Cannabis in California:
Proactive Structuralism vs
Mis and Malfeasance
Tod
H. Mikuriya, MD
President
California
Cannabis Research Medical Group
California
Compassionate Use Act of 1996
(Health & Safety Code §11362.5)
n
Safe
and affordable access to cannabis
n
Compassion
and respect for civil rights
n
“…any
other illness for which marijuana provides relief.”
n
“..no
physician in this state shall be punished or denied any right or privilege,
for having recommended marijuana to a patient for medical purposes.”
No provision for Implementation &
Compliance- “A new car in a bad neighborhood without insurance”- Jeffrey
Jones
n
Widespread
failure in county government to develop guidelines
n
Criminal
Justice entities have effectively blocked efforts
n
Physicians
& health institutions have refused compliance
Public and private sectors fail to obey
the law throughout the state.
n
While
more liberal and urban areas like the San Francisco Bay Area appear
more accepting, there is significant resistance by certain special interest
groups.
n
In
Southern California and rural areas policies are repressive with widespread
official ignorance.
Barry
R. McCaffrey threatens California Physicians
12/30/96
n
Removal
of DEA Rx license
n
Drop
from Medicare
n
Federal
law suits
n
IRS
audits
n
Termination
of grants
Physicians
and health institutions continue non compliant and fearful.
n
Physicians
and health institutions are dependent on federal money
n
Mass
self censorship in response to federal threats and despite a court injunction
n
Widespread
fear of the psychotic 8,000 lb federal intrabeltway gorilla
Gridlock,
fear of federal intervention, and ignorance presents opportunity
n
Prohibitionist
elements and special interests dependent on status quo
n
The
numbers of individuals protected produce a strong and continuing demand
n
Increasing
physician recommendation and approval
Intrabeltway
federal interagency gridlock
n
White
House Office of National Drug Control Policy
n
National
Institute on Drug Abuse
n
Food
And Drug Administration
n
Drug
Enforcement Administration
n
Health
and Human Services
n
Congress
California
Criminal justice chaos
n
Negligent
legislative or administrative oversight
n
Civil
forfeiture and slush funds
n
No
General Orders
n
No
Training or Information bulletins
n
No
fiscal audits
n
Excessive
discretionary power
n
No
standard possession or cultivation
State
and local government blocked
n
Passive
or captive AG
n
Refuses
to intervene locally
n
Constitutionally
mandated
n
Deputy
AG’s, BNE, local DA’s, prosecutors, judges, and police
block implementation and compliance.
Federal law supersedes California law by Senior Assistant AG untried opinion only, but used to rationalize criminal justice noncompliance
n
Narcotics
and Peace Officers Association opposition
AG & State senator characterized as enemies
Successfully gained access to patient records through addition to CLETS in amended SB 187 mandating a voluntary health department ID program.
n
Unaccountable
to deliberative and executive governance.
Deliberative – executive disconnect.
CALIFORNIA
HSC §11362.5 IMPLEMENTATION AROUND THE STATE
n
ARCATA:
police card ID system
n
BERKELEY:
10 plants and 2.5 lbs
n
BUTTE
COUNTY: Sheriff and DA agree: 2 outdoor plants
or 4 indoor or 1 lb
n
CALAVERAS
COUNTY: 6 plants and 2 lbs
n
COLUSA
COUNTY: No firm policy, generally same as Butte County
n
EL
DORADO COUNTY: Sheriff and DA agree: 6 plants or 1 lb or 1 oz in vehicle
n
HUMBOLDT
COUNTY: 10 plants or 2 lbs
n
MARIN
COUNTY: 12 plants, 6 in flower, and/or ½
lb
n
MENDOCINO
COUNTY: Sheriff and DA agree: 12 plants, 6 flowering, and or 2 lbs
n
NEVADA
COUNTY: 10 plants or 2 lbs
n
OAKLAND:
96 plants, 48 flowering, and/or
1.5 lbs
n
SAN
FRANCISCO:Health Department Card ID
n
HUMBOLDT
COUNTY: Health Department Card ID
n
SHASTA
COUNTY: Sheriff, DA and local police agree; 2 outdoor plants or 6 indoor
(3 flowering) or 1 1/3 lbs
n
SIERRA
COUNTY: 3 outdoor plants or 6 indoor plants
n
SONOMA
COUNTY: Sonoma Medical Association reviews claims
n
TEHEMA
COUNTY: Sheriff’s policy of 18 immature or 6 mature plants
n
YUBA
COUNTY: 5 plants or 1.5 lbs
Counties
with some implementation and compliance
Compassionate
Use Act of 1996 as of 5-2001
Compassionate
Use Act of 1996-
Diagnostic tool of government dysfunction
n
Passing
a law is not enough
n
Deliberative
executive disconnect
n
Budgetary
obfuscation and opacity
n
Fiefdoms
and centers of influence
n
Elective
and non elective covens
Sanctions
against physicians
n
Criminal
subpoena abuse
n
A
mandatory appearance
n
Milking
the cow through the fence: percipient vs expert witness
n
Slander:
n
“This
letter of approval is not recognized”
n
Exclusionary
attempts
n
Local
M.D.’s only, peer review
n
Malicious
referrals to Medical Board
Medical
Board of California
n
Criminal
justice complaints; not from any patients or families
n
47
abusive accusations with scary letters to patients.
n
4
compliant with threats to subpoena records
n
Unrestrained
fishing for evidence
n
Review
by anonymous experts
n
Illicit
sharing of information
n
United
Airlines MRO, Medicare
n
Accusatory
sanction on medical practice
n
No
new Blue Shield insured patients
n
Recredentialling
problems
n
“have
you ever….?”
Gridlock
and ambiguity: Opportunity for Proactive Structuralism
n
Proactive
structuralism: “If it walks like a duck and quacks like a duck it’s
probably not a criminal conspiracy.” Traditional precedential behavior
n
Oakland
Cannabis Buyers Co-op
n
Organized
and self governed
n
Safe
and affordable cannabis
n
City
government agency
n
Community
resource
n
Supreme
Court litigant
California
Cannabis Research
Medical Group
n
Accredited
medical group oriented to clinical & social research
n
Ambulatory
medical group model bylaws for research
n
Non
Profit Educational 501c3 status
n
Comparative
efficacy, long term effects, biomonitoring
n
Coordinate
& facilitate cannabis center harm reduction
Treatment
Programs in Cannabis Centers- clean, safe, well lighted places to buy and
visit.
n
Chronic
illness alienates
n
Negative
social contract
n
Withdrawal
n
Diminished
self image
n
Marginalization
n
Criminality
worsens and aggravates
n
Fear,
vulnerability, victimization
Cannabis
center harm reduction:
substitution
for non medical drugs and fellowship.
n
Education
Safe use of cannabis
Vaporize
Oral
n
Harm
reduction peer support groups
n
Egalitarian,
non-authoritative, supportive without enabling
n
Monday
morning caffeine and cannabis
n
Identify
health/social services needs
n
Liaison
with community with suitable referrals
