TAX AND REGULATE

Not Tax And Become Hysterical

Someone needs to tell a few of the city council members that the
approach to medicinal marijuana that the people of Santa Barbara and
the state of California voted overwhelmingly for in 1996 is tax and
regulate, not tax and get hysterical.

An article in the Santa Barbara County Medical Society News by
current County Medical Society President Philip R. Delio, M.D.,
stated, "One would have hoped that as city council members gathered
to discuss the methods of distributing medical marijuana in Santa
Barbara, they would have asked doctors, pharmacists, or health care
professionals for input and guidance. Instead, the topic is being
sorted out via public forums that are dominated by emotion, personal
opinion, anecdotal testimony, and the like." I couldn't agree more
with Dr. Delio.

The latest excursion into the silly and inane is that somehow having
a pharmacy, in this case a pharmacy that deals in one medicine,
cannabis, near a drug rehab center, has an adverse affect on
recovering substance abusers. Clearly this allegation is a bit unique.
If memory serves me correctly, Caldwell's has a pharmacy across the
street from Cottage Hospital, and Cottage has a pharmacy in the
building. Both of these pharmacies carry, among other drugs, THC
(Marinol), with no apparent adverse affects on their recovering
patients who have substance abuse problems.

If one looks at the epidemiology of opiate abuse (in my career I have
treated over 800 opiate abusers), one finds that the most common
antecedent drug to heroin is alcohol, and alcohol is also the most
commonly used drug subsequent to stopping use of heroin. Yet there
has been no hue and cry to deny alcohol at the Encina Restaurant
right down the block from Cottage. In fact, as a matter of public
health policy, I think I would like to see fewer outlets for alcohol
and tobacco. True, their availability is so ubiquitous that the
result would likely be more cosmetic than substantive, and when I had
my successful quadruple bypass surgery at Cottage (thank you very
much) my wife waited out the surgery time over a beer at Derf's. But
it would still be a nice gesture.

If we weigh this medicinal cannabis dispensary concern against
concern over the school near to one of these outlets -- a school that
the City didn't know was a school; a school for the handicapped
which, according to testimony of former city attorney Steve
Amerikaner and former city councilman and architect Gil Garcia, did
not meet state school earthquake standards and did not have
handicapped access -- you have to ask yourself if opponents to
medicinal cannabis are manufacturing concerns out of their own
ill-informed zealousness.

I'm familiar with the historical literature on the matter of
cannabinoids and do not recall finding any problems (big or small)
with pharmacies dispensing medicinal cannabis from 1854-1941. The
literature does not mention robberies or abuse by pharmacy personnel.
The AMA testified in 1937 that they knew of no dangers from
medicinal cannabis.

On the other hand, Harry Anslinger, first director of the Federal
Bureau of Narcotics and Dangerous Drugs, gave outrageous and it turns
out mostly inaccurate testimony at the 1937 Marijuana Tax Act
hearings. According to the AMA, Anslinger had no facts, just
allegations. Even he did not raise this drug-abuse-treatment canard
as an issue. The AMA opposed the Marijuana Tax Act in 1937 and now,
in 2010, the AMA is demanding that cannabis be rescheduled to allow
more research on cannabis and cannabinoids. Rescheduling would also
allow all pharmacies to again dispense cannabis as they did
uneventfully for over three quarters of a century.

Dr. Delio is right on point when he asks, "So what can we do to
ensure that patients in need of medical marijuana have access, while
at the same time limit abusers, children, and others from
inappropriate use?" He suggests:

1. "As a therapeutic drug, marijuana should be subject to the same
prescribing guidelines and regulations that would apply to any
prescription drug. This includes close supervision of patients using
medical marijuana by their treating physicians, strict regulation of
the amounts and types of marijuana dispensed, and attention to how
often the drug is being refilled."

2. He also recommends that the Santa Barbara County Medical Society
should offer their "services to the County as a resource for
information, guidance, and direction on this challenging issue. The
goal of these discussions should not be to limit access to effective
therapeutics, but rather to ensure the safe and responsible
distribution to those with medical need."

If we as a society are truly concerned about drug abuse, let's put
our energy and money into more and better parenting education, making
every child a wanted child, and supporting increased emphasis on
early intervention. I've been involved in drug abuse treatment and
prevention for over 40 years and my take on recovery is that, in
addition to family and community support, key elements to recovery are
length of time in treatment, quality of treatment, commitment, and
the motivation of the patient.

Do we really want to follow the weird logic of the anti-dispensary
activists and start clamoring to close Caldwell's -- and all the rest
of the pharmacies, which carry all manner of highly addictive drugs
that are subject to abuse?

This is a states' rights issue, as the late Chief Justice of the
Supreme Court William Rehnquist, now retired Justice Sandra Day
O'Connor, and current Justice Clarence Thomas wrote in dissent in
Gonzales v. Raich. What we need is a return to sanity and to the
Constitution, particularly the 9th and 10th amendments. If the
federal government followed the Constitution, cannabis too would be
dispensed in pharmacies, as it was for nearly a century, and we
wouldn't be having this discussion.