Medical cannabis in the United States

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Map of US states with cannabis laws
  States with medical cannabis laws only
  States with marijuana decriminalization laws only
  States with both decriminalization and medical cannabis laws
  States with both medical marijuana laws and legalized recreational cannabis
Medical cannabis card in Marin County, California.

As of June 2014, 23 states have legalized cannabis for medical use[1] with three states pending legislation.[2]

In the United States, there are important legal differences between medical cannabis at the federal and state levels. At the federal level, cannabis per se has been made criminal by implementation of the Controlled Substances Act, but as of 2009, new federal guidelines have been enacted. According to U.S. Attorney General Eric Holder, "It will not be a priority to use federal resources to prosecute patients with serious illnesses or their caregivers who are complying with state laws on medical marijuana, but we will not tolerate drug traffickers who hide behind claims of compliance with state law to mask activities that are clearly illegal."[3][4][5]

California passed an initiative to allow medical cannabis in 1996. In the intervening years, multiple states have passed similar initiatives. A January 2010 ABC News poll showed that 81 percent of Americans believed that medical cannabis should be legal in the United States.[6] Most recently, in June 2014 New York became the 23rd state to legalize medical marijuana not including DC, however the marijuana cannot be smoked.[7]]

Overview[edit]

Timeline of medical marijuana legalization in the USA

(State-level legalization)

  • 1996: California
  • 1998: Alaska, Oregon, Washington
  • 1999: Maine
  • 2000: Colorado, Hawaii, Nevada
  • 2004: Montana
  • 2006: Rhode Island
  • 2007: New Mexico, Vermont
  • 2008: Michigan
  • 2010: Arizona, New Jersey
  • 2011: Delaware, Washington, D.C.
  • 2012: Connecticut, Massachusetts
  • 2013: New Hampshire, Illinois
  • 2014: Maryland, Minnesota
Total states: 23

The Federal Food, Drug, and Cosmetic Act of 1938 makes the U.S. Food and Drug Administration (FDA) the sole government entity responsible for ensuring the safety and efficacy of new prescription and over-the-counter drugs, overseeing the labeling and marketing of drugs, and regulating the manufacturing and packaging of drugs.[8] The FDA defines a drug as safe and effective for a specific indication if the clinical benefits to the patient are felt to outweigh any health risks the drug might pose. The FDA and comparable authorities in Western Europe, including the Netherlands, have not approved smoked cannabis (partly because of the problems related to smoking per se and the inherent crudeness of it as an effective and dosed delivery mechanism) for any condition or disease.[9][10] Indeed, the FDA has not approved medical cannabis in any form for any indication.

Cannabis remains illegal throughout the United States and is not approved for prescription as medicine, although 23 states— Alaska, Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington—as well as the District of Columbia approve and regulate its medical use. (The Federal government continues to enforce its prohibition in these states.)

Two American (for-profit) companies, Cannabis Science Inc., and Medical Marijuana, Inc., are working towards getting FDA approval for cannabis based medicines (including smoked cannabis). Cannabis Science Inc. wants to have medical cannabis approved by the FDA so anyone, regardless of state, will have access to the medicine.[11] Also, there is one non-profit organization, the Multidisciplinary Association for Psychedelic Studies (MAPS) working towards getting Cannabis approved by the FDA for PTSD.

Potential health benefits aside, cannabis remains a U.S. federally controlled substance, making possession and distribution illegal.[citation needed] Those seeking to acquire medical cannabis may have to resort to the black market in order to obtain the product if their state does not allow the existence of legal dispensaries. However, in some states—such as Colorado—legal dispensaries are plentiful, and there is no need to resort to the black market.

Researchers face similar challenges in obtaining medical cannabis for research trial. Recently, the FDA has approved a number of cannabis research clinical trials, but the Drug Enforcement Administration has not granted licenses to the researchers in these studies.[citation needed]

Neon sign from a medical marijuana dispensary on Ventura Boulevard in Los Angeles, California.

Cannabis was listed in the United States Pharmacopeia from 1850 until 1942.[12] The United States Federal government does not currently recognize any legitimate medical use, although there are currently four patients receiving cannabis for their various illnesses through the Compassionate Investigational New Drug program that was closed to new patients in 1991 by the George H. W. Bush administration. Francis L. Young, an administrative law judge with the United States Drug Enforcement Administration declared in 1988 that, "in its natural form, [cannabis] is one of the safest therapeutically active substances known."[13] Twenty three U.S. state laws, as well as the District of Columbia, currently allow for the medicinal use of cannabis,[14] but the United States Supreme Court ruled that the Federal government has the right to regulate and criminalize cannabis also in these states, even for medical purposes.

The term "medical marijuana" post-dates the U.S. Marijuana Tax Act of 1937. Enacted by the Franklin D. Roosevelt administration, the tax act made cannabis prescriptions illegal in the United States. Since the creation of the DEA, the agency has spent over US$100 billion trying stop the flow of illegal drugs into the United States. States that have legalized marijuana have seen an increase in revenue though taxation. For example, in 2008, the state of Hawaii made over US$10 million through taxation of medical marijuana.[citation needed]

A paper published in May 2012 by the University of California Center for Medicinal Cannabis Research, entitled "Medical Marijuana: Clearing Away the Smoke", concluded:

... it will be useful if marijuana and its constituents can be prescribed, dispensed, and regulated in a manner similar to other medications that have psychotropic effects and some abuse potential. Given that we do not know precisely which cannabinoids or in which combinations achieve the best results, larger and more representative clinical trials of the plant product are warranted ... The classification of marijuana as a Schedule I drug as well as the continuing controversy as to whether or not cannabis is of medical value [59] are obstacles to medical progress in this area. Based on evidence currently available the Schedule I classification is not tenable; it is not accurate that cannabis has no medical value, or that information on safety is lacking. It is true cannabis has some abuse potential, but its profile more closely resembles drugs in Schedule III (where codeine and dronabinol are listed).[15]

Comparisons to alcohol prohibition[edit]

In an essay entitled Physicians Are Not Bootleggers, bioethicist Jacob Appel compared the medicinal cannabis movement to the medicinal alcohol movement that took place during the Prohibition era of the 1920s in the United States. Just as modern physicians who want the right to prescribe cannabis may or may not support its legalization for use without a prescription, the essay notes that physicians in the 1920s who wanted the right to prescribe alcohol were not uniformly in favor of repealing Prohibition. They were united instead by their opposition to what they saw as unwarranted governmental interference in the practice of medicine.[16]

Medical cannabis by state[edit]

In the United States, cannabis per se has been criminalized at the Federal level by implementation of the Controlled Substances Act, which classifies cannabis as a Schedule I drug – the strictest classification, on par with heroin, LSD and ecstasy. In 2005, the U.S. Supreme Court ruled in Gonzales v. Raich that the Commerce Clause of the U.S. Constitution allows the government to ban any use of cannabis, including medical use. The United States Food and Drug Administration states "marijuana has a high potential for abuse, has no currently accepted medical use in treatment in the United States, and has a lack of accepted safety for use under medical supervision".[17][18]

Since the medical marijuana movement began, 23 states and the District of Columbia, starting with California in 1996, have legalized medical cannabis or effectively decriminalized it: Alaska,[19] Arizona,[20] California,[21] Colorado,[22] Connecticut,[23][24] Delaware,[25] Hawaii,[26] Illinois, Maine,[27] Massachusetts, Maryland,[28] Michigan,[29] Montana,[30] Nevada,[31] New Hampshire, New Jersey,[32] New Mexico,[33] Oregon,[34] Rhode Island,[35] Vermont,[36] Washington;[37][38] Maryland allows for reduced or no penalties if cannabis use has a medical basis.[39][40][41] Despite legalization of marijuana in Washington and Colorado, an employee may still be fired if they test positive on a drug test, despite having a doctor's recommendation.[42] California, Colorado, Arizona, New Mexico, Maine, Rhode Island, Montana, and Michigan are currently the only states to utilize dispensaries to sell medical cannabis; Connecticut and Massachusetts are also planning to do so. During 2008, California's medical cannabis industry took in about $2 billion and generated $100 million in state sales taxes[43] with an estimated 2,100 dispensaries, co-operatives, wellness clinics and taxi delivery services in the sector colloquially known as "cannabusiness".[44]

Though it does not have an established medical registry program, the state of Virginia,[45] does allow for possession under the directive as medicine.

Some individual states such as Oregon choose to issue medical marijuana cards[46] to residents with a doctor's recommendation after paying a fee.

In October 2009, the U.S. Deputy Attorney General issued a U.S. Department of Justice memorandum to "All United States Attorneys" providing clarification and guidance to federal prosecutors in states that have enacted medical marijuana laws. The document is intended solely as "a guide to the exercise of investigative and prosecutorial discretion and as guidance on resource allocation and federal priorities." It includes seven criteria to help determine whether a patient's use, or their caregiver's provision, of medical cannabis "represents part of a recommended treatment regiment consistent with applicable state law". The Department advised that it "likely was not an efficient use of federal resources to focus enforcement efforts on seriously ill individuals, or on their individual caregivers. ... Large-scale, for-profit commercial enterprises, on the other [hand], ... continued to be appropriate targets for federal enforcement and prosecution."

The sale and distribution of cannabis remains illegal under federal law,[47] however, as the Food and Drug Administration's position – that marijuana has no accepted value in the treatment of any disease in the United States – remains unchanged.[17]

In November 2011, in accordance with 35 U.S.C. 209(c)(1) and 37 CFR part 404.7(a)(1)(i), the NIH announced that it is contemplating the grant of an exclusive patent license to practice the invention embodied therein to KannaLife Sciences Inc.. The prospective exclusive license territory may be worldwide, and the field of use may be limited to: The development and sale of cannabinoid(s) and cannabidiol(s) based therapeutics as antioxidants and neuroprotectants for use and delivery in humans, for the treatment of hepatic encephalopathy, as claimed in the Licensed Patent Rights.[48]

Alaska[edit]

The medical use of cannabis, Ballot Measure # 8, was endorsed by 58% of voters in Alaska in November 1998 and the law became effective on March 4, 1999. The law legalizes the possession, cultivation and use of cannabis for patients who have received a certificate from a doctor confirming they can benefit from the medical use of cannabis. The conditions and symptoms eligible are: cachexia, cancer, chronic pain, epilepsy and other conditions characterized by spasms, chronic glaucoma, HIV or AIDS, multiple sclerosis and nausea. The state maintains a confidential list of patients who are assigned an identity card.[49]

Arizona[edit]

Arizona's proposition 203, also called "Arizona Medical Marijuana Act", was a measure to legalize the use of medical cannabis[50] and appeared on the general election ballot via a citizen petition.[51] The initiative will allow patients with a "debilitating medical condition" to possess up to 2.5 ounces of marijuana every two weeks with a doctor's recommendation. They will also be able to cultivate no more than twelve cannabis plants only if they do not live within twenty-five miles of a state licensed dispensary. Arizona has allocated the licensing of dispensaries at a ratio of one per ten pharmacies in the state, or a total of 124. The outcome of Prop. 203 was not announced until Sunday, November 14, 2010, when it passed by 4,300 votes, or 50.1% yes to 49.9% no.[52] Arizona legislature passed an exception to Arizona Proposition 203 (2010) in early February 2012, in the form of House Bill 2349. This new bill states that medical marijuana cannot be used in educational institutions and child care facilities.

Arkansas[edit]

In November 2012, voters rejected The Arkansas Medical Marijuana Act would have allowed up to 30 medical marijuana dispensaries to open in Arkansas and let patients to possess up to 2.5 ounces of cannabis. Cities and counties would have been able to ban marijuana dispensaries under the law. The act failed by a vote of 51.44% - 48.56%.

California[edit]

"Cannabis is Medicine, Let States Regulate!" protest in San Francisco, April 4, 2012

In 1996 California voted Proposition 215, also called the Compassionate Use Act, into law. CA Senate Bill 420 was passed in 2003 to clarify Proposition 215 by specifying statewide minimum limits on possession of cannabis and enact a Statewide Medical Cannabis ID Card Program (the G214 card). As of January 16, 2008, only 36 of 58 counties are issuing cards in the program, with 18,847 cards having been issued,[53] however, participation in the ID Card program is optional and the identification card is not required to claim the Act's protections.[54]

On November 5, 1996 56% of voters approved Proposition 215. The law removes state-level criminal penalties on the use, possession, and cultivation of cannabis by patients who possess a "written or oral recommendation" from their physician that he/she "would benefit from medical cannabis." Patients diagnosed with any illness where the medical use of cannabis has been "deemed appropriate and has been recommended by a physician" are provided with legal protection under this act. Conditions typically covered by the law include: arthritis; cachexia; cancer; chronic pain; HIV or AIDS; epilepsy; migraine; and multiple sclerosis, with other less debilitating conditions like insomnia, reduced appetite, anxiety, and PTSD often treated also. No regulations regarding the amount of cannabis patients may possess and/or cultivate were provided by this act, though the California Legislature adopted guidelines in 2003.[55]

The Act added Section 11362.5 to the California Health and Safety Code. This law has caused much conflict in the United States between states' rights advocates and those who support a stronger federal presence.

Author, activist, and grower Ed Rosenthal of High Times was raided and charged by federal agents in 2002. Rosenthal was cultivating marijuana "clones" (or cuttings) to be distributed to Bay Area medical marijuana clubs. The presiding judge, Charles Breyer, did not allow any testimony that would have substantiated what Rosenthal was doing was legal under state law as he was being charged in violation of federal law, which makes no exception for any legality under state law. Further testimony citing Rosenthal as an agent of the City of Oakland was also not allowed.[56]

Across California there are an estimated 2,100 dispensaries, co-operatives, wellness clinics, and taxi delivery services in the sector known as “cannabusiness”.[57]

On May 21, 2013, Los Angeles voters approved, with 63% of the vote, a proposition limiting the number of medical marijuana dispensaries in the city.[58]

Colorado[edit]

Cannabis shop in Denver

On November 7, 2000, 54% of Colorado voters passed Amendment 20, which amends the Colorado State constitution to allow the medical use of cannabis.[49] Patients can possess no more than two ounces of "usable cannabis" and not more than six cannabis plants, and they may neither take their medicine in public, nor even on their own property, if the public can see them taking it.[49]

In November 2009, in Breckenridge, Colorado, 70% of voters elected to amend the town code to remove all criminal and civil penalties, including fines, for the private possession of up to one ounce of marijuana. More than 70% of local voters voted yes on a similar, but unsuccessful, statewide measure in 2005.[citation needed]

In December 2010, CNBC aired a one-hour special titled Marijuana USA that focused on the tremendous growth of the legal cannabis trade in Colorado as marijuana emerges from the black market to the mainstream market.[59] As of February 29, 2012, the total number of patients who currently possess valid medical marijuana ID cards is 89,646.[60] In November 2012 Amendment 64 won by popular vote for the legalization of cannabis for recreational use. The first time since cannabis was legal in almost a century.[61]

Medical marijuana clinic, Denver

As of June 26, 2013, 532 medical marijuana dispensaries operate in the state of Colorado, including 389 with licenses and 143 that are in the process of obtaining one.[62]

Following the first day of legalized recreational marijuana sales in Colorado, the retailers claim they made over $1 million in sales statewide. Most of the 24 stores that opened on January 1, 2014 are located in Denver. In accordance with federal banking legislation, the marijuana retailers remain prohibited from using bank accounts to manage the revenue from sales, as the drug continues to be prohibited by federal law; however, the U.S. Department of Justice and federal regulators stated in September 2013 that they will assist Colorado's marijuana retail industry to negotiate a reasonable arrangement.[63] The state government stated that the tax revenue from sales will be used for school construction and marijuana regulation.[64]

In September 2014, a legislative panel did not endorse a bill to limit the number of marijuana plants each grower and patient can possess.[65]

Connecticut[edit]

On May 5, 2012, the Connecticut State Senate passed a bill approving the use of medical marijuana.[66] Connecticut became the 17th state to legalize medical marijuana on June 1, 2012, after Governor Dannel Malloy signed a bill into law. Some portions of the law were effective immediately while the remaining portions became effective on October 1, 2012.[67][68]

Delaware[edit]

On May 13, 2011, Delaware became the 16th state to legalize medical cannabis after Governor Jack Markell signed the bill. The bill passed the state senate on May 11 by a 17-4 vote. Patients who certify they have a serious medical condition are allowed to possess up to six ounces, or, of cannabis. State-licensed centers are allowed to grow the marijuana and dispense it to patients 18 and older.[69] Although Delaware passed the law, Gov. Markell has decided to not move forward with implementation of steps needed for patients to obtain their cards.

Hawaii[edit]

In Hawaii, Senate Bill 862 became law on June 14, 2000. Patients can possess a maximum of () of usable cannabis and a maximum of 7 cannabis plants.[49]

Illinois[edit]

Illinois Governor Pat Quinn signed a medical Pre-marijuana legalization bill into law on August 1, 2013. The law allows 2.5 ounces of marijuana to be prescribed every two weeks to patients suffering from any of a specific list of illnesses. The prescribing doctor must also have a prior & ongoing care relationship with the patient. The law took effect on January 1, 2014.[70]

Iowa[edit]

Iowa law gives control of marijuana policy to the Iowa Pharmacy Board and not to elected law makers. On November 2, 2010, the Iowa Board of Pharmacy declared marijuana to be a schedule two drug. What that classification means is that marijuana is a drug with potential benefits, but a high risk of misuse. The Iowa Board of Pharmacy refused to create any set of rules or regulations regarding medical marijuana usage, claiming that it should be elected Iowa officials that handle such issues. There is currently no medical marijuana system set up in Iowa, but the Iowa Board of Pharmacy retains the power to create it if they so desired.[71]

Maine[edit]

On November 2, 1999, 62% of voters in Maine passed Question 2. Patients or their primary physicians could possess a maximum of 114 ounces (35 g) of usable cannabis and a maximum of 6 plants. The law was amended when Maine Senate Bill 611 was signed into law on April 2, 2002, increasing the maximum quantity of usable cannabis a patient is allowed to possess to 212 ounces.[49]

November 2009 Maine voters approved Question 5, the Maine Marijuana Medical Act. The measure amends existing state law by: establishing a confidential patient registry, expanding the list of qualifying conditions for which a physician may recommend medicinal cannabis, and by allowing for the creation of non-profit state-licensed dispensaries to assist in the distribution of medical cannabis to qualified patients.

Maryland[edit]

The legislature of Maryland passed a "medical marijuana affirmative defense law" in the year 2003,[40] and amended it May 10, 2011.[40][41] If someone is being prosecuted by the state for certain marijuana related crimes, then the court is required by law to consider a defendant's "medical necessity."[40][41] If medical necessity is proven, possession up to one ounce carries no penalty - higher possession and cultivation may then only be fined $100.[40][41] In April 2014, The Maryland legislature passed a bill lowering penalties for small amounts of marijuana possession to civil fines.[72]

Massachusetts[edit]

Voting results of the 2012 Massachusetts Medical Marijuana Initiative

On November 6, 2012, Massachusetts voters passed the Massachusetts Medical Marijuana Initiative with 63% support, legalizing the use of medical marijuana and establishing a state-regulated distribution network. Massachusetts was the 18th state to legalize the medical use of marijuana. A decision will have to be made regarding the specifics of Question 3 going into effect by May 1.

Michigan[edit]

On December 10, 2013, The Michigan voters introduced SENATE BILL 660 to amend the Public Health Code to specify that marijuana, including pharmaceutical-grade cannabis, would be a schedule II controlled substance if manufactured, obtained, dispensed, or grown in compliance with the Public Health Code.[73]

On November 4, 2008, Michigan voters passed the Michigan Medical Marijuana Initiative, also known as Proposal 1, a measure allowing the use of medicinal cannabis for patients with debilitating medical conditions (including cancer, multiple sclerosis and HIV). State-wide the measure passed with 63% voting yes. The measure was approved by voters in every one of Michigan's 83 counties. The measure also required Michigan's health department to create a registry of qualified patients. Growing cannabis was also approved, for registered individuals using secure facilities.[74] The mandate also introduced a medical necessity defense clause for persons without a card or who use cannabis to treat ailments not covered by the law. Despite the law calling for cards to be issued within 20 days, the typical wait is 6 months.

Minnesota[edit]

On May 29, 2014 Governor Dayton signed into law a bill establishing a medical marijuana program in Minnesota.[75] Minnesota was one of the first states in the union to decriminalize marijuana in the 1970s.

Montana[edit]

On November 2, 2004, voters of Montana passed Initiative 148, which took effect immediately. The vote was 62% yes to 38% no.[49] It eliminated criminal sanctions for medical cannabis authorized by a patient's physician.[49] Possession of as many as six cannabis plants is allowed.[49]

New Hampshire[edit]

On July 25, 2013, Gov. Maggie Hassan signed HB 573, making New Hampshire the 19th state to allow medicinal cannabis to certain qualified patients.[76]

Nevada[edit]

On November 7, 2000 voters in Nevada passed Question 9, amending the state constitution to sanction medical cannabis. The vote was 65% yes to 35% no.[49] The law provides that patients may possess a maximum of 1 ounce (28 g) of usable cannabis and grow a maximum of 7 cannabis plants.[49]

New Jersey[edit]

On January 11, 2010, the New Jersey legislature approved a measure legalizing medical cannabis for patients with severe chronic illnesses, the New Jersey Compassionate Use Medical Marijuana Act.[77] Governor Corzine signed the bill into law on January 18.[78]

New Mexico[edit]

On April 2, 2007, New Mexico Governor Bill Richardson signed into the law Senate Bill 523, which legalizes the use of medical cannabis by patients authorized by the state.[49]

New York[edit]

On June 3, 2013, the NY State Assembly passed a bill that would legalize medical marijuana with 99 Assembly members voting Yes and 41 Voting No. It was delivered to the Senate and was voted down. On January 4, 2014 Governor Cuomo announced an upcoming initiative to enact medical marijuana laws by executive order.[79] On June 20, 2014, the Legislature passed a bill allowing non-smokable medical marijuana. [80] On July 5, 2014 Governor Cuomo signed New York's medical marijuana bill into law with a ceremonial signature taking place the following Monday in New York City. [81]

Oregon[edit]

Main article: Cannabis in Oregon

The Oregon medical cannabis program has the name, "The Oregon Medical Marijuana Program," which administers the Medical Marijuana Act approved there by the public in November 1998 through Oregon Ballot Measure 67 (1998). The vote was 55% yes to 45% no.[82] The Oregon Medical Marijuana Program administers the program within the Oregon Department of Human Services. Virtually all patients benefiting from the program suffer from severe pain and almost 2500 from nausea. The other conditions are given as epilepsy, AIDS / HIV, cancer, cachexia, chronic glaucoma and tremors caused by Alzheimer's disease.[83] As of January 1, 2012, there were 57,386 registered patients with medical cannabis cards.[84]

Rhode Island[edit]

On January 3, 2006, The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act (Rhode Island) became law and simultaneously went into effect.[49] It legalizes medical cannabis, provided that certain conditions are met. Patients can possess a maximum of 2.5 ounces of cannabis and a maximum of 12 cannabis plants.[49]

On June 16, 2009, the Rhode Island legislature overrode a gubernatorial veto of a bill authorizing up to three medical cannabis dispensaries in the state. The House voted 68-0 for the cannabis measure and the senate followed minutes later by a 35-3 count. The new law will make Rhode Island the third state, following New Mexico and California, to allow the sale of medical cannabis. Under the new law, one dispensary will be authorized to open in 2010, to be followed by two more in 2011.[85]

In 2011 RI Governor Chafee announced that he was putting a hold on the licenses that were to be issued to the 3 Compassion Centers and as of December 2011 there are still no operating dispensaries in Rhode Island.[86]

On April 19, 2013 Rhode Island's first medical marijuana dispensary, The Thomas C. Slater Compassion Center in Providence, opened.

Texas[edit]

Texas introduced House Bill 594 on January 18, 2013, allowing individuals with serious illnesses to demonstrate to a judge that their use was for medical reasons, an "affirmative defense". There are no specific amounts specified in the Bill; as of April 24, 2014, it has been in committee for nearly a year.[87][88][89]

Vermont[edit]

In Vermont, Senate Bill 76 went into effect July 1, 2004, legalizing medical cannabis, provided certain conditions are met.[49] Patients or their primary doctor are allowed to possess a maximum of 2 ounces of usable cannabis and a maximum of 3 cannabis plants, a maximum of which one can be mature.[49]

Amendments[edit]

Vermont Senate Bill 7 went into effect July 1, 2007 further defining which patients qualify for medical cannabis and how much they may possess without penalty of law at the state level.[49] The amendment allows physicians licensed outside of Vermont to recommend medical cannabis for Vermont patients.[49]

Washington[edit]

The State of Washington adopted a law in November 1998 (Initiative 692), legalizing the use, possession, and cultivation of cannabis for patients with a medical certificate. The vote was 59% yes to 41% no. The legislature amended the statute in 2007 and 2010. After June 10, 2010, the medical documentation may be issued by a physician, physician's assistant, naturopath, or advanced registered nurse practitioner; it must be on tamper-resistant paper and accompanied by photo ID. The following conditions are eligible: cachexia, cancer, HIV or AIDS, epilepsy or other seizure disorders, glaucoma unrelieved by standard drugs or treatments, chronic pain otherwise intractable, Crohn's disease with intractable symptoms, Hepatitis C with intractable nausea or pain, and multiple sclerosis. According to the law in Washington,[90] a qualified patient and the patient's designated provider may together possess not more than a 60-day supply; it is presumed in regulation that this will be not more than 24 ounces of usable marijuana and not more than 15 marijuana plants.[91]

In November 2012 WA voters passed Initiative 502 which legalized cannabis for recreational use.[92] The initiative passed 55 to 45 percent and allows citizens over the age of 21 to possess up to an ounce of marijuana. It provides a new "drugged driving" law with guidelines for THC levels that are illegal, akin to blood alcohol levels.

The first-ever legal farmer's market for the drug was opened in Tacoma in 2010. The Cannabis Farmer's Market has since received worldwide coverage for its operation.[93][94][95][96]

Washington DC[edit]

A bill by the Washington DC council was not overruled by Congress. Medical cannabis became legal on Jan. 1, 2011.[97] Dispensaries have begun opening [98] and cultivation centers are in process to be permitted.[99] The DC council has also reduced penalties for possession of 1 oz. of marijuana to a $25 civil fine without jail.[100] This bill was signed by the Mayor and took effect in July 2014.[101]

Wisconsin[edit]

The Wisconsin legislature legalized Marijuana oil for seizure conditions in children.[102]

Opposition and support[edit]

Notable pro-medical cannabis individuals[edit]

Pro-cannabis demonstrators in Los Angeles (August 2007)

Supporters of legalizing cannabis for medical use range from actors and musicians to politicians, writers, and scientists. Major activists include Steve Kubby, Ethan Nadelmann, Dennis Peron, Angel Raich, John Morgan, Robert Randall,[103] Keith Stroup, and Marc Emery.

Politicians from multiple parties support medicinal cannabis use[104] Democratic members and former members of Congress Barney Frank, Dennis Kucinich, Steve Cohen, and Sam Farr, Republican Congress members Ron Paul[105] and Dana Rohrabacher, Republican State Senator Bill Mescher, and Libertarian Loretta Nall.

Researchers and scientist advocates include Jay Cavanaugh, Lyle Craker, Milton Friedman, Stephen Jay Gould, Lester Grinspoon, Bob Melamede,[106] and Carl Sagan.

Writers, such as William F. Buckley, Fred Gardner, Christopher Hitchens,[107] Jack Herer, Peter McWilliams, Salman Rushdie, Ann Druyan, Ed Rosenthal, Rick Steves, Samuel Thompson, and Robert Anton Wilson also support the legalization of medical cannabis.

Musician Melissa Etheridge supports medical cannabis. On September 25, 2009, on the HBO show Real Time with Bill Maher, former governor of New York Elliot Spitzer expressed support for the legalization of medical cannabis.

The 2007 documentary film Waiting to Inhale, by award-winning filmmaker Jed Riffe, examines the debate over medical cannabis and has been screened in states during medical cannabis campaigns.[108]

In 2011 the Marijuana Policy Project called on the government to allow the FDA-approved study of veterans. The California Medical Association called for legalization of marijuana on October 15, 2011, stating to the Los Angeles Times that the question of whether marijuana is a medicine "can only be answered once it is legalized and more research is done".[109]

Notable anti-medical cannabis individuals[edit]

Politicians that oppose the medicinal use of cannabis include former Drug Czars Andrea Barthwell, William Bennett,[citation needed] Barry McCaffrey,[110] and John P. Walters, former U.S. Presidents George H. W. Bush and George W. Bush[citation needed], Theodore Sophocleus,[111] Mark Souder, and former governors Mike Huckabee[112] and Mitt Romney.[113]

Former Attorneys General Michael Mukasey, Janet Reno, and Dan Lungren also prefer cannabis to be illegal, as well as former U.S. Prosecutors Bonnie Dumanis,[114] Carol Lam, and Asa Hutchinson,[citation needed] former Solicitor General Paul Clement, International Narcotics Control Board president Hamid Ghodse, Republican Senior Senator John McCain,[115] and former U.S. Secretary of Health and Human Services Donna Shalala. Conservative talk show hosts, such as Rush Limbaugh and Hal Lindsey, also oppose the use of medical cannabis.

See also[edit]

References[edit]

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  2. ^ http://medicalmarijuana.procon.org/view.resource.php?resourceID=002481
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  4. ^ http://www.justice.gov/opa/pr/attorney-general-announces-formal-medical-marijuana-guidelines
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  13. ^ "In The Matter Of Marihuana Rescheduling Petition, Docket No. 86-22, Opinion and Recommended Ruling, Findings of Fact, Conclusions of Law and Decision of Administrative Law Judge Francis L. Young". United States Department of Justice, Drug Enforcement Administration. Carl E. Olsen. 1998-09-06. 
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