Cannabis in California:
Proactive
Structuralism vs
Mis and Malfeasance
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Tod H. Mikuriya, MD |
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President |
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California Cannabis Research Medical
Group |
California Compassionate
Use Act of 1996
(Health
& Safety Code §11362.5)
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Safe and affordable access to cannabis |
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Compassion and respect for civil rights |
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“…any other illness for which marijuana
provides relief.” |
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“..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
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Widespread failure in county government
to develop guidelines |
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Criminal Justice entities have
effectively blocked efforts |
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Physicians & health institutions
have refused compliance |
Public and private
sectors fail
to obey the law throughout the state.
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While more liberal and urban areas like
the San Francisco Bay Area appear more accepting, there is significant
resistance by certain special interest groups. |
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In Southern California and rural areas
policies are repressive with widespread official ignorance. |
Barry R. McCaffrey
threatens California Physicians
12/30/96
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Removal of DEA Rx license |
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Drop from Medicare |
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Federal law suits |
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IRS audits |
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Termination of grants |
Physicians and health
institutions continue non compliant and fearful.
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Physicians and health institutions are
dependent on federal money |
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Mass self censorship in response to
federal threats and despite a court injunction |
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Widespread fear of the psychotic 8,000
lb federal intrabeltway gorilla |
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Gridlock, fear of federal
intervention, and ignorance presents opportunity
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Prohibitionist elements and special
interests dependent on status quo |
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The numbers of individuals protected
produce a strong and continuing demand |
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Increasing physician recommendation and
approval |
Intrabeltway federal
interagency gridlock
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White House Office of National Drug
Control Policy |
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National Institute on Drug Abuse |
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Food And Drug Administration |
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Drug Enforcement Administration |
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Health and Human Services |
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Congress |
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Criminal justice chaos
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No effective legislative oversight |
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Civil forfeiture and slush funds |
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No General Orders |
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No Training or Information bulletins |
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No fiscal audits |
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Excessive discretionary power |
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No standard possession or cultivation |
State and local
government blocked
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Passive or captive AG |
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Refuses to intervene locally |
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Constitutionally mandated |
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Deputy AG’s, BNE, local DA’s,
prosecutors, judges, and police block
implementation and compliance. |
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Narcotics Officers Association
opposition |
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Unaccountable to deliberative and
executive governance. |
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Opportunities for mis and malfeasance |
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CALIFORNIA HSC §11362.5
IMPLEMENTATION AROUND THE STATE
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ARCATA: police card ID system |
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BERKELEY: 10 plants and 2.5 lbs |
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BUTTE COUNTY: Sheriff and DA agree: 2
outdoor plants
or 4 indoor or 1 lb |
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CALAVERAS COUNTY: 6 plants and 2 lbs |
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COLUSA COUNTY: No firm policy,
generally same as Butte County |
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"EL DORADO COUNTY:"
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EL DORADO COUNTY: Sheriff and DA agree:
6 plants or 1 lb or 1 oz in vehicle |
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HUMBOLDT COUNTY: 10 plants or 2 lbs |
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MARIN COUNTY: 12 plants, 6 in flower, |
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and/or ½ lb |
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MENDOCINO COUNTY: Sheriff and DA agree:
12 plants, 6 flowering, and or 2 lbs |
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NEVADA COUNTY: 10 plants or 2 lbs |
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OAKLAND: 96 plants, 48 flowering, |
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and/or 1.5 lbs |
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"SAN
FRANCISCO:Health Department Card..."
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SAN FRANCISCO:Health Department Card ID |
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HUMBOLDT COUNTY: Health Department Card
ID |
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SHASTA COUNTY: Sheriff, DA and local
police agree; 2 outdoor plants or 6 indoor |
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(3 flowering) or 1 1/3 lbs |
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SIERRA COUNTY: 3 outdoor plants or 6
indoor plants |
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SONOMA COUNTY: Sonoma Medical
Association reviews claims |
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TEHEMA COUNTY: Sheriff’s policy of 18
immature or 6 mature plants |
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YUBA COUNTY: 5 plants or 1.5 lbs |
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Counties with some
implementation and compliance
Compassionate Use Act of
1996-
Diagnostic tool of government dysfunction
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Passing a law is not enough |
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Deliberative executive disconnect |
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Budgetary obfuscation and opacity |
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Fiefdoms and centers of influence |
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Elective and non elective covens |
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Sanctions against
physicians
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Criminal subpoenas abuse |
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A mandatory appearance |
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Milking the cow through the fence
percipient vs expert witness |
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Slander: |
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This letter of approval is not
recognized |
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Exclusionary attempts |
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Local M.D.’s only, peer review |
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Malicious referrals to Medical Board |
Medical Board of
California
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Criminal justice complaints; not from
any patients or families |
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47 abusive accusations with scary
letters to patients. |
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4 compliant with threats to subpoena
records |
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Unrestrained fishing for evidence |
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Review by anonymous experts |
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Illicit sharing of information |
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United Airlines MRO, Medicare |
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Accusatory sanction on medical practice |
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No new Blue Shield insured patients |
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Recredentialling problems |
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“have you ever….?” |
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Gridlock and ambiguity:
Opportunity for Proactive Structuralism
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Proactive structuralism: “If it walks
like a duck and quacks like a duck it’s probably not a criminal conspiracy.”
Traditional precedential behavior |
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Oakland Cannabis Buyers Co-op |
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Organized and self governed |
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Safe and affordable cannabis |
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City government agency |
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Community resource |
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Supreme Court litigant |
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California Cannabis
Research
Medical Group
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Accredited medical group oriented to
clinical & social research |
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Ambulatory medical group model bylaws
for research |
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Non Profit Educational 501c3 status |
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Comparative efficacy, long term
effects, biomonitoring |
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Coordinate & facilitate cannabis center harm reduction |
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Treatment Programs in Cannabis Centers-
clean, safe, well lighted places to buy and visit.
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Chronic illness alienates |
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Negative social contract |
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Withdrawal |
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Diminished self image |
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Marginalization |
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Criminality worsens and aggravates |
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Fear, vulnerability, victimization |
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Cannabis centers offer fellowship
without dogma or control |
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Structured for comfort and safety |
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Non intrusive but supportive |
Cannabis center harm
reduction: substitution for non medical drugs and fellowship.
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Education |
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Safe use of cannabis
Vaporize
Oral |
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Harm reduction peer support groups |
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Egalitarian, non-authoritative,
supportive without enabling |
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Monday morning caffeine and cannabis |
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Identify health/social services needs |
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Liaison with community with suitable
referrals |
Medical Cannabis
Association
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Promote and re establish the legitimacy
of the medical cannabis industry. |
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Assure that all patients have access to
safe, affordable, and consistent supply of effective cannabis medicines. |
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Develop and promote standards for
quality and safety of medicinal cannabis. |
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Advocate for public policy supporting
medicinal cannabis |
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Develop self governance with highest
ethical standards |
Medical Cannabis
Association Membership Categories
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Providers-dispensaries |
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Growers Manufacturers |
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Patients |
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Caregivers |
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Distributors |
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Lawyers |
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Doctors |
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Nurses |
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Associates |
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Sponsors |
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Pharmaceutical Companies |
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Technology
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Internet |
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Benefits of instant communication and
sharing of information |
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Risks of vulnerability to hackers: |
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Viruses and worms |
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Privacy |
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2 way video: 8x8 Via TV |
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Benefits of Plain Old Telephone service
but choice of movement or resolution |
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Fax and conference calls |
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Drawbacks & benefits: Not as good
as in person but practical and useful for clinical and administrative
applications |
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Cannabis centers for
alternative medicine
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Education programs with non
pharmaceutical intervention |
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Phytopharmacognosy |
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Massage, physical therapy |
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Nutrition |
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Exercise |
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Harm reduction support groups |
Cash Based Products and
Services
“He Who Pays the Piper Calls the Tune.”
A Restaurant Model
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Ultimate cost containment |
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No Accounts Receivable |
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Customer patients in control |
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No 3rd party payers |
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No audits or gratuitous interference |
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Self sustaining, self
funded
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A secular business model |
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Dime
a dance, pot luck |
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Ultimate cost containment |
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Independent from public funding
vagaries |
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Last to be funded, first to be cut |
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Community treatment resource |
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Cannabis centers that serve customers
the best survive and prosper |
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Sales and medicated socialization |
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Like Vietnam After the
Tet Offensive
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Compassionate Use Act of 1996 passage
sent a message to the federal government |
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Collaborators and federal money
corrupted lackeys |
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County by county combat for the new law |
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Eventual victory |
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Most cannabis treated conditions
chronic and not rapidly fatal |
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Implemented and compliant areas not
likely to surrender gains |
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Civil suits
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Federal |
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Conant et al. v McCaffrey |
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State |
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Shasta & Tehema counties |
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Medical Board |
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Contributions to
California physician and patient civil suits may be made to:
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California Cannabis Research Medical
Group (CCRMG) |
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1168 Sterling Ave. |
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Berkeley, CA 94708-1757 |