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)
nSafe
and affordable access to cannabis
nCompassion
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
nWidespread
failure in county government to develop guidelines
nCriminal
Justice entities have effectively blocked efforts
nPhysicians
& health institutions have refused compliance
Public and private sectors fail to obey
the law throughout the state.
nWhile
more liberal and urban areas like the San Francisco Bay Area appear
more accepting, there is significant resistance by certain special interest
groups.
nIn
Southern California and rural areas policies are repressive with widespread
official ignorance.
Barry
R. McCaffrey threatens California Physicians12/30/96
nRemoval
of DEA Rx license
nDrop
from Medicare
nFederal
law suits
nIRS
audits
nTermination
of grants
Physicians
and health institutions continue non compliant and fearful.
nPhysicians
and health institutions are dependent on federal money
nMass
self censorship in response to federal threats and despite a court injunction
nWidespread
fear of the psychotic 8,000 lb federal intrabeltway gorilla
Gridlock,
fear of federal intervention, and ignorance presents opportunity
nProhibitionist
elements and special interests dependent on status quo
nThe
numbers of individuals protected produce a strong and continuing demand
nIncreasing
physician recommendation and approval
Intrabeltway
federal interagency gridlock
nWhite
House Office of National Drug Control Policy
nNational
Institute on Drug Abuse
nFood
And Drug Administration
nDrug
Enforcement Administration
nHealth
and Human Services
nCongress
California
Criminal justice chaos
nNegligent
legislative or administrative oversight
nCivil
forfeiture and slush funds
nNo
General Orders
nNo
Training or Information bulletins
nNo
fiscal audits
nExcessive
discretionary power
nNo
standard possession or cultivation
State
and local government blocked
nPassive
or captive AG
nRefuses
to intervene locally
nConstitutionally
mandated
nDeputy
AG’s, BNE, local DA’s, prosecutors, judges, and policeblock implementation and compliance.
Federal law supersedes
California law by Senior Assistant AG untried opinion only, but used to
rationalize criminal justice noncompliance
nNarcotics
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.
nUnaccountable
to deliberative and executive governance.
Deliberative – executive
disconnect.
CALIFORNIA
HSC §11362.5 IMPLEMENTATION AROUND THE STATE
nARCATA:
police card ID system
nBERKELEY:
10 plants and 2.5 lbs
nBUTTE
COUNTY: Sheriff and DA agree: 2 outdoorplants
or 4 indoor or 1 lb
nCALAVERAS
COUNTY: 6 plants and 2 lbs
nCOLUSA
COUNTY: No firm policy, generally same as Butte County
nEL
DORADO COUNTY: Sheriff and DA agree: 6 plants or 1 lb or 1 oz in vehicle
nHUMBOLDT
COUNTY: 10 plants or 2 lbs
nMARIN
COUNTY: 12 plants, 6 in flower, and/or½
lb
nMENDOCINO
COUNTY: Sheriff and DA agree: 12 plants, 6 flowering, and or 2 lbs
nNEVADA
COUNTY: 10 plants or 2 lbs
nOAKLAND:
96 plants, 48 flowering,and/or
1.5 lbs
nSAN
FRANCISCO:Health Department Card ID
nHUMBOLDT
COUNTY: Health Department Card ID
nSHASTA
COUNTY: Sheriff, DA and local police agree; 2 outdoor plants or 6 indoor
(3 flowering) or 1 1/3 lbs
nSIERRA
COUNTY: 3 outdoor plants or 6 indoor plants
nSONOMA
COUNTY: Sonoma Medical Association reviews claims
nTEHEMA
COUNTY: Sheriff’s policy of 18 immature or 6 mature plants
nYUBA
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
nPassing
a law is not enough
nDeliberative
executive disconnect
nBudgetary
obfuscation and opacity
nFiefdoms
and centers of influence
nElective
and non elective covens
Sanctions
against physicians
nCriminal
subpoena abuse
nA
mandatory appearance
nMilking
the cow through the fence: percipient vs expert witness
nSlander:
n“This
letter of approval is not recognized”
nExclusionary
attempts
nLocal
M.D.’s only, peer review
nMalicious
referrals to Medical Board
Medical
Board of California
nCriminal
justice complaints; not from any patients or families
n47
abusive accusations with scary letters to patients.
n4
compliant with threats to subpoena records
nUnrestrained
fishing for evidence
nReview
by anonymous experts
nIllicit
sharing of information
nUnited
Airlines MRO, Medicare
nAccusatory
sanction on medical practice
nNo
new Blue Shield insured patients
nRecredentialling
problems
n“have
you ever….?”
Gridlock
and ambiguity: Opportunity for Proactive Structuralism
nProactive
structuralism: “If it walks like a duck and quacks like a duck it’s
probably not a criminal conspiracy.” Traditional precedential behavior
nOakland
Cannabis Buyers Co-op
nOrganized
and self governed
nSafe
and affordable cannabis
nCity
government agency
nCommunity
resource
nSupreme
Court litigant
California
Cannabis Research
Medical Group
nAccredited
medical group oriented to clinical & social research
nAmbulatory
medical group model bylaws for research
nNon
Profit Educational 501c3 status
nComparative
efficacy, long term effects, biomonitoring
nCoordinate
& facilitate cannabis center harm reduction
Treatment
Programs in Cannabis Centers- clean, safe, well lighted places to buy and
visit.
nChronic
illness alienates
nNegative
social contract
nWithdrawal
nDiminished
self image
nMarginalization
nCriminality
worsens and aggravates
nFear,
vulnerability, victimization
Cannabis
center harm reduction:
substitution
for non medical drugs and fellowship.
nEducation
Safe use of cannabis
Vaporize
Oral
nHarm
reduction peer support groups
nEgalitarian,
non-authoritative, supportive without enabling
nMonday
morning caffeine and cannabis
nIdentify
health/social services needs
nLiaison
with community with suitable referrals
Medical
Cannabis Association
nPromote
and re establish the legitimacy of the medical cannabis industry.
nAssure
that all patients have access to safe, affordable, and consistent supply of
effective cannabis medicines.
nDevelop
and promote standards for quality and safety of medicinal cannabis.
nAdvocate
for public policy supporting medicinal cannabis
nDevelop
self governance with highest ethical standards
Medical
Cannabis Association MembershipCategories
Providers-dispensaries
Growers Manufacturers
Patients
Caregivers
Distributors
Lawyers
Doctors
Nurses
Associates
Sponsors
Pharmaceutical Companies
Cannabis
centers for alternative medicine
nEducation
programs with non pharmaceutical intervention
nPhytopharmacognosy
nMassage,
physical therapy
nNutrition
nExercise
Cash
Based Products and Services
“He
Who Pays the Piper Calls the Tune.”
A Restaurant Model
nUltimate
cost containment
nNo
Accounts Receivable
nCustomer
patients in control
nNo
3rd party payers add on costs
nNo
audits or gratuitous interference
Self
sustaining, self funded
nA
secular business model not dependent on grants
nDime
a dance, pot luck, fellowship
nCommunity
treatment resource
nCannabis
centers that serve customers the best survive and prosper
nSales
and medicated socialization
Like
Vietnam After the Tet Offensive
nCompassionate
Use Act of 1996 passage sent a message to the federal government
nCollaborators
and federal money corrupted lackeys
nCounty
by county combat for the new law. Juries refuse to convict: Varley, Kubby, Hayes
nEventual
victory
nMost
cannabis treated conditions chronic but not rapidly fatal
nImplemented
and compliant areas not likely to surrender gains
Recall
Petitions
Marin county D.A. Paula Kamina
Possibly Sonoma, Placer,
Civil
suits
nFederal
nConant
et al. v McCaffrey
nState
nShasta
& Tehema counties
nMedical
Board
Contributions
to California physician and patient civil suits may be made to:
California Cannabis Research Medical
Group (CCRMG)