MaMaMoJo is pleased share to this excellent letter written to Frank Smizik by Babz McGovern, a longtime friend and dedicated activist who has been studying medical marijuana law implementation in California, and other states, to complete her Masters in Public Health. Thanks to the author for this thoughtful, informative feedback .
RE: Comments on HB 2160 An Act to regulate the medical use of marijuana by patients approved by physicians and certified by the department of public health.
Dear Representative Smizik, Committee Members, and staff,
It is with great pleasure that I write. It is time for Massachusetts to join the dozen other states that allow sick and suffering patients access to the cannabis plant for relieving their suffering.
I am a MPH student from UMass Amherst currently doing research in California to finish my degree. My MPH practical experience has been working with a medical marijuana advocacy group. I have been assessing different state policies and have been tracking what I have found to be a basis for “best practices” guidelines. What follows is a submission of some of my findings in the hope of helping to shape medical marijuana policy implementation that is designed to provide the patient with a compassionate and dignified experience on their path to healing.
I submit the following partial assessment of medical marijuana policy and elements of “best practices” that I have identified.
1) Ensure patient right to access to fresh, raw cannabis plant material.
The state of Massachusetts must reserve the option for patients to access the marijuana plant in its’ raw and fresh form. The ingestion of fresh leaf (non-psychoactive) is of particular interest to patients with maladies such as undiagnosable, autoimmune disorders that involve challenging and painful reproduction, digestion and elimination symptoms.
Dr. William Courtney in Mendocino County California is on the leading edge of marijuana research and treatment. It is important to reserve access to fresh leaf for patients.
2) The need for language that supports patient collectives. We need to reserve the right of the patient to associate.
“The patient collective evolved as a legal strategy. Under the US Constitution individuals have a right of association. However no one has a US Constitutional right to engage in commerce or business. However if all the members of a collective are lawful patients then they may associate and exchange items in a non commercial atmosphere, like a gardening group that exchanged flowers or fruits and vegetables casually,“ according to a medical marijuana legal pioneer. “Egalitarian in both financial benefits and distribution of power, and they never devolve to an individual or owner for private benefit.”
Legally the state of CA codified the patient collective in CA law in Berkeley SA 420 11362.775
An example of a medical marijuana patient collective: Wo/Men’s Alliance for Medical Marijuana (WAMM)
“Members receive a multitude of services including medical relief, but the creation of community is an aspect of paramount concern to those disenfranchised by illness. We enlist a collective council responsible for initiating ideas and responding to internal problems. During our weekly support and supply meetings participants join together to find much needed emotional and social support. Sick and dying people often face discrimination, intolerance and arrest. Problem solving, attention to the personal, empowerment, consciousness and awareness are among the gifts that we are called upon to share. “ (From WAMM website)
3.) Make patient data from registry accessible for researchers via DPH website.
The data collected for the report to the Joint Committee on Public Health, and to the Joint Committee on the Judiciary, on the use of marijuana for symptom relief shall be made available to the public electronically via the Internet.
4.) Patient focused and driven services.
Collaborative programming that includes input and recommendations from all interested communities helps to insure that medical marijuana programs meet the professional and ethical mandate for cultural competency. The outcome of this type of process is often enhanced quality and delivery of services, decreased cultural bias, and programming that is informed by the knowledge, skills, and experience of the community it designed to serve.
Include language that will encourage cultural competency in local planning and implementation in the case of the state licensing compassion centers. Better yet, go one step further, and include a mandate for cultural competency and patient derived policy. Include the patient/caregiver in the process of developing and ongoing policy implementation.
The experts regarding cultivation will not come from within the DPH system. These people will come sheepishly from the shadows as the medical marijuana movement moves from the black market into the more grey areas. The best policy guidelines -- cultivation, ingestion, and service delivery information, etc. --- will come from the people with experience. Including patient and caregivers in ongoing policy issues will make for easier transitions and implementation. The best examples of this patient/caregiver inclusion can be found:
Oregon Medical Marijuana Program (OMMP) - State level
Berkeley Medical Cannabis Commission (BMCC) – Local level
The Advisory Committee on Medical Marijuana consists of 11 members who have been appointed by the DHS Director. Members of the board represent registered patients, designated primary caregivers, persons responsible for a grow site, and advocates of the Oregon Medical Marijuana Act (OMMA).
4.) Develop a method to track patient arrests.
Across the country, there is a lack of reporting regarding the numbers of patients legally possessing medicine who have encounters with law enforcement. This data is an important element in judging the impact of overshadowing of marijuana prohibition on patient health and wellbeing. If the state DPH could implement some form of recordkeeping in conjunction with law enforcement. An example of this might be the patient ID number is put into a database from the arrest record. This is a long shot request but when we are looking across the board there is no record of the numbers of patients arrested yet we know it happens.
5.) Regarding the issues related to state-licensed distribution centers (dispensaries).
Don’t allow the dispensaries to run out of medicine by bad policy!
Shortages lead law-abiding people to potentially buy from the black market. Be aware that limits set upon dispensaries regarding the numbers of plants that they are allowed to grow as well as, not allowing the dispensaries to purchase medicine from other growers has limited patient access severely. A good limit for grow to purchase may be 70/30 split. Allowing dispensaries to purchase will ensure access. Shortages have plagued dispensaries in New Mexico and left patients in great need.
Allow patients access to a homegrown supply for the raw cannabis leaf even if they designate a dispensary as their provider. This will become an issue if not now, in the near future.
The best source for understanding the limits to plants and growing capacity see: http://www.safeaccessnow.net/yieldsdosage.htm
I have attached a PDF of this document, written by cannabis expert Chris Conrad. This document is the most important source for understanding plant limits.