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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

 

 

Medical Cannabis Association  

n    Promote and re establish the legitimacy of the medical cannabis industry.

n    Assure that all patients have access to safe, affordable, and consistent supply of effective cannabis medicines.

n    Develop and promote standards for quality and safety of medicinal cannabis.

n    Advocate for public policy supporting medicinal cannabis

n    Develop self governance with highest ethical standards

 

Medical Cannabis Association Membership Categories


Providers-dispensaries

Growers Manufacturers

Patients

Caregivers

Distributors

Lawyers

Doctors

Nurses

Associates

Sponsors

Pharmaceutical Companies


 

Cannabis centers for alternative medicine

           

n   Education programs with non pharmaceutical intervention

n   Phytopharmacognosy

n   Massage, physical therapy

n   Nutrition

n   Exercise

 

Cash Based Products and Services


“He Who Pays the Piper Calls the Tune.”
A Restaurant Model

n   Ultimate cost containment

n  No Accounts Receivable

n  Customer patients in control

n   No 3rd party payers add on costs

n   No audits or gratuitous interference

 

Self sustaining, self funded

n   A secular business model not dependent on grants

n  Dime a dance, pot luck, fellowship

n  Community treatment resource

n   Cannabis centers that serve customers the best survive and prosper

n   Sales and medicated socialization

 

Like Vietnam After the Tet Offensive  

n     Compassionate Use Act of 1996 passage sent a message to the federal government

n     Collaborators and federal money corrupted lackeys

n     County by county combat for the new law. Juries refuse to convict: Varley, Kubby, Hayes

n     Eventual victory

n    Most cannabis treated conditions chronic but not rapidly fatal

n     Implemented and compliant areas not likely to surrender gains

 

Recall Petitions

Marin county D.A. Paula Kamina

Possibly Sonoma, Placer,

Civil suits             

n    Federal

n    Conant et al. v McCaffrey

n    State

n    Shasta & Tehema counties

n    Medical Board

 

 

 

Contributions to California physician and patient civil suits may be made to:

California Cannabis Research Medical Group (CCRMG)

May 8, 2001