug. Currently marijuana is schedule 1 meaning “it has no medicinal value and is highly addictive.” The US government knows this is false because they own a patent for cannabinoids as a neuroprotectant. In addition there are 14 studies conducted by UCSD Cannabis Research Center proving that cannabis treats pain effectively. The pharmaceutical industry needs to get involved because they are the ones directly blocking this on all levels most likely by lobbying congress.

6) Stop focusing on out-right legalization and put all efforts into making medical marijuana legal in all 50 states. The more patients that use it, the more they will realize that it is safe and effective and should not be a schedule 1 drug. Once we have critical mass where patients start voting and contacting their elected officials about this issue nothing will happen.

What can you do? I do not think the answer is obvious. The DEA and federal prosecutors have decided that they will ignore whatever California implements regardless of any proposition that passes. I have spoken to people working to put ballot initiatives on the ballot for November. What good will that do if it passes if the feds will send forfeiture letters to landowners regardless. I think what we have to start is start by writing and calling your local elected officials and let them know you will be voting based on this issue (even if you aren’t ultimately). No one cares about DWI laws until they lose a loved one. Many people don’t care about medical marijuana until they finish their first day of chemotherapy. I would encourage every citizen to use their constitutional right to pick up the phone to let their congressmen, senators and President Obama know that they should not ignore this issue. The health of many patients is at stake. California’s economy is 19 billion dollars in debt and medical marijuana can put a huge dent in reducing the deficit.

OK. I have no more energy left today. I hope this made sense.

Dr Sean Breen