MEDICAL MARIJUANA - LOST IN THE HAZE OF STATE LAW

Californians need to be honest with themselves: The marijuana industry
that is flourishing in plain sight is not really about medicine. No
question, some patients with HIV/AIDS, glaucoma, cancer and other
serious conditions are getting much-needed relief from medical
marijuana. But the law is so loosely structured that almost anyone who
wants to smoke marijuana or grow it for sale to dispensaries can do so
with near impunity - at least from the state - under the voter-passed
Proposition 215 of 1996.

It's a nudge-and-a-wink, live-and-let-live system of
quasi-legalization that no one in a position of leadership seems to
have the will or courage to change. California voters defeated an
attempt last year to drop the charade and legalize marijuana outright.
Yet polls show the support for the continued medical use of marijuana
is overwhelming, despite the law's flaws.

There have been intense local fights about the location and
proliferation of dispensaries and growing operations, but very little
debate about the boundaries, if any, between medical and recreational
marijuana.

Want to smoke marijuana legally? There is no shortage of Dr. Feelgoods
who are more than willing to write a recommendation for as little as
$35 for an array of conditions. Want to go into the pot-growing
business? Just get yourself listed as part of a "collective" with the
dispensaries you supply and you're clear with the state.

"If truly they were only getting marijuana to people with AIDS and
cancer ... that would make us the sickliest state in the union," Keith
Humphreys, a professor at the Stanford School of Medicine, said of the
scale of medical marijuana operations.

Even if California were making a genuine effort to limit Prop. 215 to
its stated medical purposes - as states such as Colorado are doing -
it still would be in conflict with federal law, which lists marijuana
along with heroin and LSD as a Schedule 1 drug, meaning it has a "high
potential for abuse" and "no currently accepted medical use."

In 2009, President Obama's Department of Justice had promised not to
use its scarce resources to prosecute those who were in "clear and
unambiguous compliance" with existing state laws on medical marijuana.

Then again, in California, the laws are neither clear nor
unambiguous.

In recent weeks, the feds have threatened to come down hard on the
state: vowing to go after suppliers and dispensaries that are
profiting off the marijuana trade - and landlords or property owners
who rent to them, or even media outlets that accept their advertising.
Oakland's Harborside Health Center just received a $2.5 million tax
bill from the Internal Revenue Service, threatening its closure.
"Heavy-handed enforcement is a waste of time and a waste of money -
and it's cruel," said Sen. Mark Leno, D-San Francisco, citing the
impact on patients who rely on marijuana for relief. Asked whether he
believed Prop. 215 was being exploited for ecreational use, Leno said,
"That is the nature of the conundrum here. Prohibition is a messy affair."

The other paradox is that the listing of marijuana as a Schedule 1
drug has severely limited the ability to research its medical efficacy.

Caught in the middle of this legal haze is the medical profession,
which is left to be the gatekeeper of an illegal drug. Expressing its
frustration with the lack of research about medical marijuana - and
the absence of controls over purity and safety - the 35,000-member
California Medical Association this month came out in favor of
legalization of marijuana.

Paul Phinney, the CMA's president-elect, said legalization would allow
a "robust regulation of recreational use" and better research into the
medical use of cannabis, including its side effects and interactions
with other drugs.

"We don't know what doses at what ages for what medical conditions are
safe and appropriate," Phinney said. "In a way, it (the status quo)
puts us in a position of recommending relatively blind, because the
medical research (on marijuana) just isn't there."

Stanford's Humphreys, a senior policy adviser to Obama's Office of
National Drug Control Policy, said he's talked with young doctors who
are uncomfortable with how they are viewed by patients looking for a
feel-good elixir in seeking a marijuana recommendation.

"It's like you're their drug dealer, basically," Humphreys said,
adding that the concern also applies to certain prescription drugs.
"It's very demoralizing for them," he said. "That's not why they
wanted to become a doctor."

The ideal solution would be for the federal government to declassify
marijuana as a Schedule 1 drug, clearing the way for research and
allowing states to establish medical marijuana programs without fear
of federal interference. But that is not likely to happen anytime soon.

In the meantime, if California wants to argue with a straight face
that it has legalized marijuana for medical use - nothing more,
nothing less - then it should move toward a Colorado-type structure of
real oversight on supply and distribution.

California's current system of pretending that this is all about
medicine undermines respect for the law and all but invites the
federal attention its look-the-other-way approach is receiving.

What's missing in California's medical marijuana laws?

Supply chain oversight

The dispensaries are supposed to obtain their medical marijuana from
growers with whom they have formed cooperative agreements - a loosely
defined, nonbinding and largely uninspected 2008 "guideline" from the
attorney general. Mendocino County is an exception: Licensed growers
are required to zip-tie and mark each plant that is intended for
medical use - and pay a fee to the county. But there is no meaningful
oversight of the cultivation and distribution of the vast majority of
marijuana that reaches the dispensaries, raising the possibility that
"medical marijuana" growers also could be supplying the black market.

Quality control

The dispensaries are essentially left to self-police the purity,
potency and safety of the marijuana they sell. Patients are left with
a "trust us" system of quality control - a situation most consumers
would never accept for any other product, especially a medicine.

Medical standards

Patients are required to obtain a doctor's recommendation to use
medical marijuana - and some physicians readily write them for anyone
who claims to have insomnia or stress and is willing to pay fees
advertised in alternative weeklies at as little as $35. Unlike some
other states, California law does not specify the conditions
(HIV/AIDS, glaucoma, cancer, etc.) that qualify for medical marijuana.