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HomeMy WebLinkAbout10/19/2004, BUS 2 - DISCUSSION OF LOCAL REGULATION OF MEDICAL MARIJUANA DISPENSARIES council M�D=I j ac,Enaa REpont CITY OF SAN LUIS OByI.—SPO FROM: Jonathan P. Lowell, City Attorney 4" Deborah Linden, Chief of Police SUBJECT: DISCUSSION OF LOCAL REGULATION OF MEDICAL MARIJUANA DISPENSARIES CAO RECOMMENDATION That Council: 1. Receive and consider the information contained in this report; and 2. Provide direction to staff regarding how to proceed. REPORT-IN-BRIEF Staff was directed to bring to Council information regarding medical marijuana dispensaries. This report advises of the legal status of medical marijuana dispensaries under state and federal law. It tells of experiences of other California cities in addressing this issue. It sets forth 4 options for Council consideration: imposing a temporary moratorium pending a ruling by the U.S. Supreme Court, banning medical marijuana dispensaries, taking no action, and allowing medical marijuana dispensaries. DISCUSSION Background At the May 18, 2004 meeting of the City Council, during the communications portion of the agenda, Council Member Mulholland requested Council consider the issue of allowing medical marijuana dispensaries in the City of San Luis Obispo. Council directed staff to return at a meeting in September or October to present information regarding this matter. Council Member Mulholland and City Attorney Lowell have both been contacted by an attorney representing a client who wants to open a medical marijuana dispensary in San Luis Obispo, and attached is information provided by this attorney to Council Member Mulholland. In addition, copies of ordinances from several cities were shared with the City and these documents are available for review in the Council Reading File. Another group has independently inquired of the City Attorney about opening a medical marijuana dispensary in the City. This report provides general information regarding the issues involved with medical marijuana dispensaries, including the experience of other jurisdictions that have dispensaries in their cities. This report also outlines four options for Council to consider in providing further direction to staff. o�� 1 I / f Discussion of Local Regulation of Medical Marijuana Dispensaries Page 2 The city of Davis conducted extensive research regarding the issues involved with marijuana dispensaries, including what actions other cities have taken, and the impacts of the dispensaries on cities that have them. The Davis City Council has enacted and extended a moratorium prohibiting dispensaries while staff drafts appropriate guidelines for Council consideration. The most recent city of Davis staff report is attached for Council reference. Summary of the California Law In November 1996 California voters passed the Compassionate Use Act of 1996 (Act) which protects patients, their primary caregivers (defined as an individual designated by the patient who has consistently assumed responsibility for the housing, health, or safety of the patient), and physicians who prescribe marijuana for medical treatment from criminal prosecution or sanction. In 2003 the state legislature adopted S.B. 420 to "clarify the scope and application of the Act and facilitate the prompt identification of qualified patients and their designated primary caregivers in order to avoid unnecessary arrest and prosecution of these individuals and provide needed guidance to law enforcement officers." Pursuant to this legislation, use of an identification card contemplated by S.B. 420 is voluntary; a patient need not possess an identification card to claim the protections of S.B. 420. Neither the Act nor S.B. 420 specifically addresses medical marijuana dispensaries, however, the findings made by the legislature when approving S.B. 420 included a statement that the legislation is intended to "enhance the access of patients and caregivers to medical marijuana through collective, cooperative cultivation projects." It is asserted by those seeking to operate medical marijuana dispensaries that this language authorizes such facilities: S.B. 420 directs the state Department of Health Services to establish and maintain a voluntary program for the issuance of identification cards to qualified patients who satisfy the requirements set forth in the statute and voluntarily apply to the identification card program. County health departments are directed to administer the programs locally. The Department of Health Services has not yet established such a program. Similarly, the County of San Luis Obispo has not done so. S.B. 420 sets forth the amount of dried marijuana a patient or caregiver may possess, and also provides limits on the number of immature and mature live plants that may be maintained. The statute provides that the state Attorney General may recommend modifications to these limits and such suggested revisions shall be made to the legislature no later than December 1, 2005. Another provision of the statute directs the Attorney General to promulgate guidelines to ensure the security and non-diversion of marijuana grown for medical use under the Act. There is no deadline for this requirement. S.B. 420 does not require any accommodation of any medical use of marijuana in any place of employment. It provides that nothing in the statute shall authorize smoking of marijuana: where smoking is prohibited by law; within 1,000 feet of a school, recreation center or youth center; on a school bus; while in a motor vehicle that is being operated; or while operating a boat. Discussion of Local Regulation of Medical Marijuana Dispensaries Page 3_ Pending United States Supreme Court Case Federal law prohibits the possession, cultivation, and dispensing of marijuana, regardless of its purpose. There exists a conflict between California and federal law regarding medical marijuana, and for this reason some cities in California have banned medical marijuana dispensaries, or have adopted moratoria prohibiting them until the law is settled. Currently pending before the United States Supreme Court is a case that stems from California, Ashcroft v. Raich, that should decide whether the federal Controlled Substances Act exceeds California's power under the Commerce Clause as applied to the intrastate cultivation and possession of marijuana for purported personal "medicinal" use or to the distribution of marijuana without charge for such use (language excerpted from U.S. Supreme Court docket.) In other words, the Court will decide whether or not federal law takes precedence over state laws regarding medical marijuana, and whether or not medical marijuana users and distributors in California are violating federal law. Should the Supreme Court rule that the state medical marijuana laws violate federal law, then California's medical marijuana laws would likely be ruled invalid and much of this discussion would become moot. On the other hand, should the Supreme Court rule that the state laws on this subject are not in conflict with federal law, then this concern would be alleviated and California and other jurisdictions could address the issues from a policy standpoint without fear of violating federal law or sanctioning others to do so. Either way, the Supreme Court is poised to provide key direction to California cities and counties regarding this issue. However; a decision may not be rendered by the U.S. Supreme Court until June 2005. Issues to Consider The concept of medical marijuana dispensaries in the City raises several issues to consider: 1. Unsettled Legal Questions and Loose Ends. As mentioned above, the U.S. Supreme Court is currently dealing with the "big picture" legal issue regarding the conflict between federal and state law. In addition, there are other legal issues staff is waiting for the State to act upon: A. The law provides for the creation of a statewide identification card system for qualified patients and primary caregivers. This task has been assigned to the State Department of Health Services, which will be implementing the ID card program through local County Health Departments. The ID card program will provide a consistent and verifiable mechanism for determining who has a legal recommendation from a physician to use marijuana or to act as a caregiver for another patient. The State Department of Health Services has not implemented the ID card program yet. Without it, it is extremely difficult for law enforcement officers to distinguish between individuals who possess legitimate recommendations from those who do not. This would be especially problematic when dealing with a dispensary distributing marijuana to multiple individuals. Some counties (e.g. Santa Barbara, Santa Cruz) and cities (e.g. Oakland) have ��2 Discussion of Local Regulation of Medical Marijuana Dispensaries Page 4 established identification card programs on their own relying upon the language of S.B. 420. Implementation of such a program in a city of our size would be a sizeable administrative undertaking, and is strongly discouraged. B. The new state law requires the state Attorney General to develop and adopt appropriate guidelines to ensure the security and non-diversion of marijuana grown for medical use by qualified patients. These guidelines will be important to ensure that marijuana grown for medical use is not sold or provided to individuals who do not have valid physician recommendations. This has been a problem in cities that host marijuana dispensaries, The Attorney General has not yet produced these guidelines. 2. Zoning. The City's zoning regulations currently do not address medical marijuana dispensaries as a potential use. There has been no discussion or consideration by the Planning Commission, the Council or the public regarding where in the City such type of an establishment would be permitted, or the compatibility of such establishments with other uses. Zoning issues to be considered include where such uses are appropriate, with what other uses are they compatible/incompatible, whether they should be allowed by right in certain zones or as conditional uses.. 3. Regulation. The City currently does not have an ordinance regulating medical marijuana dispensaries in such areas as hours of operation, on site activities (i.e. prohibiting alcohol sales), employee registration and background checks, security plans, etc. Based on the experience of other cities, it would be important to regulate dispensaries so that the City has the ability to revoke a use permit or have some other mechanism to ensure compliance should the establishment violate conditions or become a public nuisance. Such regulation could include the imposition of reasonable fees to recoup the City's costs. 4. Increased Crime. The city of Davis conducted research of other cities that have marijuana dispensaries in their jurisdictions. This research indicated that these cities all have experienced an increase in crime associated with the dispensaries, ranging from the resale of medical marijuana to individuals who do not have physician recommendations to violent, take-over robberies of the dispensaries themselves. Especially of concern is the fact that crime is not being consistently reported by dispensaries and users themselves because they do not want to jeopardize the status of the dispensaries. The Davis staff report (copy attached) outlines these crime problems in more detail. Based on the experience of these other cities, staff is very concerned about the potential for increased crime and violence in San Luis Obispo should Council allow marijuana dispensaries to operate here. 5. Use by Non-SLO Residents.. Currently, there are no authorized marijuana dispensaries in San Luis Obispo County. Should the City of San Luis Obispo allow dispensaries, it is likely that individuals from many other areas outside the City will come to San Luis Obispo to obtain marijuana. This has been the experience of other cities that currently 9, Discussion of Local Regulation of Medical Marijuana Dispensaries Page 5 have dispensaries. This creates concern for staff since some of these individuals would likely contribute to the increase in crime and problems associated with dispensaries, including driving while under the influence of marijuana violations. Options Ultimately, it is a policy decision for Council whether or not to allow medical marijuana dispensaries to operate in the City. In an effort to assist Council in providing further direction to staff regarding this complex issue, staff has prepared the following options for Council to consider: Option 1 — Temporary Moratorium Pending Legal Ruling. The case pending in the U.S. Supreme Court is likely to clear up, one way or another, the primary concern regarding whether or not medical marijuana dispensaries violate federal law. However the Supreme Court rules, its decision will allow staff and the City Attorney to better advise Council on the legalities of any proposed policy action. Until this legal issue is settled, staff's opinion is that medical marijuana dispensaries in the City of San Luis Obispo are in violation of federal law. Council could advise staff to return with an ordinance imposing a temporary moratorium prohibiting medical marijuana dispensaries pending the outcome of this case, and to return to Council with further information and recommendations once the Supreme Court ruling is made public. A moratorium would ensure that dispensaries would not suddenly open in the City without a means to regulate them and ensure conformity with zoning and compatibility with neighboring uses. Such a moratorium would also be appropriate while staff prepares a detailed regulatory scheme and zoning criteria for medical marijuana dispensaries in the City, if directed to do so by the Council. The moratorium imposed by the city of Davis included a conditional use permit mechanism to deal with dispensaries seeking to open before that city adopts regulations governing dispensaries. If the City Council directs staff to return with a regulatory scheme, a moratorium like that used in Davis would be appropriate pending adoption of the new regulations. If the Council is not inclined to allow dispensaries or prefers to wait for clarification by the U.S. Supreme Court, then a moratorium without a conditional use permit mechanism would be appropriate. Pursuant to the San Luis Obispo Charter, such a moratorium would be an emergency measure for preserving the public peace, health or safety. It would be required to contain a statement of the reasons for its urgency, and may be introduced and adopted at once at the same meeting if passed by at least 4 affirmative votes. Option 2 — Ban Medical Marijuana Dispensaries in the City. Several cities have banned dispensaries in their jurisdictions based on the federal law violation and/or incompatibility with zoning regulations. Other cities are in the process of banning dispensaries. A list of these cities is included in the Davis report. This is a policy decision for Council. Discussion of Local Regulation of Medical Marijuana Dispensaries Page 6 Option 3 — Do Nothing. Council could choose to take no further action at this point, and to direct staff to take no further action. This option raises concern since the current City zoning regulations and municipal code do not address the location or regulation of dispensaries, and doing nothing provides the opportunity for individuals or groups to open dispensaries without regard to the compatibility with other land uses, and without appropriate regulation. Once a dispensary is in place, it is generally grandfathered-in for zoning purposes. Future regulations regarding dispensaries could apply, but a change in zoning would not apply to a dispensary already in continuous operation. Option 4—Allow Dispensaries in the City. Council could vote to allow marijuana dispensaries in the City, and direct staff to prepare an ordinance regulating such establishments and an ordinance amending the zoning map and regulations to provide for such uses. This is a policy decision for Council. Consistencv with Previous Council Action: When Proposition 215 was first being considered, Council by Resolution No. 8195-1993 voted to support it. Council action on any of the options outlined above would still be consistent with Council's general support of medical marijuana for individuals who possess a valid physician's recommendation. Currently, these individuals and/or their primary caregivers are allowed by law to possess and cultivate marijuana in sufficient amounts to provide for their own personal use. The allowance or prohibition of marijuana dispensaries in the City, or the temporary delay via a moratorium in enacting a policy pending the Supreme Court decision, does not change this fact. CONCURRENCES As no specific course of action is being recommended, no concurrences have been sought at this time. Notice of tonight's meeting has been provided to parties that have expressed an interest in this topic. FISCAL IMPACT If directed by Council, staff will return at a future meeting with an item for further consideration and action and an explanation of any fiscal impact will be provided at that time. ALTERNATIVES Staff has provided several options, as set forth above in the body.of the report. ATTACHMENTS 1. City of Davis staff report 2. Information from attorney representing client requesting to operate dispensary I Discussion of Local Regulation of Medical Marijuana Dispensaries Page 7 AVAILABLE FOR REVIEW IN THE COUNCIL OFFICE Proposition 215 S.B. 420 Ordinances from various other cities (provided by attorney representing client requesting to operate dispensary) G:\Agenda-Ordinances-Resol\Medical Marijuana Dispensaries.DOC a - � ATTACHMENT i Staff Report August 27, 2004 TO: City Council FROM: Steven Pierce, Captain SUBJECT: Report on Medical Marijuana Dispensaries Moratorium Recommendation 1. Informational—request Council direct staff how to proceed. 2. Approve attached Ordinance extending the moratorium for an additional 10 months and 15 days, the legal maximum (to 12:00 am,July 31, 2005). Fiscal Impact This report is provided for informational purposes and therefore does not result in any immediate fiscal impact. However, the issues presented in this report may lead to future Council action with potentially minor/major fiscal impact. Background and Analysis The voters of the State of California approved Proposition 215, codified as Health and Safety Code section 11362.5 et seq. and entitled "The Compassionate Use Act of 1996" (the "Compassionate Use Act"). The purpose of this Act was to allow patients suffering from a number of serious illnesses an opportunity to find relief through the use of doctor recommended marijuana. Additionally, in January 2004 the State enacted SB 420 to clarify the scope of the Compassionate Use Act and allows cities to adopt and enforce rules and regulations consistent with SB 420. This includes controlling sites where medical marijuana is dispensed to primary caregivers and patients. Other provisions of SB 420 include: • Recognizes the right of patients and caregivers to associate collectively or cooperatively to cultivate medical marijuana. • Requires the State Department of Health, working with county health departments, to set up a voluntary statewide identification program to protect qualified patients and their primary caregiver from arrest and prosecution of certain marijuana related crimes. • Disallows marijuana smoking in no smoking zones, within 1000 feet of a school or youth center except in private residences, on school buses, in a motor vehicle that is being operated, or while operating a boat.. �� - ' ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 2 • Protects patients and caregivers from arrest for transportation and other miscellaneous charges not covered in 215. • Allows probationers, parolees, and prisoners to apply for permission to use medical marijuana; however, such permission may be refused at the discretion of the authorities. • Makes it a crime to fraudulently provide misinformation to obtain a card, to steal or misuse the card of another, to counterfeit a card, or to breach the confidentiality of patient records in the card program. On August 2, 2004, City Council approved a moratorium on medical marijuana dispensaries in the City of Davis. The moratorium allowed staff and Council an opportunity to research and review the options and impacts of allowing a dispensary somewhere within the city limits. This report represents that research. There are three possible approaches to this issue: 1) do nothing, 2) ban them outright, or 3) allow dispensaries, but develop a variety of regulations controlling them. Option#1 - Do nothing The existing City zoning regulations do not provide for the location and/or regulation of medical marijuana dispensaries and such uses might be permissible in any zone that allows retail uses, drug stores, or medical uses. Since there are no current regulations specifically dealing with medical marijuana dispensaries, if medical marijuana dispensaries were allowed to be established without appropriate regulation, such uses might be established in areas that would conflict with the requirements of the General Plan, be inconsistent with surrounding uses, or be detrimental to the public health, safety and welfare; and if such uses were allowed to proceed as allowed under the current zoning, such uses could conflict with, and defeat the purpose of, the proposal to study and adopt new regulations regarding medical marijuana dispensaries. Option-#2- Banning There is still an ongoing legal controversy between those states which permit medical use of marijuana and the federal government, as a result of the federal law which still prohibits the use and/or possession of marijuana for any purpose. It is the position of, for example, the Rocklin City Attorney that a city can prohibit the operation of such an enterprise for a variety of reasons, not the least of which is that it violates federal laws. Medical marijuana dispensaries violate federal law. For that reason, the City of Rocklin has moved to ban the facilities in the community. If you wish to deny a permit to such enterprises, it is would be easier to defend if ordinances are already in place and justification is articulated. a - ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 3 Option#3 - Regulation The City of Davis could move to regulate dispensaries. For example, the City could, by establishing clear zoning requirements and a new ordinance, regulate location, hours of operation, on site activities (e.g., no alcohol sales), age of people allowed on site, and the registering of employees and background checks on those employees. Additionally, regulating the enterprise gives the City a process by which a facility's permit can be discontinued or modified if it becomes a public nuisance. It also gives the operator a process to appeal the denial or cancellation of a permit. Other Jurisdictions' Experiences Police departments who have had dispensaries in their jurisdiction for some time were polled. The following are the comments received from those agencies: City of Arcata • There are two dispensaries in town that share a building. • The two dispensaries have an ongoing disagreement with each other that has resulted in numerous calls for police services to settle disputes. • The facilities do not have the correct electrical support and continuously blow out the electricity in the area. They have not complied with upgrading their electrical systems or responded to fire department concerns regarding proper exits and signage. • There have been numerous instances where people have purchased marijuana at the dispensary and then resold it at a nearby park. • A doctor has come to the dispensaries and, for a fee, will provide a medicinal marijuana recommendation for just about any complaint the patient makes. City of Roseville: • They currently have one dispensary in town. This dispensary was established prior to their current regulations and was grandfathered in. • Street level dealers are trying to sell to those going to the dispensary at a lower price. • People are smoking marijuana in public around the facility. • People are coming to the community from out of town and out of state to obtain marijuana (Nevada State and San Joaquin County, etc). • Marijuana DUI by people who have obtained marijuana from dispensary. • There has been at least one burglary attempt into the dispensary building. City of Oakland • They had more than 15 in Oakland,now limited to four by ordinance but control is not very strong. The fines are too small to control a lucrative business. • Large criminal element drawn to the dispensary location. ATTACHMENT i Staff Report to City Council August 27, 2004 Page 4 • Marijuana dealers who have a doctor's recommendation are purchasing from the dispensary and then conducting illegal street sales to those who do not have the recommendation. • Street criminals in search of the drugs are robbing medical marijuana use patients of their marijuana as they leave the dispensary. • Thefts and robberies around the location are occurring to support the illegal and legal (by State law) drug commerce. • The Police Chief mentioned that a shoe repair business next door to a dispensary has been severely impacted because of the concentration of criminals associated with the dispensary. The shoe repair business owner is considering shutting down his business. • Most of the crime goes unreported because the users do not want to bring negative publicity to the dispensary. • The dispensaries have an underground culture associated with them. • At least one of the dispensaries had a doctor on the premises giving recommendations on site for a fee. • One location was a combination coffee shop and dispensary and marijuana was sold in baked goods and for smoking. • Dispensary management has told police that they cannot keep the criminal element out. City of Hayward: • Hayward has three dispensaries, two legal under local ordinance and one illegal. • They have had robberies outside the dispensaries. • They have noticed more and more people hanging around the park next to one of the dispensaries and learned that they were users in between purchases. • They have problems with user recommendation cards—not uniform, anyone can get them. • One illegal dispensary sold coffee, marijuana and hashish —DA would prosecute the hashish sales and possession violations after arrests were made. • They have received complaints that other illegal drugs are being sold inside the dispensaries. • The dispensaries are purchasing marijuana from growers that they will not disclose. • The Police Chief believes the dispensaries do not report problems or illicit drug dealers around their establishments because they do not want the police around. • Hayward Police arrested a parolee attempting to sell three pounds of marijuana to one of the dispensaries. • Hayward has recently passed an ordinance that will make marijuana dispensaries illegal under zoning law in 2006. ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 5 Lake County: • Lake County has one marijuana dispensary in Upper Lake. • The biggest problem is the doctor close by the dispensary who is known across the state for being liberal in his recommendations to use marijuana for a fee of $175. • Many "patients" come from hours away and even out of state, Oregon specifically, to get a marijuana recommendation from the doctor. • Upper Lake has been impacted by the type of people coming from the marijuana doctor and dispensary. Citizens report to the Sheriff that the people coming to Upper Lake for marijuana look like drug users ("dopers"). • One quilt shop owner has told the Sheriff that she does not feel safe anymore because of the type of people drawn to the marijuana doctor and the dispensary, which are located close together in a very small town. • They also have a notorious marijuana grower who beat prosecution for cultivation by make a medical claim. Law enforcement has taken a hands-off approach even though he is blatantly violating the law. • The marijuana grower has recently claimed to be a church to avoid paying taxes. City of Fairfax: • Fairfax has one marijuana dispensary. • Fairfax has had some problems with patients selling to non-patients. • They have had problems with purchasers from dispensary congregating at a baseball field to smoke their marijuana. • Fairfax police arrested one person who purchased marijuana at the dispensary and then took it to a nearby park where he tried to give it to a minor for sex. • Very small town and low crime rate. Berkeley • Has four facilities operating in the City currently (last 3-4 years). • There have been several take over robberies of the dispensaries. • There have been arrests where legitimate purchasers have resold marijuana on the street to well individuals. • Obvious young people entering and purchasing marijuana from the dispensary. • Recommended that if we did not currently have the dispensaries, we should not allow them. • Police department has been given explicit instructions by their City Council not to take any kind of enforcement action against the dispensaries or people going in or out of the facility. • Facilities will accept any Health Department cards, even those obviously forged or faked. Below is a list of other California cities that do not have dispensaries and what they have or have not done on the issue. ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 6 MEDICAL MARIJUANA City Approach Action Follow-up/Details Have a marijuana Town researched and found Chico dispensary that is trying no legal precedent for such to establish itself operation and plans to shut down establishment Chowchilla Have not been approached Have not been Will probably adopt an Clovis approached ordinance banning facilities similar to Rocklin's Have not had any formal As a result of the phone Dixon application, but did have calls,Town adopted an telephone inquiries emergency ordinance similar to Roseville Two groups (who were Town had no formal Chief plans to push a total ban EI Cerrito kicked out by Oakland) guidelines in book, so they with Council; does realize he requested info about passed a 45-day has to be open for required process of opening clinics emergency ordinance study to take place A Grow& Distribution After approach, PD City decided to use Gridley department contacted cities Placerville's ordinance as a Center approached city about possible ordinances model Jackson Was approached about Has an ordinance regulating clinics clubs Los Gatos Telephone inquiries Surveying cities to discuss issue with Council Actually had an emergency Plan to prevent Palo Alto Received 2 calls ordinance adopted a few establishments through zoning years ago ordinances Have not been Plan to implement an Paso Robles approached ordinance to prevent establishment of clinics Have not been No immediate plans to do Oroville approached anything on the issue. Will wait until inquiries are made. Received 4 inquiries and Application was denied due Town's ordinance has been in Placerville one formal application for to zoning and security place since June 22,2004 a clinic issues. x ' 13 ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 7 Redding Have not had any City is considering taking inquiries some preventative actions Rocklin Was approached about Enacted urgency ordinance clinics July of 2004 banning clubs Sacramento Several inquiries, but no City Attorney is reviewing the effort to actually open one law to advise the City Have not been Considering taking some San Luis Obispo action, but no idea what that approached will be Had one application in Denied application based West Sacramento last month on federal law violation, no ordinance enacted In response,city enacted an Was approached by emergency ordinance Woodland parties during the same setting zoning and CUP time as other cities regulations for any possible club In summary, the experiences of other cities that already have dispensaries are bad. Dispensaries have experienced robberies themselves; legitimate patients have been robbed of their marijuana as they leave the facility; people purchasing marijuana at the dispensaries have been caught reselling the marijuana nearby; street level dealers have begun selling marijuana and other drugs nearby in an effort to undersell the dispensary; some dispensaries have doctors present in their facility who will recommend marijuana as a course of treatment for just about any patient complaint; and many dispensaries do not take serious steps to ensure they are selling only to legitimate patients or their caregivers. When asked, many of the police departments that already have facilities in their cities said that if Davis did not already have a dispensary, we should take steps to prohibit one from opening in the city. Y010 District Attorney's Opinion The District Attorney for Yolo County feels dispensaries violate federal law. He is unwilling to enter into any discussion about regulating dispensaries. As they are illegal, discussions about regulation give the impression that the DA's office endorses violating federal law. Yolo County Health Department SB420 requires the State of California Department of Health to work with the counties to develop a statewide voluntary identification system for patients and their caregivers. According to the Yolo County Health Department, the State has not made contact with the counties to resolve this issue. Yolo County is waiting for the State. They have no plans on creating their own identification system as some counties have already done. ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 8 Patients' Rights Groups Two patients' rights advocacy groups were contacted in developing this staff report: Americans for Safe Access and Compassionate Friends. Both groups applaud the City's consideration of this issue. They feel that marijuana provides a unique relief that other medications cannot. They are supportive of providing reasonable regulations on the business and the owners/employees. Representatives stated that patients who receive recommendations from physicians to use marijuana to relieve pain and suffering fall into two categories. There are those who will be unable or unwilling to purchase marijuana because there is no dispensary near them to purchase it legally. And, there are those who will take other measures to get marijuana despite the lack of a readily available dispensary. Those who will seek out marijuana without a legal dispensary nearby have several choices. First, the patient or their caregivers will drive long distances to a legal dispensary. This can be problematic since the patient may be suffering in a way that may prohibit driving long distances. Second, they may attempt to purchase marijuana from level dealers. With this decision comes the danger inherent with any street purchase, specifically, physical danger from the dealer or his/her cohorts and not knowing the quality of the product purchased. Finally, the patient/caregiver may attempt to grow the marijuana themselves. Again, the patient may not be well enough to grow their own. Also, there are inherent fire dangers with some of the grow lights. Furthermore,many renters run into disputes with their landlords when they grow medicinal marijuana in a rented house/apartment. For these reasons patients' rights advocates feel it is important to have a safe, credible and legal dispensary-nearby for patients and their caregivers. When asked if a patients' rights group would be willing to open and operate a dispensary, both groups said they knew their group would not be willing to and they doubted any legitimate advocacy agencies would. As long as the federal government is willing to prosecute dispensary owners, patients' rights groups would not run a dispensary. They feel that if they are in prison they would be unable to do their primary function, advocate for the sick. Moratorium Extension On August 2, 2004, City Council approved a moratorium on medical marijuana dispensaries in the City of Davis. The moratorium allowed staff and Council an opportunity to research and review the options and impacts of allowing a dispensary somewhere within the city limits. Staff has outlined various options for Council's consideration. The current moratorium is due to expire on September 17, 2004. That timeline does not leave Council sufficient time to take any action on this item. Therefore, staff is recommending an extension of the moratorium for the maximum ten-months 15-day extension as permitted under Section 65858(a) of State Planning and Zoning Law. Any extension would require a 4/5 ATTACHMENT 1 Staff Report to City Council August 27, 2004 Page 9 vote of the City Council. (to 12:00 am, October 30, 2004). See the attachment for Ordinance language. At1ACH ENT 2 Proposed Resolution Subject: Resolution re: Safe and Lawful Access to Medical Cannabis for Qualified Patients and Primary Caregivers in San Luis Obispo INTRODUCTION On November 5, 1996, the voters of the State of California adopted by initiative the Compassionate Use Act of 1996, codified as Health and Safety Code§11362.5, pertaining to the medical use of cannabis. The City of San Luis Obispo has a documented history supportive of medical cannabis and recognizes the local medical cannabis patient needs that have been sanctioned by the California voters, the legislature and the California Supreme Court. The purpose of this resolution is to address the issue of local qualified patients' lawful,cultivation,possession, and distribution of medical cannabis under the authority of the Health and Safety Code by creating reasonable guidelines upon which qualified patients, primary caregivers, citizens and law enforcement can rely, and to ensure that local law enforcement continues to acknowledge and respect the rights of qualified patients and primary caregivers who grow,use, obtain,distribute and supply medical cannabis and to ensure that local law enforcement resources are not utilized in the investigation, arrest,seizure or other action against legitimate qualified patients, primary caregivers and lawfully operating and authorized medical cannabis facilities within the City of San Luis Obispo. TEXT OF PROPOSED RESOLUTION 1. The Council recommends that an ordinance be adopted setting forth reasonable guidelines for the safe and lawful cultivation,possession and obtaining of medical cannabis by qualified patients and primary caregivers, and allowing, authorizing and regulating the establishment and operation of City authorized medical cannabis provider associations within the City limits which sets forth qualifications,regulations and limitations, including location,payment of license fees, and other regulations to be established by the City. 2. The City Council directs the San Luis Obispo Police Department to continue its current policy to actin accordance with Health and Safety Code§11362.5 in allowing the lawful possession,use, and cultivation of medical cannabis and to not cooperate with the U.S. Drug Enforcement Agency investigations or actions against lawfully operating and authorized qualified patients, primary caregivers and medical cannabis provider associations operating within San Luis Obispo. �1\ ATTACHMENT 2 ORDINANCE AUTHORIZING SAFE AND LAWFUL ACCESS TO MEDICAL CANNABIS IN SAN LUIS OBISPO CHAPTER 1. MEDICAL CANNABIS. SECTION 1. FINDINGS AND PURPOSES. On November 5, 1996,the voters of the State of California adopted by initiative the Compassionate Use Act of 1996 codified as Health and Safety Code§11362.5 pertaining to the medical use of cannabis. The City of San Luis Obispo supports the lawful use of medical cannabis in accordance with Health and Safety Code§11362.5. The purpose of this Chapter is to facilitate medical cannabis patients' lawful production and obtaining of medical cannabis under the authority of Health and Safety Code §11362.5 and to recognize and protect the rights of qualified patients, their primary caregivers,and physicians, as well as to ensure access to safe and affordable medical cannabis. In support of this purpose, the City of San Luis Obispo recognizes that qualified patients,primary caregivers, and medical cannabis provider associations as defined herein may provide educational information concerning access to safe, affordable and lawful medical cannabis and may also obtain and provide safe and affordable medical cannabis in a consistent, reliable and legal fashion. The implementation of this Ordinance is consistent with, and does not conflict with, the goals set forth in Health and Safety Code§11362.7,which mandates that the Counties of this State establish a voluntary identification card system. The voluntary identification card system set forth in Health and Safety Code §11362.7 has not been implemented by the State. If and when the State mandated voluntary identification card system is implemented, its implementation shall not modify, affect or nullify any of the provisions of this Ordinance. SECTION 2. DEFINITIONS. "Medical cannabis provider association"means a cooperative, affiliation, association, or collective of persons who are qualified patients or primary caregivers,the main purpose of which are to provide education,referral, or network services, and to facilitate or assist in the lawful production,acquisition, and distribution of medical cannabis. An entity may function as a medical cannabis provider association only if designated as such by the City of San Luis Obispo pursuant to Section 3 of this Chapter. "Qualified patient"means a person who obtains a written or oral recommendation from a physician for the use of medical cannabis. '01 ATTACHMENT 2 "Primary caregiver"means a person who is designated by a qualified patient to assume responsibility for the housing,health, or safety of the qualified patient, including the lawful cultivation, acquisition, and delivery of medical cannabis. SECTION 3. MEDICAL CANNABIS PROVIDER PROGRAM. The City of San Luis Obispo establishes a medical cannabis provider program through the authorization and regulation of medical cannabis provider associations. A medical cannabis provider association pursuant to this Chapter means a cooperative, affiliation, association or collective of persons who are qualified patients or primary caregivers,the main purpose of which is to provide education,referral and/or to facilitate or assist in the lawful cultivation, acquisition and obtaining of medical cannabis. An entity may be authorized under this section as a medical cannabis provider association only if designated as such by the City of San Luis Obispo. The City of San Luis Obispo will authorize the establishment and use of medical cannabis provider associations only if the medical cannabis provider association meets the following guidelines upon application to the City of San Luis Obispo: (a) The medical cannabis provider association shall not be located within a quarter mile of any elementary school,middle school or high school. (b) The medical cannabis provider association provides handicapped access to their facility. (c) The medical cannabis provider association will carry and maintain a liability insurance policy with minimum policy limits of$1 million. (d) The medical cannabis provider association will pay an annual license fee to the City of San Luis Obispo in the amount of$5,000.00. (e) The medical cannabis provider association will sign a liability waiver in favor of the City of San Luis Obispo. SECTION 4. QUALIFIED PATIENTS, CAREGIVERS AND.MEDICAL CANNABIS PROVIDER ASSOCIATIONS. In order to ensure that qualified medical cannabis patients and medical cannabis caregivers are not subject to criminal prosecution or sanction and to ensure that only qualified patients and qualified primary caregivers have access to medical cannabis, the medical cannabis provider associations authorized under this Chapter on behalf of the City of San Luis Obispo may issue valid identification cards to qualified patients and qualified primary caregivers upon receipt of a physician's recommendation or approval for medical cannabis. ATTACkMENT 2 SECTION 5. TRANSPORTATION AND DELIVERY OF MEDICAL CANNABIS. All activities entailing the cultivation,possession, transportation and delivery of medical cannabis in accordance with this Chapter shall be lawful when conducted by qualified patients,primary caregivers, and medical cannabis provider associations, where the quantity cultivated,possessed,transported and delivered are reasonably related to the medical needs of qualified patients. SECTION 6. PRIMARY CAREGIVER SERVICES. Qualified patients,primary caregivers, and medical cannabis provider associations authorized by the city of San Luis Obispo under this Chapter may receive or provide consideration or compensation for actual expenses, including reasonable compensation for performing or providing primary caregiver services for qualified patients and shall not, on the sole basis of that fact,be in violation of Health and Safety Code§11359 or§11360. SECTION 7. NO LIABILITY. To the fullest extent permitted by law,the City of San Luis Obispo shall assume no liability whatsoever and expressly does not waive any governmental immunities with respect to the medical cannabis provider program established herein or for the activities of any medical cannabis provider association. Each medical cannabis provider association designated by the City shall (a) indemnify the City of San Luis Obispo; (b) carry liability insurance with minimum policy limits of$1 million; and(c)name the City as an additional insured. ATTACHMENT 2 California N G ` ' _ kepepts National Organization for the Reform of Marivana Laws "Grassroots News from the Golden State" VoL 28#1 -March 2004 9th Circuit Strikes Down Federal Ban on MMJ SAN FRANCISCO,Dec.16th,2003.In a stunning Puling on Feb. 26th. The government's only remaining victory for medical marijuana, the Ninth Circuit Court of recourse to overturn the ruling is to appeal to the Supreme Appeals upheld the right of patients Angel Raich and Diane Court. Monson to possess and cultivate marijuana for their own "This is a huge victory," declared California personal medical use in accordance with Prop 215. NORML coordinator Dale Gieringer, "It essentially makes Raich,who claims medical necessity for marijuana, Prop.215 federal law in California."The decision applies to and Monson, whose Prop 215 garden was raided by the all states in the Ninth Circuit with medical marijuana laws, DEA,had filed for an injunction to protect them from federal including Washington,Oregon,Alaska,Nevada and Hawaii. arrest or prosecution under the Controlled Substances Act. The Raich-Monson decision does not address the They appealed to the Ninth Circuit after U.S.District Court broader question of the federal government's power to block Judge Markin Jenkins denied the injunction. distribution and commerce of medical marijuana within In'.a 2-1 ruling, Justices Harry Pregerson and California. That is the subject of a second,pending appeal Richard Paez held that the federal government lacked power by the Wo/Men's Alliance for Medical Marijuana and the under theVnterstate Commerce Clause of the Constitution Oakland Cannabis Buyers' Cooperative, which distributed to interfere with the plaintiffs' possession and cultivation cannabis to their members. Adecision in the WAMM/OCBC of marijuana for personal medical use. case is expected this spring. The Ninth Circuit denied a request by the.Justice This is thought to be the first case in which the Department for an en banc reconsideration of the three-judge Continued on page Oakland Initiative to Tax & Regulate Cannabis OAKLAND,CA. An initiative calling for the regu- for Dale Gieringer,proponent of the initiative and a mem- lation and taxation of cannabis for adult use in Oakland has ber of the OCLA board. He estimates that a$1 per joint tax been launched by a group known as the Oakland Civil Lib- could raise$1 billion in California. erties Alliance. If approved,the measure would direct the The initiative envisions a system of licensed outlets city to tax and regulate cannabis for adult use as soon as similar to Amsterdam's cannabis cafes, with regulations to possible under state law,and make adult private use of can- keep cannabis away from schools and children,prohibit bill- nabis lowest enforcement priority immediately. board and TV advertising, and bar smoking in streets and The proposed "Oakland Cannabis Regulation and public places. Revenue Ordinance" would not actually legalize cannabis Based on pre-campaign polling,organizers are opti- in Oakland,since that is impossible under current state law. mistic that Oaklanders will approve the measure if it makes However,it would put the city officially on.record as favor- the ballot. In a telephone poll by McGuire Research Services, ing a "tax-and-regulate" scheme. Organizers see it as the over 70% of likely voters expressed support for a "tax and first step in a larger campaign to change state —and ulti- regulate"system when details were explained. In addition, mately federal—law,much like San Francisco's path-break- 75%agreed that adult private cannabis use should be"low- ing medical marijuana initiative,Prop.P. est enforcement priority" for police. By an 8 to 3 margin, OCLA declares that the purpose of its initiative is Oaklanders were more likely to vote for officials who favored to reduce law enforcement costs,eliminate criminal traffick- the tax-and-regulate idea. ers, keep cannabis off the streets and away from children, City Councilwoman Desley Brooks endorsed the and raise much-needed revenue for the city. initiative,saying, "It's unfortunate that people have to go to "In this time of budget crisis,it's crazy to waste tax- the ballot or sue before their elected officials represent them." payers'money criminalizing rather than taxing California's number one cash crop," said California NORML coordina- ontinu on page ATTACHMENT 2 March 2004 California NORML Reports MJ I�ecrim Sill Faces Crucial that California NORML is supporting SB 131 in the hopes at it will lead to further legislation decreasing penalties Vote In State Assemblyfor marijuana offenses. If SB 131 is passed and signed into law by the Governor, it will be a sign that the state is ready to consider more ambitious measures, such as a bill to de- SACRAMENTO. In a crucial vote on marijuana criminalize personal use cultivation. Assemblyman John policy, the State Assembly will be taking up SB 131, Sen. Longville(D-Long Beach)is sponsoring a bill to decriminal- Byron Sher's bill to downgrade possession of one ounce or ize cultivation of six plants or less to a misdemeanor. How- less of marijuana from a misdemeanor to an infraction. ever,no action is likely unless SB 131 passes. The bill would not affect the current penalties for Last year, SB 131 failed the Assembly on a vote of petty possession, but would spare offenders the trouble of a 36-36,five votes short of passage. Supporters are seeking to court appearance and criminal conviction. The purpose,as win over moderate Democrats who failed to support the bill described by its sponsor, the eminently conservative Judge on the first vote,notably: Dario Frommer(LA),Manny Diaz Quentin Kopp, is to save the state's courts the expense of (San Jose), Cindy Montanez(San Fernando),Rebecca Cohn trying petty pot cases. (Saratoga), Sarah Reyes (Fresno), Simon Salinas (Salinas), California NORML estimates that the state currently Nicole Parra(Hanford),Barbara Matthews(Tracy),and Lou spends$156 million per year on marijuana enforcement. The Correa(Santa Ana). overwhelming bulk of the cost is due to marijuana felonies, CONTACT your Assembly member now in support such as cultivation and distribution. of SB 131 through the NORMLwebsite www.canorml.org. 9th Circuit Decision- Continued from page 1 ruling will be appealed to the Supreme Court, medical Controlled Substances Act has been held unconstitutional. marijuana supporters are optimistic of victory.This is because The Ninth Circuit based its decision entirely on the the Ninth Circuit's reasoning was based on recent precedents Commerce Clause,declining to address other issues raised by the Supreme Courts' conservative majority restricting by the plaintiffs,such as states'rights,medical necessity;and federal powers under interstate commerce, in particular the the right of patients to relief from pain and suffering under . Lopez and Morrison decisions. the 5th and 9th amendments. Courts.have so far moved cautiously in implementing Writing for the majority, Judge Harry Pregerson the Raich-Monson decision. Some judges have indicated found that "The intrastate, noncommercial cultivation, skepticism about the ruling pending review by the Supreme Court. The Ninth Circuit denied bail motions by medical possession and use of marijuana for personal medical purposes on the advice of a physician is,in fact,different in marijuana defendant Steve McWilliams and prisoner Bryan kind from drug trafficking." The court further noted that Epis for reconsideration of their punishment in light of the "this limited use is dearly distinct from the broader illicit Raich-Monson ruliing. However,U.S.District Judge Jeremy drug market,as well as any broader commercial market for Fogel has agreed to reconsider a request by WAMM for an medical marijuana,insofar as the medical marijuana at issue injunction similar to that sought by Raich and Monson. in this case is not intended for,nor does it enter,the stream The court's decision may be found on the internet at of commerce." http://raich-v-ashcroft.com. In a dissenting opinion, Justice C. Arlen Beam, visiting from the.8th Circuit, wrote that he could see no r b difference between the marijuana grown by Raich and ! or Monson and the wheat grown by farmer Roscoe Filburn, whose crop was ruled illegal in a famous precedent,Wickard v Filburn (1942). In that case,which concerned a New Deal .1 . statute aimed at controlling the price of wheat;the court ruled that Filburn's crop could be considered within the scope of " l interstate commerce,even though he was growing it for his a` . own private use. -� The Raich-Monson opinion followed two other 1 recent Ninth Circuit precedents,McCoy and Stewart,in which the court struck down federal prosecution of defendants charged with personal use possession of pornography and home manufacture of machine guns, respectively, on the grounds they exceeded federal interstate commerce powers. While it appears certain that the Raich-Monson Legal! Angel Raich and Diane Monson -2- baa fiTTACHMENT 2 California NORML Reports March 2004 Prop 215 Enforcement Abuses Continue Despite New State Law California's new medical marijuana law, SB 420, is will continued to ate medical marijuana patients so long as off to a rocky start amidst continuing complaints of wrong- the state ID cards are lacking. ful arrests, confusion over the guidelines, and delays in implementing the statewide identification system. Local Governments Debate SB 420 Guidelines California NORML continues to hear reports about The enactment of state guidelines for possession and patients who have been arrested despite being within the SB cultivation in SB 420 has inspired some local governments 420 guidelines,which supposedly allow up to 1/2 pound of to re-examine their own policies. Local governments are marijuana and 6 mature or 12 immature plants. - authorized to enact higher,but not lower, limits than those • At the San Diego airport, sheriff's deputies cited in SB 420. Medical marijuana activists argue that the SB 420 patient Ron Brownlow for possessing medical marijuana limits are too low for many patients. As an alternative, which he voluntarily declared at the security check. On a many advocate the Sonoma guidelines,which allow up to 3 previous flight from Sacramento, Homeland Security offi- pounds of marijuana and 99 plants in a 100-square foot area. cials had allowed Brownlow to carry his medicine onto the So far,the predominant impact of SB 420 has been to plane. exert downward pressure on limits. In Ventura County, • In Kern Co.,the CHP cited Sean Despain for pos- which had previously allowed patients to possess up to one sessing a small amount of medical marijuana in a toolbox in pound,the Board of Supervisors voted 4-1 to adopt the new his car trunk during a traffic stop. Despain says the CHP state limit of one-half pound. In Oakland,the City Council told him they were under orders to confiscate all marijuana voted to decrease the limits for caregivers serving multiple regardless of 215. patients in view of SB 420. • In Los Banos, the CHP cited a wheelchair-bound In Humboldt County, the limits became a political patient,Dennis Ainsworth,for less than an ounce of pot while football when the incumbent District Attorney,Paul Gallegos, he was attending to a roadside auto breakdown on I-5. was challenged with a tough recall election backed by cor- SB 420 was originally intended to protect patients porate timber interests and law enforcement, Gallegos,who from arrest provided that they abided by the limits and had came into office supporting the Sonoma guidelines, began a valid state identification card. In practice,the state identi- to backpedal after being attacked for being too soft on pot. fication card system has yet to be implemented. Officials at He referred the limits to the Humboldt Board of Supervi- the Department of Health Services report they don't expect sors,who are evenly split on the issue and have appointed a to have it up and running until the end of the year. task force to study it. (Gallegos handily beat back the recall In actuality,however,the text of SB 420 as currently 61%to 39%). written states that it applies to all "qualified patients," re- In Santa Cruz County,patient advocates are press- gardless of whether they have a state ID. ing the Board of Supervisors to override the SB 420 limits by Confusion Prompts SB 420"Clean-Up"Bill adopting a more liberal version of the Sonoma guidelines, a The author of SB 420, Sen.John Vasconcellos, says allowing 200 square feet and 6 pounds per patient. that this was a last-minute drafting error, and that the task El Dorado Patients Organize Collective force which wrote the bill intended to protect patients from An important new provision in SB 420 recognizes arrest only if they had a state ID card. the right of patients to associate "collectively or coopera- In another drafting error, the current text of SB 420 tively" to cultivate medical marijuana. In a public test of misleadingly implies that it is illegal for patients to exceed this measure, an El Dorado County patients' group an- the limits,even though Prop.215 constitutionally authorizes nounced that it intends to cultivate a collective garden. whatever is necessary for their own personal use. "It is our intention to provide safe access to afford- In order to dear up this confusion. Sen.Vasconcellos able,high quality medicinal cannabis for qualified patients is sponsoring an"SB 420 Clean-Up"bill,SB 1494,in the leg- and caregivers who reside in El Dorado County," stated the islature. SB 1494 would make it dear that patients can pos- group's spokesman,Dr.Philip Denney,in a letter to the Board sess and grow however much marijuana they need for per- of Supervisors. " Our plan is to cultivate medicinal can- sonal medical use, but that they are protected from arrest nabis at a single outdoor site with strict controls to prevent only if they have an ID card and are within the limits. theft or diversion. We do not intend to cultivate or distrib- In the meantime,California NORML is planning to ute cannabis for profit and will be open and transparent in file a complaint with Attorney General Lockyer's office about all our activities." El Dorado County officials have yet to continuing disregard for Prop 215. NORML has evidence respond to the group's plan. that law enforcement officials have enunciated "zero toler- California NORML is continuing to monitor enforce- ance"policies toward medical marijuana in Fresno Co.,Kern ment of SB 420. Patients are encouraged to report complaints Co., Long Beach, and elsewhere. The CHP has indicated it to the Cal NORML hotline:(415)563-5858 - canorml@igc.org -4- ATTACHMENT 2 California NORML Reports March.2004 l exemptions from the city's smoking ordinance were already Oakland to License Medica allowed for tobacconists. A majority of the Council appeared Cannabis Dispensaries ready to drop the ban, but at Quart's insistence the issue was referred to the City Manager for a final decision. The Oakland City Council adopted a path-breaking Despite their strenuous objections to specific ordinance to license and regulate medical cannabis dispen- provisions,medical cannabis proponents put a positive spin saries, making it the fust city to try to legally license what is on the ordinance. "It's very exciting," said Clare Lewis of still considered an illegal substance under federal law. the Oakland Civil Liberties Alliance. "Licensed medical The ordinance, sponsored by council members cannabis dispensaries seem like a small thing,but it's a huge Ignacio De La Fuente and Jean Quart, included controversial" step forward.Right now,they have nothing." provisions that were hotly contested by medical marijuana Under the ordinance,existing clubs will have until advocates, in particular limiting the number of clubs in the the end of March to file for a license,at an application fee of city to four and restricting on-site consumption. $400. The City Manager will award four licenses effective However, patients succeeded in wresting important on June 1st. License fees range from$5,000 for dispensaries concessions from the Council, which agreed to revisit the with fewer than 500 members up to $20,000 for those with regulations in six months to consider further modifications. more than 1,500. The ordinance was passed in response to complaints The ordinance was passed 7 —1. Desley Brooks by a gay youth group, SMAAC, about a growing prolifera- voted"No,"while Nancy Nadel held her nose voting"Yes." tion of near-by dispensaries in the so-called "Oaksterdam" While debating the ordinance, some council mem- district of downtown near the 191'St. BART Station, where bers brought up the issue of full-scale legalization."We can some 8 or 9 facilities are located.SMAAC's complaints were have that debate," suggested council member Danny Wan, eventually addressed by moving it to a new location,and it "I might even agree with you.But let's have that as a sepa- withdrew its support for the ordinance. However, momen- rate debate." CoincidenW*e next day,the Oakland Civil tum for the ordinance was sustained by pressure from Court- Liberties Alliance announced its petition campaign to tax cil members De La Fuente and Quan. and regulate cannabis for adult use,grabbing the front page Medical marijuana supporters turned out in force to of the Oakland Tribune with the catchy headline,"Advocates oppose provisions they regarded as too restrictive,beginning Get Down to Grass Tax." with the limitation on clubs.At first,De La Fuente had pro- posed that all of the clubs be closed except for one. Oppo- OCLA Initiative- Continued from page 1 nents objected that this would unduly limit patients'choices, and that a single'dub would become an easy target for fed- Supporters need to collect 19,948 valid signatures eral intervention. De La Fuente went on to raise the limit to from Oakland voters by June 21st in order to qualify for the four. Opponents objected that this was still insufficient,given November ballot. Text of the initiative is posted at http: that Berkeley and Hayward each have four dubs, but only www.canorml.org/laws/oaklandinitiative.htm. one-third Oakland's population. In the end, the council The OCLA initiative is supported by the Marijuana agreed to begin with four,but have the City Manager recon- Policy Project, which provided startup funding, plus the sider the quota should it prove insufficient. Drug Policy Alliance, NORML, and Cannabis Action Net- Patient advocates also strongly opposed a regulation work. OCLA is seeking volunteers and financial support sponsored by Jean Quart to forbid on-site cannabis consump- for the signature gathering drive. tion at the dispensaries. Opponents pointed out that this Oakland Civil Liberties Alliance-PAC would only encourage patients to smoke on public streets 1714 Franklin Street#100-118 and in cars. Council member Jane Brunner,an anti-smoking Oakland,CA 94612 advocate, suggested that alternatives to smoking could be (510)268-9979—www.taxandregulate.org found,while council member Desley Brooks pointed out that California NORML Reports Edited by Dale Gieringer- March 2004 Name Mail address: 2215-R Market St.#278 San Francisco,CA 94114 Address Phone: (415)563-5858 or(510)540-1066 Zip E-Mail: canorml@igc.org Website: http://www.canom-d.org E-mail* California membership/subscription* $25 Phone(optional): (`includes introductory membership in National NORML) Low-income subscription: $10 •Receive posts about upcoming events and action alerts. -5- �{ l ATTACHMENT 2 News and Notes - ..It is possible to keep cannabis out of the hands of TYje ®a ianb �Gributte street dealers and away from children,if we tax and February 19,2004 regulate it,"said Dale Gieringer,a member of the Oak- land Civil Liberties Alliance. Advocates Get Down to Grass Tax To put the measure on the November ballot,the alli- Oakland group wants voters to OK levy on pot. ance must collect a minimum of 20,000 signatures By Heather MacDonald from registered voters in Oakland. STAFF WRITER Controlling the sale of cannabis and limiting it to Li- OAKLAND—Advocates for the legalization of maxi- censed vendors would eliminate street-level pot deals, juana plan to ask voters to adopt an initiative in No- while the taxes generated would fund vital city services vember that aims to tax and regulate the sale of pot in in a time of severe budget crunches,according to Clare Oakland. Lewis,a spokeswoman for the alliance. While the measure,to be submitted to City Attorney A poll of 600 people commissioned by the group and John Russo today,would not decriminalize pot,it conducted by McGuire Research Services found more. would direct the Oakland Police Department to treat than 70 percent favored the initiative. the private use of marijuana by adults as its lowest pri- ority until cannabis is legalized by California officials. Why do Oakland voters want to tax and regulate cannabis? The top three reasons (January 2004 public opinion poll) are: ♦ If marijuana was sold by licensed businesses,it would take business away from street dealers,breaking their hold on our neighborhoods. (73%) ♦ Each year California spends$100 million enforcing marijuana laws and another es- timated$40 million incarcerating these non-violent offenders.It makes more eco- nomic sense to raise money by taxing and regulating the adult use of marijuana than spending to criminalize it. (74%) ♦ Our police should be focusing on solving murders-and violent crime rather than wasting their time on adult non violent marijuana offenses. (75%) Want to get involved? Clip here and return this form, after filling out both sides. Thanks! Name: Organizational Affiliation: Address: City, State, Zip: Phone: Email: 02 /2)� ATTACHMENT 2 OAKLAND CIVIL LIBERTIES ALLIANCE Jti1' Political Action Committee v 1714 Franklin St. #100-118 Oakland, CA 94612 IP� Oclaiiifo@progressivecommunications.org O '�O www.taxandregulate.org OAKLAND CANNABIS REGULATION AND REVENUE ORDINANCE OCLA is circulating a local ballot initiative to promote responsible regulation of cannabis! This initiative directs the city to support changes in public policy re- garding cannabis (marijuana), with the aim of regulating, licensing and taxing cannabis sales to adults in Oakland as soon as possible un- der California law, and, in the meantime, making private adult canna- bis offenses the lowest law enforcement priority. The purpose of this ordinance is to reduce law enforcement costs, eliminate criminal traf- fickers, keep cannabis off the streets and away from children.-raise much-needed revenue for the city, and advocate for sensible changes to cannabis law at the State level, and other levels of government as necessary. Our signature drive begins in March 2004— we need to collect 20,000 valid signatures by the end of June to place the initiative on the November 2004 ballot in Oakland, California. Please join us in this effort! UPDATES about signature gathering times and other events are available on our website. www.taxandregalate.org ------------------------------------------------------------- Want.to help out or learn more? Please complete both sides and mail to the address above. YES!I want to help enact sensible and financially sound cannabis policies! ❑ 1 would like to make a contribution to support these efforts. Enclosed is my check (made out to OCLA-PAC) for$ Occupation*: Employer*: 'This information is required to be reported for contributors over$99.00 ❑ Please send me additional information about the campaign. ❑ 1 would like to help gather signatures. 1 would like to volunteer to help. My volunteer interests are: w M DICAL .r CAN NA1515 RECEIVED 2, 1004 5LO SLO CITY CLERK CITYCOUNCIL MEETING i o- i 9..o+ 7:00 p.m. -- CITY MALL 990 Falm 5trect 'Pt'onal AJJI I information .;o - FINDIP Facket ACRO {.i FIRE CHIEF RED FILE ��--arroRlvEY Rw[)I P, MEETING AGENDA yC ERK/CRIG .2�=ouCE CHF F-jAEPT HEADS REC DIY DATE D 6 ITEM # A � „' r SAN LUIS OBISPO CITY COUNCIL PROPOSED MEDICAL CANNABIS ORDINANCE October 19,2004 This report is submitted in connection with the Council's consideration of an ordinance authorizing and regulating medical cannabis caregivers and medical cannabis dispensaries in the.City of San Luis Obispo. Background The City of San Luis Obispo has a well documented history supportive of medical cannabis. In 1993, the City adopted Resolution 8195, supporting the use of medical cannabis and urging the State and Federal Government to restore cannabis to the list of available medicines which can be prescribed by licensed physicians. Resolution 8195 also requested that the government takes steps to ensure the safe and a,/fordable supply of cannabis for medical use. In 1996,California voters approved Proposition 215 (Health and.Safety Code§113625)which authorizes the possession, cultivation and distribution of medical cannabis by qualified patients and their primary caregivers upon the oral or written recommendation of a physician. In January 2004,the State Legislature adopted SB 420(Health and Safety Code§11362.7)which established minimum state guidelines regarding quantities of medical cannabis possessed by each qualified patient and primary caregiver,allowed primary caregivers to receive compensation for their services,and provided for the establishment of a voluntary identification card program through the County Health Department. Additionally,SB 420 encouraged and authorized cities to enact their own medical cannabis guidelines. Since the passage of Proposition 215 and the implementation of SB 420, several cities have passed ordinances regulating medical cannabis and authorizing medical cannabis dispensaries. The City of San Luis Obispo now has the opportunity to adopt its own ordinance to ensure the safe and affordable supply of medical cannabis,consistent with Resolution 8195,Proposition 215 and SB 420. Oudine of Proposed Ordinance Need for Ordinance Pentons within the City of San Luis Obispo are acting as primary caregivers to qualified patients in the absence of the local guidelines encouraged by SB 420. The adoption of an ordinance would give patients and caregivers additional protection, peace of mind, safe access to medicine and would clarify the issue for all involved parties. In summary,the establishment of an ordinance will meet the needs of the community in the following fashion: 1. The proposed ordinance will serve local qualified patients' needs that California voters,the legislature and the Courts of this state have sanctioned 2. The proposed ordinance will codify and clarify guidelines for qualified patients, designated primary caregivers, medical cannabis dispensaries and law enforcement Draft of Proposed Ordinance Attached for review of the Council is a draft of a Proposed Ordinance related to medical cannabis and medical cannabis dispensaries. The Proposed Ordinance is based on Proposition 215,SB 420 and California case law including People vs. . Mower (2002) 28 C.A.4`" 457 and Raich vs. Ashcroft (2003) 352 F.3d 1222 (pending review by the U.S Supreme Court in 2005). The Proposed Ordinance was drafted after review and analysis of medical cannabis dispensary ordinances adopted by the cities of Auburn, Berkeley, Citrus Heights, City of Angels, Elk Grove, Jackson, Oakland, Plymouth and Roseville. Summary of Proposed Ordinance ■ Authorizes and regulates lite operation of licensed medical cannabis dispensaries in San Luis Obispo. ■ Sets qualifications and standards regarding the operation of medical cannabis dispensaries based on the guidelines set forth in Proposition 215 and SB 410. ■ Limits authorized dispensaries to those persons or entities granted permits by the City of San Luis Obispo Goals of Proposed Ordinance ■ Fairly authorize and regulate distribution of medical cannabis in the City of San Luis Obispo consistent with the parameters of Proposition 215 and SB 420 with a minimum of bureaucratic oversight ■ Provide basis and reference point for qualified patients, designated primary caregivers and medical cannabis dispensary operators to insure compliance with California law. ■ Provide basis and reference point for local law enforcement to supplement and clarify its current policy regarding possession,cultivation and distribution of medical cannabis. Comment on Draft of Proposed Ordinance In regards to local law enforcement, a minority of cities with medical cannabis dispensary ordinances have imposed an additional and unnecessary burden on local police by requiring the police chief to review each medical cannabis dispensary application and accept or deny the application based on various criteria. Involving the police chief in the permitting process is not authorized or even contemplated by Proposition 215 and SB 420. Also, it discourages qualified patients and primary caregivers from participating and invites legal challenges against the City. Additionally and significantly,the Police Department of the City of San Luis Obispo is not qualified,trained or willing to take on this responsibility. Chief of Police Deborah Linden has previously stated her opposition to police screening and review of medical cannabis patients in San Luis Obispo. A copy of Chief Linden's memorandum,dated July 31,2003, is included herein. 1 As a result,the Proposed Ordinance does not include any direct involvement by the Police Department in the medical cannabis dispensary application process. Under the terms of the Proposed Ordinance,no additional bureaucratic burden would be placed on the City. Instead, the City would process the medical cannabis dispensary applications similarly to other business license permit applications,and would receive a license fee from the applicant. The basic terms of the Proposed Ordinance are directly based on the language of Proposition 215 and SB 420. The balance of the Proposed Ordinance mimics the language of the medical cannabis dispensary ordinances which have been successfully implemented in the California cities mentioned above. Conclusion The issue of medical cannabis is best addressed by the implementation of an ordinance which fairly addresses the needs of qualified patients and designated primary caregivers within our City and which is based on the mandate and guidelines ser forth in both Proposition 21.5 and SB 420. The City Council should implement the spirit and letter of Resolution 8195,Proposition 215 and.SB 420 by adopting an ordinance authorizing and regulating licensed medical cannabis caregivers and medical cannabis dispensaries within San Luis Obispo. Submitted by: Lours KooRY,ESQ. JAMES MCKIERNAN LAWYERS 21 SANTA ROSA STREET SUITE 300 SAN LUIS OBISPO,CA 93405 (805)541-5411 tkoory@mckiernanlaw.com RESOLUTION NO. 8295 (1993 Series) CITY-OF SAN LUIS OBISPO RESOLUTION SUPPORTING THE USE OF MEDICAL MARIJUANA WHEREAS; For the purposes of this resolution, "Cannabis/Marijuana medical preparations" shall mean: all products made from Cannabis/Marijuana, in any form intended or used for human consumption, for the treatment of any disease, the relief of pain, or as an adjunct to any medical procedure for the treatment of Cancer, Glaucoma, or HIV/AIDS; or for any other medical heating purpose defined within the bounds of the patient/doctor relationship; and WHEREAS, Scientific and medical studies by the National Academy of Sciences have shown Cannabis/Marijuana to be a safe and effective medicine with very low toxicity compared to most prescription drugs, and that Cannabis/Marijuana has been shown to be effective in the treatment of glaucoma, epilepsy, multiple sclerosis, muscle spasticity and arthritis, the nausea, vomiting and appetite loss associated with chemotherapies, anxiety and depression, and the symptoms of withdrawal from alcohol and narcotics; and WHEREAS, Studies show that one-third of all cfncer patients discontinue potentially life-saving chemotherapy due to severe and debilitating side effects, and that the same is true for many HIV/AIDS patients receiving AZT or other similar therapies, and that a 1990 poll of oncologists conducted by the John F. Kennedy School of Public Policy at Harvard University, found overwhelming acceptance of Resolution No. 8195 (1993 Series) Page 2 Cannabis/Marijuana's medical utility, and that nearly 70% of the cancer specialists said they would prescribe Cannabis/Marijuana if it were legal to do so; and WHEREAS, Despite a federal court order recognizing the "clearly.established medical value" of Cannabis/Marijuana and mandating that it be reclassified and available.by prescription, the-federal government continues to deny access to this substance; and NOW, THEREFORE, BE IT RESOLVED, that within thirty (30) days of the. adoption of this resolution, the San Luis Obispo City Council shall transmit the text of this resolution to the County of San Luis Obispo and to the President of the United States, the Governor of Ithe State of California, and the Federal and State Legislative Representatives of the City of San Luis Obispo, and urge them to take whatever actions may be in their power to: A) Restore Cannabis/Marijuana preparations to the list of available medicines which can.be prescribed by licensed physicians. B) Provide for by law and institute such mechanisms as may be necessary, to ensure a safe and affordable supply of Cannabis/Marijuana for medical use; and BE IT FURTHER RESOLVED that the Mayor communicate the City Council's support of Senate Joint Resolution #8 to the City's state legislative representatives. Upon motion of council MemA - Rmmnrn , seconded by Council Member Settle and on the following roll call vote: Resolution No: 8195 (1993 Series) Page 3 AYES: Council Members Romero, Settle, Rappa, Roalman and Mayor Pinard NOES: None ABSENT: None the foregoing resolution was adopted this 20th day of July . 1993. MayorfPeg Pinard ATTEST: tr1. y fi. r I�• a er ell, City C6hk r APPROVED: _ rl hereby cafti r that the foregoing, i3 a tuft, true and correct copy of Resolution No. 8195 (1993 Series) on five in tc•O{-;Ce of the C Y Cie,"". In witnsss hem y.h-.rl-d erj� .cEsea!: 7/22/93 Dare Win; City of c31. LL-,s Cbisho ttor y . .seana"puan . i crty of san tins osispo Police Department m Memorandum 1042 Walnut p= SLO, CA 93401 (805)781-7317 "Service,Pride,Integrity" July 31,2003 To: Vice Mayor Christine Mulholland Via: Ken Hampian, CAO From: Deborah Linden, Chief of Police Subject: Physician Recommendations for Medicinal Marijuana You recently called me and asked me whether or not medical marijuana users who possess written recommendations from physicians should proactively present the recommendation to SLO PD prior to any contact with officers. After discussing the idea with Captain Dan Blanke,I do not recommend this course of action for several reasons, outlined below. Our reasons and recommendations are consistent with the information we provided Council several months ago in a report titled, "Analysis of Proposition 215 Implementation in San Luis Obispo". In essence, having medical marijuana users present their recommendations in advance would basically create a San Luis Obispo Police Department registry system, which would not be practical or desirable for the following reasons: • Recommendation Verification—Currently,the District Attorney's Office has a detailed process in place for verification of case-specific physician recommendations. The verification process is necessary to determine the validity of a defendant's Prop..215 assertion. This process can be quite time-consuming. More specifically, a recommendation is not-good indefinitely, and it requires research to ensure the recommendation is valid. Like a prescription,it is only valid as long as the medical condition being treated exists. Unlike the case-specific investigations conducted by the DA's Office,maintaining a San Luis Obispo Police Department registry would not only require initial verifications, but continued periodic investigations. The Department is not appropriately staffed to assume that additional workload. • Medical Privacy—Verifying and maintaining registry information would require the collection and maintenance of health information and medical data for medical marijuana users. This data would constitute medical records, which are subject to specific legal requirements for their maintenance and confidentiality under both state and federal laws. The Police Department is not at all equipped or prepared to maintain medical records subject to specific privacy laws, and this area is entirely out of our expertise and experience. I would be greatly concerned about the City's legal liability,if, for example, a medical record was improperly disclosed. 1 i \ cny of san Luis osispo Ponce Department • Quantity and Circumstances of Marijuana Possession—Regardless of whether or not a person has a verified physician's recommendation for medicinal marijuana, officers must evaluate each situation based on the totality of the circumstances. The quantity of marijuana possessed must be appropriate for the condition being treated. Additionally, even in the case of possession of small quantities of marijuana,Proposition 215 does not provide a defense in all cases. For example, a physician's recommendation does not allow a patient to possess marijuana in a motor vehicle, or to drive under the influence of marijuana. Police officers have an obligation to investigate people who may be involved in illegal activity,particularly when another citizen calls in a complaint. Registering their recommendations with the Police Department could give patients a false sense of immunity from law enforcement scrutiny regarding their marijuana-related activities. There are communities in California that have medical marijuana patient registries, but it is my understanding that the registries are maintained by local health departments, which are better' able to deal with the issues regarding the medical records. Creating and maintaining a medical marijuana registry within the Police Department is completely outside our expertise and is not consistent with our role as a law enforcement agency. While the creation of a.Police Department registry is not practical, the Department remains committed to protecting the rights of all citizens, including medicinal marijuana patients. As indicated in our February report, we are currently working with the District Attorney's Office to provide our Officers information and investigative tools to assist them in their field evaluations of Proposition 215 defense claims. There are also legal issues pending at both the State and Federal levels concerning Prop. 215 that may or may not clarify some of these issues. cc: Mayor and City Council City Attorney 2 ORDINANCE.AUTHORIZING SAFE AND LAWFUL ACCESS TO MEDICAL CANNABIS IN SAN LUIS OBISPO CHAPTER 1. MEDICAL CANNABIS. SECTION 1. FINDINGS AND PURPOSES. On November 5, 1996, the voters of the State of California adopted by initiative the Compassionate Use Act of 1996 (Proposition 215), codified as Health and Safety Code § 11362.5, relating to the medical use of cannabis. In January of 2004, the California legislature implemented SB 420, codified as Health and Safety Code § 11362.7. The City of San Luis Obispo supports the lawful use of medical cannabis in accordance with Health and Safety Code§11362.5 and§11362.7. The purpose of this chapter is to implement Health and Safety Code § 11362.5 and Health and Safety Code § 11362.7 by facilitating medical cannabis patients' lawful production and obtaining of medical cannabis and to recognize and protect the rights of qualified patients, their primary caregivers, and physicians, as well as to ensure lawful access to safe and affordable medical cannabis within the City of San Luis Obispo. In support of this purpose, the City of San Luis Obispo recognizes that qualified ---patients,-primary caregivers,_and_medicaLeannabis.._dispensaries. as .defined herein_ may-provide services. to..facilitate or. assist in the lawful cultivation,_ manufacture, acquisition and distribution of safe and affordable medical cannabis to qualified patients in a consistent;reliable and legal fashion.- SECTION ashion.SECTION 2. DEFINITIONS. "Medical cannabis dispensary" is any facility or location where a primary caregiver acquires, makes available, sells, distributes or otherwise provides medical cannabis to two or more qualified patients as defined in Health and Safety Code § 11362.5 and Health and Safety Code§ 11362.7. An entity may be authorized as a medical cannabis dispensary if designated as such by the City of San Luis Obispo pursuant to this Chapter. "Qualified patient" means a person who obtains a written or oral recommendation from a physician for the use of medical cannabis. "Primary caregiver" means a person who is designated by a qualified patient to assume responsibility for the housing, health, or safety of the qualified patient, including the lawful cultivation, acquisition, and delivery of medical cannabis. SECTION 3. MEDICAL CANNABIS DISPENSARY PROGRAM. The City of San Luis Obispo establishes a medical cannabis dispensary program through the authorization and regulation of designated medical cannabis dispensaries. A medical cannabis dispensary pursuant to this Chapter is any facility or location where a primary caregiver acquires, makes available, sells, distributes or otherwise provides medical cannabis to two or more qualified patients as defined in Health and Safety Code § 11362.5 and Health and Safety Code § 11362.7. An entity may be authorized as a medical cannabis dispensary if designated as such by the City of San Luis Obispo pursuant this Chapter. The City of San Luis Obispo authorizes the establishment and operation of designated medical cannabis dispensaries if the medical cannabis dispensary meets the specific qualifications set forth in this Chapter, upon application to the City of San Luis Obispo. SECTION 4. MEDICAL CANNABIS DISPENSARY: APPLICATION and PERMIT. Prior to initiating operations, and as a continuing prerequisite to conducting legally valid operations, any persons or entity wishing to operate a medical cannabis dispensary shall apply for and be issued from the City Clerk a medical cannabis dispensary permit, on the terms and conditions set forth herein. The applicant for a medical cannabis dispensary permit shall submit to the City Clerk an application for a medical cannabis dispensary permit. The application for a medical cannabis dispensary permit shall be filed in conjunction with a Business Tax Certificate Application, and shall contain such information and fees as requested by the City, including the following: (a) A complete and detailed description of the type, nature and extent of the enterprise to be conducted and for which application is made, including, but not limited - - --- - --to-an-estimate--of the-number-of qualified patients-for-which_the_dispensarywill_-be__.— providing services; (b) - -The address of the location from Which a medical cannabis dispensary for which application is made will be operated; (c) The name and address of the person who owns the medical cannabis dispensary for which application is made; (d) The application shall include a non-refundable application fee of$50.00. SECTION 5. TERMS and CONDITIONS of OPERATION. Based on the information set forth in the medical cannabis dispensary application, the City Clerk may impose reasonable terms and conditions on the proposed operations, consistent with Health & Safety Code Section 11362.5 and 11362.7 and with the public health, safety, and welfare. Such terms and conditions may include,but not be limited to,the following: (a) The medical cannabis dispensary shall not be located within 1,000 feet of any elementary school,middle school or high school. (b) The medical cannabis dispensary shall comply will applicable local, state and federal regulations and laws pertaining to building codes and the Americans with Disabilities Act. (c) The medical cannabis dispensary shall provide adequate security on the premises, including lighting and alarms, if necessary, to insure the safety of persons on the premises and to pioiect the premises from theft. (d) The medical cannabis dispensaries shall provide to the City Clerk, if requested, with evidence to the Clerk's satisfaction that the medical cannabis dispensary is not engaged in interstate commerce. (e) The medical cannabis dispensary will pay an annual license fee submitted at the time of the application to the City of San Luis Obispo in the amount of $1,000.00. If the application is denied, the City Clerk shall return the license fee. (f) The City Clerk may require that the medical cannabis dispensary sign a liability waiver in favor of the City of San Luis Obispo. (g) The City Clerk may restrict the location of the medical cannabis dispensary based on Zoning Ordinances and regulations, set forth in the San Luis Obispo Municipal Code. (h) Based on a review of the medical cannabis dispensary application, the City Clerk may issue.a medical cannabis dispensary permit to the applicant, or deny the application. (i) A medical cannabis dispensary permit shall be valid for only one year. - - An operator of amedical-cannabis dispensary may re-apply-fora permit for subsequent. yews) (j) If necessary, the City Clerk may limit the number of-medical cannabis dispensary permits issued each year. SECTION 6. IDENTIFICATION CARDS. In order to ensure that qualified patients and medical cannabis primary caregivers are not subject to criminal prosecution�or sanction and to ensure that only qualified patients and qualified primary caregivers have access to medical cannabis, and to assist in the verification of the legal status of qualified patients and primary caregivers, the medical cannabis dispensaries authorized under this Chapter may issue identification cards to qualified patients and qualified primary caregivers upon receipt of written verification of the recipient's legal status, including but not limited to, a physician's recommendation or approval for medical cannabis or a primary caregiver designation. SECTION 7. TRANSPORTATION AND DELIVERY OF MEDICAL CANNABIS. All activities entailing the cultivation, possession, transportation and delivery of medical cannabis in accordance with this Chapter shall be lawful when conducted by qualified patients, primary caregivers, and medical cannabis dispensaries, where the quantity cultivated, possessed, transported and delivered are reasonably related to the medical needs of qualified patients. SECTION 8. PRIMARY CAREGIVER SERVICES. Qualified patients, primary caregivers, and medical cannabis dispensaries authorized by the City of San Luis Obispo under this Chapter may receive or provide consideration or compensation for actual expenses, including reasonable compensation for performing or providing primary caregiver services for qualified patients and shall not, on the sole basis of that fact, be in violation of Health and Safety Code §11359 or §11360. SECTION 9. NO LIABILITY. To the fullest extent permitted by law, the City of San Luis Obispo shall assume no liability whatsoever and expressly does not waive any governmental immunities with respect to the medical cannabis provider program established herein or for the activities of any medical cannabis dispensaries. SECTION 10. VIOLATIONS. Violations by the medical cannabis dispensary of the terms and conditions of operation set forth herein, of this Chapter, the San Luis Obispo Municipal Code or of applicable local and state rules, regulations and laws shall be unlawful, and shall be grounds for revocation of the medical cannabis dispensary permit or for non-renewal. Revocation of the medical cannabis dispensary permit shall result in a forfeit of the -license fee.- _ SECTION 11. APPEAL. The City Clerk shall issue notice of her decision regarding the medical cannabis dispensary application or revocation to the applicant by personal service or by certified U.S. Mail,postage pre-paid, return receipt requested. An applicant may appeal the denial or revocation to the City Council by filing a written notice to the City Clerk within fourteen (14) calendar days of the applicant's receipt of the notice. If the notice of appeal is not timely filed, the decision of the City Clerk shall be final. SECTION 12. HEARING—'NOTICE and COUNCIL ACTION. Upon timely appeal to the City Council, the medical cannabis dispensary application or revocation shall be scheduled by the City Clerk for a public hearing within sixty(60) days. Notice of the hearing shall be mailed to the applicant at least five (5) days before the hearing, and shall be posted outside of City Hall not less than five (5) days prior to the date of the hearing. Following public hearing, the City Council may grant or deny the medical cannabis dispensary application, or uphold or overturn the revocation. The decision of the City Council shall be final. Diane Reynolds- Medical marijuana issues ,Fatrement Page 1 From: "Matthew" <earthbom @ charter.net> RECEIVED To: <ahooper @ slocity.org> OCT 19 2004 Date: 10/19/04 4:42PM Subject: Medical marijuana issue statrement gip CITY CLERK Greetings, I wish to make a statement regarding the issue of allowing a dispensary in the city of San Luis Obispo. I have intricate knowledge of these dispensaries, having associates that manage similar establishments in both Oakland and Orange County, CA. If it is handled professionally; and in accordance with all state laws, the benefits of allowing one greatly outweigh any detriment one might think comes with it. In fact,the main benefits include providing medically needy patients the ability to humanely, consistently, and safely access medication they need,without having to rely on illegal, unorthodox and many times dangerous means to procure medicinal marijuana.There are organizations in place which self-regulates the dispensaries to ensure uniformity and safety. Some of the main issues are providing : 1. Consistent quality, strength, efficaciousness and cost for the patient. 2.A safe secure environment (i.e. storefront, )with security doorlwindow with proper recorded CCTV monitoring system/alarm system, with adequate personnel to ensure 100%safety for the patient, mainly to protect them, and the dispensary from theft and unneeded attention. 3.The patients will no longer have unsafe and inconsistent means to procure medicine. Being a patient myself,these are serious issues affecting us all. Being able to get medicinal marijuana when one needs it is often extremely difficult, expensive and sometimes unavailable. Not to mention the costs can be staggering as well as getting very poor quality which is as bad as not having it at all many times. If you allow a dispensary in the city,you will be greatly benefiting all who have serious medical issues requiring the use of this helpful herb. would also like to apply for the opportunity to be able to open a dispensary here if you allow it. I would bring in the best of the best experts who have direct experience operating, managing and running other highly professional, successful dispensaries in other parts of the state who help thousands of patients every month. Please advise me on how I would start if you do in fact allow this to happen. Furthermore, I wish to express extreme gratitude to the city council for reviewing this extremely important issue and pray that you do the right thing for the community: Sincerely, Jason M. Brooks EarthBom Solutions (805)473-3975 Office Line (360) 656-2715 Home Office Fax earthbom@charter.net CC: <dreynolds@slocity.org> *, co, JCIL TCDD DIRE AO FIN DIR ,,?'ACAOc1 FIRE CHIEF -'-'ATTORNEY �2-PW DIR .C; CLERK/ORIG a-POLICE CHF RED FILE ❑ D PT HEADSy REC DIR X11 Fx,r�b 011.3 ❑ IL DIR uT ME ING AGENDA r �..�C�nCS./I;n rIR Imo,-.I EiDW ITEM 4 C=' ,DECEIVED OCT 19 2004 Mayor Romero: SLID CITY CLERK If you get a chance, you might want to look at the enclosed information regarding medical marijuana, most of it from the National Academy of Sciences/Institute of Medicine. This is a very emotional subject in that we are dealing with health issues and pictures such as those in today's paper might lead the general public to the conclusion that there should be no debate regarding medical marijuana After all, if someone says it has saved his eyesight or an HIV patient claims it helps him with appetite who are any of us to argue,even if reputable science has concerns? I have two points I hope you and the Council will consider: I. What does our most respected scientific body say on the subject? Look through the material and I believe you will see that the Academy is not very enthusiastic about smoking marijuana as a medicine and also cautions that THC in any form, even if taken in food,has been implicated in immune system suppression, although more study needs to be done on this. 2. I wonder if there is any liability on the part of San Luis Obispo if they approve these marijuana distribution centers for long-term care of patients with chronic conditions and overtime they develop other health problems which known carcinogens have been proven to lead to. Tobacco and marijuana smoke have many similarities and I believe it is not unlikely that the City could be held legally liable at some time in the future if it goes against the suggestions of our best scientific body. At the very least I would suggest that you go by the IOM's recommendations. Thank you, Walt Rehm Health Education Cuesta College �CCOUNCIL Z-0Zop DIR CAO FIN DIR %ACAO 2-FIRE CHIEF ;ATTORNEY ,Z-PW DIR iCLERK10RIG �POUCECHF RED FILE I ❑ DFPT HEADS .2 REC DIR ft UTIL DIR Pv3E,,TING AGENDA ._-d D;=�TE 1 TEM #b-&_ ,_ MARIJUANA AS MEDICINE (FINDINGS FROM THE NATIONAL ACADEMY OF SCIENCES) • Polycyclic Aromatic Hydrocarbons(PAHs)are formed during any organic combustion,such as smoking tobacco or marijuana. Unfiltered smoke from marijuana contains higher concentrations of PAHs than that from smoking tobacco. The evidence suggests that marijuana smokers'lung cells contain higher levels of an enzyme that converts PAHs into a cancer-causing form This could be a potential risk factor for lung,mouth and throat cancers. • Marijuana delivers four times as much tar to the lungs as tobacco,but cigarettes produce more smoke than hand-rolled joints. This makes it hard to compare the two. • Cellular,genetic,and clinical studies suggest that marijuana smoke is an important risk factor in the development of respiratory cancer. • With marijuana use there is an increase in DNA aberrations of a type linked to cancer development (Simi] changes are seen in tobacco smokers.) • Several biological studies suggest that cannabinoids(such as THC)can depress the immune system's response to infection. (Marijuana smoking is associated with an increased mortality among men with AIDS and this may be due to this increased burden on the immmne system. However,this is a very complex issue and no single experiment can truly reveal marijuana's effects on the immune system.) • Marijuana smoke appears to injure alveolar macrophages(a class of immune cells in the lungs.) • It is reasonable to predict that THC could interfere with the earliest stages of pregnancy, particularly with implantation of the fertilized egg. • Smoked marijuana and THC can increase heart rate from 20-100%above normal. Therefore,it is not recommended for individuals with heart problems. • The antianxiety properties of the cannabinoids may help relieve conditions worsened by anxiety such as movement disorders or nausea. The increased euphoric feeling may help in pain relief, leading some users to the false belief that marijuana improves their medical condition. This is a problem if it causes patients to choose marijuana over more effective conventional medicines that have fewer side effects. • Marijuana plants grown under different conditions contain variable mixtures of cannabinoids. Thus,the potential medical benefits would vary from plant to plant • It appears that for people with chronic medical disorders or those with compromised respiratory or immune systems,smoking marijuana is likely to do more harm than good. Likewise,for people at risk of cardiovascular disease,pregnant women,and couples trying to conceive,the potential risks of either THC or smoked marijuana appear to exceed the potential medical benefits. • Although glaucoma is one of the most frequently cited medical indications for marijuana,the data do not support this indication. High intraocular pressure is a known risk factor for glaucoma and can,indeed,be reduced by cannabinoids and marijuana. However,the effect is too short lived and requires too high doses,and there are too many side effects to recommend lifelong use in treatment of glaucoma. C. Hamm ti �►v2� Oct 19,2004 ClC L;n Attention San Luis Obispo City Council The following information concerns the initiation of a Compassion Center in San Luis Obispo. An entity was created in the year 2000 called The Compassion Center of San Luis Obispo County, Patients Local 137. In support,of this entity being established in San Luis Obispo County, let's tum our attention to our neighboring County, Santa Barbara. For nearly five years the Compassion Center of Santa Barbara County,Patients Local 127 has been in operation servicing the needs of doctor approved patients. Working in conjunction with the States Attorney Generals office, the Center is a model for what could be throughout the State. The Center is located in a medical office and is staffed with registered nurses. These nurses work with local physicians to first,verify that the individual is in fact their patient, and secondly to interface with the patient The concept is the following: Anyone can find cannabis on the street. It has been around for years and will continue to be around for years.The real issue is making cannabis accessible for those needy individuals who would not normally have access to it. These individuals would benefit from this very therapeutic substance. Attached you will find cancer research from the Department of Biochemistry and Molecular Biology from Madrid, Spain working in conjunction with the Department of Chemistry at Clemson University,Clemson, South Carolina These abstracts are clinical studies showing that,not only does cannabis inhibit the growth of highly malignant cancer, but can actually reduces it Most people do not realize that many pharmaceutical companies are in trail studies in numerous hospitals around the country. The US National Academy of Sciences came out with a report in 1999, showing THC to be one of the strongest anti-oxidants known to man. In the same study it was recommended that US pharmaceutical companies get into the cannabis business. Before 1937,there were over thirty patent medicines using cannabis, including topical cream for corns. In closing I suggest that the clinical model,as set up in Santa Barbara, be adopted for the City of San Luis Obispo. Furthermore there have been no problems or incidents arising from such as structure in Santa Barbara. In fact its success has aided local law enforcement by taking away some of the criminal element in the area Thank you for your time and attention, Patrick Fourmy [CANCER RESEARCH 61,5734-5789,Augmt 1.2a1] Inhibition of Glioma Growth in Vivo by Selective Activation of the CB2 Cannabinoid Receptor' Crkdm Sgnchez,2 Maria L.de Ceballos,2 Teresa G6mez del Pulgar; Daniel Rueda, Cisar Corbacho, Guillermo Velasco,Ismael Galve-Roperb,John W. Huffman,Santiago Ram6a y Cajal,and Manuel Guzmin3 Department of Biochemistry and Molecular Biology I. School of Biology, Complurme Untversity, 18040 Madrid Spain jC S.. T.G.d P. D.R, G.V. L G-R., M G1. Neurodegeneration Group.Cajal bntHute,CSIC 18001 Modrtd Spain fM L d C.j;Dq-v e n of Pathology,Chorea Puerta de Hkrro,18035 Afa&id Spate[C.C.S R y C]: and Deparmrera of a=urvy.Clomwr UMmersuy,Clemtan.South Cm fine 19634-1905[J.W.H.] ABSTRACT (1-6).By conttmst,the CB2 receptor is believed to be solely expressed in cells and organs of the immune system and is unrelated to canna- The development of new therapeutic strategies is essential for the binoid psychoactivity(1,2).The discovery of a family of endogenous management of gliomm one of the most malignaforms of cancer.We ligands of cannabinoid receptors,the so-called endocannabinoids(7- have shown previously that the growth of the rat glioma C6 cell line is inhibited by psychoactive connabmoids(L Galve-Roperb d aL,Nal Med., 9),together with their specific mechanisms of synthesis and inactiva- &313-319, 2000}These compounds ad on the brain and some other non(10, 11),have focused much attention on cannabinoids dining the organs through the widely expressed CB,receptor.By contrast,the other last few years. cannabinoid receptor subtype, the Cllr receptor, shows a mach more Marijuana and its derivatives have been used in medicine for[natty restricted distribution and Is absent from normal brain.Here we show centuries, and nowadays, there is a renaissance in the study of the that local administration of the selective CB, agonist JWH-133 at 50 therapeutic effects of cannabinoids, which constitutes a widely de- jog/day to RW2-'-mice induced a considerable regression of malignant bated issue with ample scientific and social relevance. Ongoing re- tumors generated by inoculation of C6 glioma cels.The selective involve- search is determining whether cannabinoid ligands may be effective mint of the CB,receptor In this action was evidenced by:(a)the preven- agents in the treatment of pain(12, 13),glaucoma(14),neurodegen- tion by the CB, antagonist SIU44528 but not the CB, antagonist SR141716;(b)the down-regulation of the CB,receptor but not the CB, erarive disorders such as Parkinson's disease(IS)and multiple sole- receptor in the tumors; and (c) the absence of typical CB,-medlated its (16), and the wasting and emesis associated with AIDS and psychotropic side effects. Cannabirmld receptor expression was sabse- rangy'chemotherapy(14).In addition,cannabinoids might be poten- gnently examined in biopsies from human astrocytomas.A toll 70%(26 of tial antitumoral agents because of their ability to inhibit the growth of 37)of the human astrocytomas analyzed expressed significant levels of various types of cancer cells in culture(17-19). Moreover, in labo- cannabinold receptam Of Interest,the extent of CB,receptor expression ratory animals,cannabinoids induce the regression of gliomas,one of was directly related with tumor malignancy.In addition the growth of the most malignant forms of cancer whose current treatment in pa- grade IV human astrocytoma cells in R19-2` mice was completely tients is usually ineffective or just palliative(20).This growth-inhib- bbeked by JWH-133 administration at 50µg/day.Experiments carried iting effect was exerted by two psychoactive cannabinoids, namely out with C6 glloma cells In culture evidenced the internalization of the CB, THC,'the main active component of marijuana,and WIN-55,212-2, but not the CB, receptor upon JWH-133 challenge and showed that a nonselective synthetic cannabinoid agonist,pointing to the involve- selective activation of the CB,receptor signaled apoptosis via enhanced ceramide synthesis de now.These results support a therapeutic approach mem of cannabinoid receptors(20).It would be desirable,however, for the treatment of malignant gliomas devoid of psychotropic side effects. that cannabinoid-based therapeutic strategies were devoid of typical CB, receptor-mediated psychotropic side effects. Hence, the recent INTRODUCTION synthesis of selective CB2 agonists(21, 22) opens a very attractive clinical possibility.The present work was therefore undertaken to test. Cannabinoids,the active components of Cannabis sativa and their (a) if gliomas, including those of human origin, express functional derivatives,exert a wide spectrum of central and peripheral actions, CB2 receptors; (b) if selective CB2 receptor activation exerts an such as analgesia,anticonvulsion,anti-inflammarion,and alleviation antitumoral action in vivo;and(c)what may be the mechanism of that of both intraocular pressure and emesis.These effects are mediated by potential CB2-mediated antitumoral action. the activation of specific G protein-coupled receptors(1,2).To date, two different cannabinoid receptors have been characterized and MATERW S AND METHODS cloned from mammalian tissues;CBI(3)and CB2(4).The central and most of the peripheral effects of cannabinoids rely on CBI receptor Materials. JWH-133 was prepared in Dr.J.W.Huffman's laboratory(22). activation.This receptor is found in high levels in the central nervous SR141716 and SR144528 were kindly given by Sanofi Recherche(Montpel- system, where it mediates cannabinoid psychoactivity, and is also her,France).The anti-CB,receptor antibody(raised agimst residues 1-14 of present in peripheral time terminals,as well as in extra-neural sites, the rat CB, receptor)was kindly given by Dr. A. Howlers(North Carolina such as testis,uterus, vascular endothelium,eye, spleen,and tonsils Central University, Durham, NC). The anti-CB, receptor antibody (raised against residues 20-33 of the human CB2 receptor)was from Cayman Chem. Received 3/12101:accepted 6/1/01. icals(Arm Arbor,MI).The Cy3-conjugated antirabbit IgG was from Amer- The costs of publication of this article were defrayed in part by the payment of page sham-Pharmacia (Buckinghamshire, United Kingdom). WIN-55,212-2 was charges.This article must thmefine be hereby mmkal advertisement in accordance with from.Sigma Chemical Co.(SL Laois,MO). 18 U.S.C.section 1734 solely to indicate this fact Gilman Cell Culture and Death. The rat glioma C6 line was cultured as 'supported by gaol from C=w6n Ince m n srcr aI de Ciencia y T=010&(PM described before(I8). Cell viability was determined by the 3-4,5-dimethyl- 98-0079;to M.G.);Commidad Au*w=de Madrid(0&1/007920M to M.G.and thiazol-2,5bromide tlliaml btu test(IS).Apoptosis was M.L.d.C.);Fundoci6n Ramon Areces(to M.G.);Universidad Complutensc de Madrid (PR64/99-8532; to G.V.); Fondo de lavesrigacimes sanitmins (Fis 99/os04; to determined by TUNEL staining.After cannabinoid treatment,C6 glioma cells S.R y C.);Aventis(to S.R.y C.);and National Institute on Drug Abuse(DA03590:to were washed with PBS,fixed in PBS supplemented with 4%paraformaldehyde J.W.H). 2 C.S.,M.L.d C.,and T.G.d.P.contributed equally to this work. 3 To whom requests for reprints should be addressed,at Department of Biochemistry 4 The abbreviations used are: THC, Dv-Wirahydroamabinol; ERK, aetraceaalar and Molecular Biology 1,School of Biology,Compluteme University.28040 Madrid, signal-regulated kinase;SPT,serine palmitoyloansfasse;TUNEL,terminal dwxyauele- Spam.Phone:3491394466&;Fax:34-913944672;E-mail:mgpQa bbmla,®es. oddyl ounsfrmse•mediaoed nick end labeling. 5784 ANTITUMORAL ACRON OF CANNAmNOI S and 5%sucrose for 15 min,and pamwbilizad with 0.05%Triton X-100 in Table 1 Cmmabinoid receptor repression in hmrrmr asrrocoon=of PBS,and TUNEL analysis was performed as described before(20). Human d;(j l malrgnancyo tumor cells were prepared from a grade IV astrocytoma. The biopsy was Grades 1-11 Grade ID Grade IV digested with collagenase (type la) in DMEM at 37°C for 90 mill, the Receptor Expression (n= 12) (n= 11) (n= 14) supernatant was seeded in DMEM containing 15%FCS and 1 ram glutamine, CB, Neptive 6000%) 8(730/.) 8(57%) and cells were inoculated in after Moderate 2(120/*) 1(9%) 3(22-/o) the animals etwo passages. Higbivery high 4(339/6) 2(19%) 3(22%) Antitumoral Action of Catmabhmids in Vivo. Tumors were induced in CB2 Negative 6(50%) 5(45%) 4(29%) mice deficient in recombination activating gene 2(Rag-2-r-),which lacks Modemte 3(250/.) 2(180/6) 1(7%) mature T and B cells(23),by s.c.flank inoculation of 5 x 106 tumor cells High/very high 3(250/.) 4(36bA) 9(64°A)b (either C6.glioma cells or human astrocytoma cells)in PBS supplemented with 'Receptor m mrmaceactrwry was evaluated as absent(negative staining)or present 0.1%glucose. When mmors had reached an average volume of 250 mm' (nwdc ate or bigh/very high sm3nmg)in biopsies from human amocymmav of low(grades (range,200-300 mm'),animals were assigned to various and t-m and high(grades IO-IV)malignancy.The percentage of cases is shown in lmsa- >3n �Y BTS theses injected inuahunontHy 58(C6 glioma cells)or 25(human astrocytoma cells) b Significantly different(P < 0.01)from values of CB2 raxptar high/very higb days with vehicle or 50µg of camabinoid ligand(JWH-133,WIN-55,212-2, moa in Im malignancy and grade In minors and from values of CB, receptor S11141716,and/or SRI44528)per day in 100µl of PBS supplemented with 5 high/very high expression in Bode Iv tr®ws. mg/ml defined and dialyzed BSA. Tumors were measured with external calipm and volume was calculated as(410)X(width/2)2 X(kngth2). RESULTS Motor Activity. Motor activity(ambultion,rearing,and time of inactiv- ity)was tested after innanmmml injection to C6-cell glioma-bearing mice, Regression of C6-CeB Gliomas in Vivo by Selective CB2 Recep- exactly under the aforementioned conditions,with vehicle or 50µg of canna- for Acdvadon. Cannabinoid-based therapeutic strategies should be binoid agonist(JWH-133 or WIN-55,212-2)in an open field(30 x 30 cm, a9 devoid as possible of psychotropic side effects.Because cannabi- divided into 16 squares of equal sin)for 15 min.Animals were not habituated noid psychoactivity is mediated by the CB, receptor(1, 2) and C6 previously to the open field. glioma cells in culture express the CB2 receptor protein (20), we Immunofluorescence Analysis of Cannabinoid Recepma After canna- evaluated if selective CB2 receptor activation inhibits the growth of binoid treatment,cells were washed with PBS and fixed in cold acetone for 5 malignant gliomas in vivo by using the selective CB2 agonist JWH- min.Immunolabeling was performed according to Hsieh er at.(24).Cells were 133 (K; = 677 nM for CB, and 3.4 tar for CB2; Ref. 22). WIN- incubated with d- h at room or anti-CB2 receptor antibodies 0:500) in the 55,212-2(Ki = 1.9 nM for CB and 0.3 nM for CB2)was used as a latter bunter for 3-4 h m room temperature and overnight at 4°C in a humid � r chamber.After washing with PBS,cultures were further incubated for 90 min reference for nonselective cannabinoid receptor activation (26). As with a Cy3 cemjugated aatimbbit IgG(1:800),washed fast with PBS and then shown in Fig. IA, tumor growth was remarkably tower in mice with 50 mM Tris-HCI(pH 7.4),and mounted with 50%glycerol.preparations inWdtumomlly injected with 50 µg(day of JWH-133 than in control were analyzed with a Zeiss confocal laser-scarrmng microscope(excitation 550 animals.The magnitude of this antiproliferative action was compara- am,emission 565 nm).There was no labeling when the primary antibody was ble with that exerted by WIN-55,212-2 at equal doses(Fig. IB). aaitted(data not shown).In other ocpa®wLs,40-µm cryostat sections from To evaluate the possible implication of the CB, and CB2 cannabi- C6 glionni cell tumors were similarly treated after fixation with 40/9 pamform- noid receptors in the antitumoral action of JWH-133 in vitro,the effect aldehyde in 0.1 M sodium phosphate buffer(pH 7.4) for 30 min. Finally, of selective cannabinoid receptor antagonists was evaluated. The imanumsminmg was also performed in 5-µm sections of human asnorytomas selective CB2 antagonist SR144528(K;=437 nM for CB,and 0.6 nM (from the files of the Department of Pathology of Clinica Puerta de Hierro and for CB2; Ref. 27), but not the selective CB, antagonist SR141716 with informed consent from each subject) pre embedded in paraffin after (Ki = 5.6 nM for CB, and >1 µM for CB2; Ref. 28), prevented depamf5nation of the sections. Deparaffinized sections were incubated in JWH-133-induced tumor regression(Fig. IA).By contrast,the anti- DAKO sodium citrate buffer in a pressure cooker for 4 min,and immunohis- torbemical with the antiCB and CB:receptor antibodies was eval- tumoral effect of W the he tw212-2 was largely evident upon min- uated using the avidin-bionn/pemxidase technique in a Horizon Dako(Mesip istration of any of to antagonists (Fig. 18).Neither SR14141716 program)automated immmohistochemical stainer,according to the mamtfac- nor SR144528 per se exerted a significant effect on tumor growth oner instructions (data not shown).Examples of tumor-bearing mice and of dissected Western Blot Analysis of Cannabinoid Receptors. Particulate cell or tumors after cannabinoid treatment for 8 days are shown in Fig. 1C. tumor fractions were subjected to SDS-PAGE,and proteins were transferred Under the conditions in which it induced tumor regression,JWH- from the gets onto polyvinytidene fluoride membranes.The blots were incu- 133 administration led to no significant alteration of typical C%_ bated with the aforementioned antibodies against the CB,receptor(1:5000)or mediated behavioral parameters,such as ambulation,rearing,and time the CB2 receptor(1:2000).Samples were finally subjected to luminography of inactivity in an open field trial.By contrast,although cannabinoids with an enhanced chemiluminescence detection kit(20). were inoculated locally at the site of the tumor,WIN-55,212-2 treat- SPT Activity. SPT activity was determined in digitonin-permeabilized C6 [Hent produced a clear inhibition of those parameters.Thus,ambula- glioma cells as the incorporation of tadiolabeled L-serine into ketospbinganine tion(in munber of squares crossed)was 124±21(vehicle),131 ±26 by a new procedure(25).Briefly,the medium was aspirated,and cells were (,TWH-133), and 89 ± 35 (WIN-55,212-2); rearing (in number of washed twice with PBS. Reactions were started by the addition of 100 mM rears) was 16 ± 3 (vehicle), 22 ± 11 (JWH-133), and 5 ± 5 HEPES(pH 8.3),200 mM sucrose,2.5 mm EDTA,5 mM dithioerythritol,50 , , and time of inactivity µM pyridoxal phosphate,t mg/ml BSA,70µg/mi digitonin,0.3 resat palm(toyl- 4 :t 3(WIN-55,212-2), ± ty (-55. was 6 ± 6 (vehicle6 for each CoA,and 0.25 M L-[U-n'Cjscdm:(3 Aci/mmy).After 45 min reactions were 4 _ 3 (JWH-133), and 204 95 (WIN-55.212-2; n = 111M stopped with 0.5 M NH.OH,and 1,4gke[osphingamne product was extracted condition). with chlomform/methmiol/1%NaCl. Expression and Dynamics of Cannabinoid Receptors in C6 ERK Activity. Cells were washed and lysed,supernatants were obtained, Glioma Cells in Culture and in Vivo. The presence and dynamics of and ERK activity was determined as the incorporation of[y-12PJATP into a CB, and CB2 receptors in C6 glioma cells were examined by immu- specific peptide substrate(20). nofluorescence experiments.As shown in Fig.2a(A),a quite homo- Statistics. Results shown represent means ± SD. Statistical analysis of gnus signal in the plasma membrane and the cytoplasm was cannabinoid receptor expression(Table 1)was performed by the X2 test.For detected for both receptors in cultured cells.Exposure to cannabinoid the rest of the data.ANOVA,with a post hoc analysis by the Student-Neuman- agonists is known to induce internalization of cannabinoid receptors Keds test.was used. (l, 2, 24). Likewise, upon WIN-55,212-2 exposure, CB, and CB2 5785 ANTITUMORAL ACRON OF CANNABn10IDS A zaao B zow 1500 1500 q� �w 1000 tom 8 a 1 wo � sou Fig. 1.Regression of C6-cell gliomas in viva r° upon selective CBz,=ptm activation.C6 glioma odls were injected ac.in mice when tumors had 0 0 Z . a 8 8 0 0 2 a 8 8 reached the desired size (day 0), animals were treated with either vehicle(0),cannabinoid alone Day of taeatteent Dray of banti.rent (0),®abmoid phis SR141716(0),or caannbi- mid plus SR144528(n far 8 days(n=6 for each C experiments]group).A.JWH-133 admnistranon. Ve dcle JWH JWN+SRI JWH+SR2 WW WIN+SRI WIN SR2 B, WAN-55,212-2 administration.C. examples of ae gliomas in the(lank of mice(top panel)and after dissection(bosom panel)after the indicated t treatments for 8 days.JWH,JWH-133;WIN,WIN- .1- 55,212-2;SRI.SR141716;SRU,SR144528. LA 1� © W D immunostaining,although still observed in the cytoplasm,turned to be cytoma cells in vitro. Immunofluorescence microscopy and Western mote intense in the perinuclear region (Fig. 2a, A). By contrast, blot analyses evidenced the expression of the CB2 receptor in the JWH-133 action was only evident on the CB2 receptor, CB, signal inoculated cells(Fig.2b,A).This particular tumor also expressed the retraining unaffected by this cannabinoid(Fig. 2a. A).Cannabinoid CB, receptor(data not shown).Of interest,JWH-133 administration receptor immunoreactivity was also detected in C6-cell gliomas ob- completely blocked the proliferation of the human astrocytoma(Fig. twined from tumor-bearing mice. CB, receptor expression was not 2b,B).Examples of tumor-bearing mice and of dissected tumors after significantly affected by JWH-133 and SR 144528 administration,but cannabinoid treatment for 25 days are shown in Fig.2b, C. in SR141716-treated tumors, a slight increase in the labelingwas Selective C82 Receptor Activation Signals Apoptosis of C6 noted(Fig.2a,B).By contrast,CB2 receptor expression was reduced Glioma Cells via Ceramide Synthesis de Novo. We have shown by JWH-133,whereas SR144528 inoculation significantly increased it previously that THC-induced apoptosis of C6 glioma cells relies on and blocked the JWH-133 effect. SR141716 did not significantly the sustained generation of the proapoptotic lipid ceramide(20,29). affect the labeling(Fig.2a;B). These observations are in agreement To obtain further evidence for the specificity of the JWH-133 antitu- with the well-known tolerance that occurs after chronic cannabinoid moral action, experiments were carried out with L-cycloserine, a administration(1,2)and finther support the notion that CB2 receptors selective competitive inhibitor of SFr, the enzyme which catalyzes are functional in C6 glioma cells.JWH-133 being a highly selective the pace-setting step of ceramide synthesis de novo(30).As shown in CB2 agonist in our experimental.system. Fig.3,A and B,exposure to JWH-133 induced apoptosis of C6 glioma Regression of Homan Astrocytomas in Vivo by Selective C112 cells, and this effect was prevented by L-cycloserine. Moreover, Receptor Activation. The presence of CB, and CB2 receptors was L-cycloserine was able to suppress JWH-133-evoked SFr induction analyzed by immunohistochemistry in biopsies from human astrocy- (Fig. 3C). We also tested the effect of L-cycloserine on JWH-133- tomas of low(grades I-11)and high(grades III-111)malignancy.High induced ERK activation,as ERK seems to be the downstream target malignancy tumors were diagnosed in all cases as pure astrocytomas, of ceramide in THC-evoked apoptosis of C6 glioma cells (20, 29). whereas some of the low malignancy tumors;were mixed oligoastro- Thus, blockade of ceramide synthesis de novo with L-cycloserine cytomas.However,no differences were observed in the distribution of abrogated JWH-133-induced ERK activation (Fig. 3D), indicating cannalimoid receptors between pure and mixed tumors (data not that JWH-133,like THC,signals apoptosis via ceramide synthesis de shown).A full 709/o(26 of 37)of the total tumors analyzed expressed novo and ERK activation. measurable levels of cannabinoid receptors (i.e., CB, and/or CB2). Among them,a similar pemetrtage of low malignancy(4 of 12)and DISCUSSION high malignancy tumors(6 of 25)expressed CB, and CB2 receptors simultaneously.Of interest,the extent of CB2 receptor expression was Recent studies have dealt with the antiproliferative effect of can- related with termor malignancy. Thus, as shown in Table 1, the nabinoids on different transformed cells. However, this property of proportion of grade IV astrocytomas showing high/very high CB2 cannabis compounds was first reported 25 years ago by Munson of al. immunoreactivity doubled that of grades I—M tumors.Moreover,C132 (31),who showed that cannabinoids may inhibit the growth of Lewis receptor expression was markedly enhanced in grade IV astrocytomas lung adenocarcinoma,B-tropic Friend leukemia virus-induced spleno- compared with CB, receptor expression. megaly, and L1210 leukemia cells in vivo.Although these observa- Given the inhibition of C6-cell glioma growth by selective CB2 tions were actually promising, further investigations were not per- receptor activation (Fig. 1), we evaluated the effect of JWH-133 formed on this area until a few years ago.Nowadays,there are data treatment on the growth of highly malignant(grade M human astro- demonstrating that cannabinoids inhibit the growth of transformed 5786 ANTTMMORAL ACTION OF CANNABINOIDS b A co, C52 Vehicle A Tumor cells cs m u x qR No^^ MW M ® 400 A JYM `o 200 CB, C82 ~ 10° VehicleMM ° 0 5 10 15 20 25 Day of beftwnt JWH C Vehicle •JWH SR2 { JWH+SR2 l� SRI a JWH+SRI Fig,2a.Immwodumacencc analysis of carmabinoid receptor dynamics in cultured glioma cells and m gliomas.Irmges of representative expermnans are shown.Similar results were obtained is three other eapciments for each experimental condition. In A, C6 glioma cells were cultured for 30 min to the absence or presence of 100 ma JWH-133 or WIN-55212-2.B.C6-ce0 gliomas Mice were treated as in Fig.1 for 8 days,tumors were dissected,and immunomicroscopy analysis was paformed Abbreviations as in Fig.1.Fig. 2b.Regression of h®an astrocytomas in Ww upon selective CBi raceptor activation.A.example of CB,receptor expression in a gado IV hymen astrocytoma(HA)as assessed by innormomictoseopy analysis of a rentor section mrd of cells derived from the tumor.Western blot analysis of the tuam was also performed using C6 glioma cells as a control In B. cells from the atom shown in A were injected sa in mice.When tmnors had reached thedesncd size(day 0),animals were treated with either vehicle(0)or JWH-133(0)for 25 days(n=6 for each experimental group).C.examples of s.c.gliomas in the Flank of mice(top panel)and after dissection(bottom parte!)after treatment with vehicle or JWH-133 (JW10 for 25 days. neural, breast, and prostate cells in culture (32) and induce the within months after diagnosis.Conventional therapies,including sur- regression of gliomas in vivo(Ref.20 and the present study).The case gery, radiotherapy, chemotherapy, and immunotherapy, are usually of gliomas is of particular interest because they are one of the most ineffective or just palliative(33, 34). The most recent strategies for malignant forms of canter,resulting in the death of affected patients glioma treatment are focused on gene thempy,but no trial performed 5787 ANTITUMORAL ACTION OF CANNABINOIDS thus far has been significantly successful (33-35). It is therefore A TUNEL C MASE essential to develop new therapeutic strategies for the management of gliomas and most likely to combine some of them to obtain significant IN • ., < clinical results.One of these alternative therapeutic approaches might Yt?ftide be on the basis of the use of no�sychoactive cannabinoid ligands because these compounds induce apoptosis in vitro and inhibition of tumor growth without significant collateral effects in vivo.Because of the current inability to kill target glioma cells with sufficient efficacy ,r to obtain significant tumor regression in the clinical practice, the JWH combined use of drugs that inhibit tumor growth with cytotoxic approaches may be envisaged as the most feasible anticancer strategy U in the near future.Of interest,cannabinoid apoptotic action relies on the generation of ceramide,a lipid second messenger that may have JWH t CS antitumoral properties either alone(36)or in combined therapies(37).We are nevertheless aware that under certain circumstances,can- nabinoids may be immunosuppressive compounds by acting on unim- 6 me organs and cells via CB2 cemptors,and this would be expected to inhibit host antitumor immunity.As a matter of fact,Zhu et al.(38) 100 have recently reported that.i.p.THC injection to immune-competent mice for 4-6 weeks leads to an accelerated growth of tumor implants in two different murine lung cancer models.This effect,although not D evidenced in the former report by Munson et al. (31),was shown to * rely on the CBZ-dependent inhibition of the capacity of antigen i 50 presenting cells and T cells to generate alloreactivity (38). it is therefore possible that cannabinoids exert a dual effect on to rnor V growth,i.e., a direct antiproliferative effect(Ref. 20 and the present study)and an indirect growth-enhancing effect via inhibition of im- munogenicity(38).Factors such as the route of drug administration (local versus systemic),the timing of drug delivery(short-term versus 0 Vehicle JWH }yyH+CS long-term treatment),and the intrinsic capacity of a particular tumor C Orcell to respond to cannabinoids (e.g., presence versus absence of 1000 cannabinoid receptors) might determine the balance between tumor progression and regression.In any event,the present.study,together 800 with our previous observations(20),shows that the antitumoral action of cannabinoids on gliomas may be exerted either via the CB,recep- 600 tar or via the CB: receptor. The attractive possibility of fording cannabinoid-based therapeutic strategies for neural diseases devoid of /0 400 nondesired CBT-mediated psycbotropic side effects is also opened by the possible implication of the CB, receptor in the control of pain 200 initiation(12)and multiple sclerosis-linked spasticity(16).Moreover, 0IN our data support the notion that the CBZ receptor might serve as a Vehicle ,pH S diagnostic marker of glial cell prolifmilion(malignancy,in line with what Valk et al. (39,40)have reported for myeloid cell growth and D * transformation during leukemogenesis. 400 ACKNOWLEDGMENTS 300 We thank J.L.Gil,M.E.Femaodez de Molina,C.Bail6n,C.HernSadei, and J.Palacin for their expert technical assistance.This article is dedicated to 200 Dr.Math J.H.Geelen,outstanding on personal and scientific grounds,on his j retirement as Professor of Veterinary Biochemistry. Y W 100 REFERENCES i1 !. 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De Petrocellis,L.Merck,D,Palmisano,A,Biwgao,T.,1�eaa.C.,Bifulco,M., vectors,a�oncolytic viruses.Exp.Cell Rs..152:1-12.1999. and Di Maar,V.The eadcgmom®abmoid mmehunide inhibits hinnm breast 36..Schmalz E M.,Bushmv,A S,Dillehay,D.L,Sullads,M.C,Liotta D.C..and anter cell proliferation.Proc.Ned.Acad.Sci.USA 95:8375-8380,1998. Merrill,A H.,Jr.Ceromido-s-D-glucmmide:synthesis,digestion,and suppression 18. Sanchez C.,Galve-Ropch,I.,Canova C,Brechet,P.,and Guzmin,M.19-Tem- of arty markers of colon carcinogenesis.Cancer Res.,59:5768-5772, 1999. hydnorannabinol induces apoptosis in C6 glioma cells.FEBS Lett.,436:6-10,199& 37. Maurer,B.3..Melton,L,Billups,C.,Cabot.M.C.,and Reynolds,C.P.Synergistic 19. Raiz,L,Miguel,A,and Din-Laviada,1.d,9-Tcmby&oaanabmol mduces apo- cytotoxicity in solid tumor cell lincs between N-(4-hydnxyphenyl)retmamide and ptosis in h®aa pmstatc PC-3 alis via a receptor-codependent mcehatuam.FEES modulators of ceramide metabolism,I Nall.Caner lose.(Bethesda),91:1897-1909, Le1t,458:400-404.1999. 2000. 20. Gaive-Roperh,1,Sdncha C,Cort6s,M.L,Gdmez del Pulgar,T,b4uiadc,M., 38. Zoe,L.X.,Sharma S.,Stolina M,GaNner,B.,Roth,M.D.,Tashkin,D.P.,and and Guzmin,M. Anti-tumoral action of aMmbimids involvement of sustained Dubinett S.M.d-9-Tenahydmanmbiml inhibits antitumor immunity by a CB2 cermnide accumulation and extracellular agoal-regumted km= activation. Nat mccpmr-mediaed,cytol®e-dependent pathway.L Immanuel.,165:373-380,2000. Med,6.•313-319,2000. 39. Valk,P.J.M.,Hol,S.,Vankan,Y.,Ihle,J.N.,Askew,D,Jenkins,N.A,Gilbert 21. Hous,L,Breuer,A,Tchiliboo,S.,Sbiloah,S,Goldenberg,D.,Horowitz, M., D.1.,Copeland,N.G.,de Both,N.J.,Lbwmber&B.,and Delwel,R The genes Peuwee,R G..Ross,R A,Methouiam.R,and Fride,E HU-308:a specific agonist encoding the peripheral amabinoid receptor and a-L fircasidaa-are located ear a for CBs,a peripheral cannabinoid receptor.Proc.Nati.Aad.Sci.USA 96:14228- newly identified common virus integration site,Evill.J.Viol, 71:6796-6804, 14233,1999. 1997. 22. Huffman,J.W.,Liddle,J,Yu,S.,Aung,M.M,Abood,M.E,Wiley,J.L,and 40. Valk P.J,Vankan,Y.,Joostea M.,Jenkins,N.A.,Copeland.N.G.,L.6wenberg,B., Marta B.R 3-O',I'-Dimetbylb*[)-1-deoxy-delta-B-THC and related compounds: and Delwel,R Retmv'val iaserton in Evi12,a novel common virus integration site synthesis of selective ligands for the CB2 receptor.Bioorg.Med.Chem.Lett, 7: upstream ofTml/Grp94,fiequatty coincides with insertions in the geoemod'mg the 2905-2914,1999. peripheral cannabinoid receptor Cm2.J.Vhol,73:3595-3602,1999. 5789 i iyLlr uL,a and Alemcme: Assess=the 5c ence base aae 1 cr , All=Tri@ MATioaAL ACACEMM EM42 rnerr Farr er=RF33 Mal a EMM PRE'Sr5'emus -ok WHAMM111 smise d bAed�e +Jo7®d; 6 Czmc3 aftica of Nnss and Puwlc luw manse Date. March.17, 1999 16p R"m C 4ntaL15 Dan Quinn, Meds Relations Officer Haus k z0fte Brad Horton, Media Relations Assistant stlance in the Headitm (202) 334-2138; a-rnail <news@naseduw Tire National knid"ies Rp•Fd Ee.�ice EMBARGOED- NOT FOR PUBLIC RELEASE BEFORE 11 AAI(_EST Raparts&E>ems WEDNESDAY. MARCH 17 Ths page is Madjuana's Components Have Potential as Medicine, bythe %nonan Clinical Trials,Drug Development Should Proceed Academies Office- News News and P WASHINGTON'—Marijuana's active components are potentially ice, effective in treating pain, nausea,the anorexia of AIDS wasting, and - other syrnptoms,and should be tested rigorously in clinical trials, i�aeff according to a new report from the Iraffl ute of Medicine(IOM).Such trials should be carried out in parallel with the development of new Jmdw roam delivery mechanism for the drug that are safe, fas"cting, and reliable, onam produce but do not involve inhaling harmful smoke. Moreover,clinical trials of marijuana use should be approved by institutional review boards, and Contact us may e-nmt should involve only short-term use among patients who are most likely ne n@mrhedu to benefit from treatment. "Manjlsana has potential as medicine, but it is undermined by the fad that patients must inhale harmful smoke'said Stanley Watson, co- principal investigator of the IOM study, and co-director and research scientist at the Mental Health Research lnsL� University of Michigan, Ann Arbor.'Until researchers develop a safe and effective delivery system, caregivers must consider the health problems that can result from smoking when deciding whether to recommend marijuana to patients.° Voters in Alaska,Arizona, Colorado, Nevada, Oregon, and Washington approved referenda in 1998 in support of the legal medical use of marijuana; California passed such an initiative in 1996. Public opinion on medical use of marijuana has been sharply divided.To help illuminate the policy debate, the IOM examined all relevant scientific evidence and found "substantial consensus"about the drug's potential effectiveness, as well as the health problems it can cause.. Marijuana is a powerful drug that produces a variety of biological effects. While the most common effect is euphoria, it also can lower a user's control over movement and cause occasional disorientation and other ® _ unpleasant feelings. Some chronic users can develop dependence on marijuana,though withdrawal symptoms are relatively mild and short- lived. hup:i/www4.naTionzlacademies.org/newsmsIT&cn/0309071550?OpenDocument 11/27/1999 Mars urn and Meic=-ne: _kssessma the Science Base p^Qe 2 0`3 The usefulness of medical marijuana is limited by the harmful effects of smoking,which can increase a person's risk.af cancer, lung damage, and problems with pregnancies, such as low birth weight. Therefore, smoking marijuana should only be recommended fortenninaily ill patients, or those with debilitating symptoms that do not respond to approved medications,the report says. Beyond the harmful effects from smoking,g, however, the range of problems associated with marijuana is not out of line with those of sum used in adw medicines. Pois:rrtlai Uses "Marijuana's medical effects are generally modest, and for most symptoms there are more effective medicines already avaRabte on the market"said co-principal investigator Jahn Berman Jr_,dean and professor of medicine emeritus, Oregon Health Sciences University School of Medicine, Portland.'For patients who do not respond well to other medications, however,short-term nanjuana use appears to be suitable in treating=riditions like chemotherapy-induced nausea and vomiting. or the wasting caused by AIDS Data do not support the contention that marijuana should be used to treat glaucoma,which is one of its most frequently cited medical applications. Smoked marijuana can reduce some of the eye pressure associated with glaucoma,but only for a short period of time-These short-term effects do not outweigh the hazards associated with regular long-term use of the drug.Also,with the exception of muscle-spasms in multiple sclerosis there is little evidence of its potential for treating move hent disorders like Parkinson's disease or Huntington's disease, the report says. For people with chronic conditions and no alternative to smoking marijuana, one approach would be to permit them to smoke marijuarta on an experimental basis, fully informing them that they are experimental subjects and are using a harmful drug delivery system. Their condition also should be closely monitored and documented under med'ual supervision,which would increase what is known zibm the risks and benefits of medical marijuana use. For these and other patients. cMcah trials should be designed to study the psychological effects of the compounds in marijuana, such as anxiety.radudion and sedation,which the report says are probably important detemii,im of the drugs' potential therapeutic value. Futrue Drug Development The effects of marijuana derive from a group of compounds(mown as cannabinoids, including THC, the primary psychoactive ingredient of marijuana. Some compounds ad on cannabinoid receptors that occur naturally in the body,where they are involved in pain, control of movement, and memory. Cannabinoids also may play a role in the immune system,though that rote remains unclear. Knowledge of cannabinaid biology has progressed rapidly in recent years, pointing the way to new, potentially promising avenues for drug development. Basic research has revealed a variety of cellular pathways through which potentially therapeutic drugs could ad on cannabinoid receptor systems. Such drugs might include chemical derivatives of plant-derived c annabindds, of those compounds that occur roturally in the body, or even of offer drugs that act on the cannabinoid system. The only cannabinoid-tased drug an the market, Marinol, is THC in pill nttp://w-ww4.nationalacaden,ies.org/news.nsfFisbn/0309071550?OpenDocumem 11/27/1999 li�t:ara and-Medic= A.s�g the �ren�Base pane 3 of fi:rrrr.-Its pp aroved Ly the FDA far nausea and vomiting aid wr�h cue spy, as well as for snore da and weight loss ossa iated.with AIDS. For drug development, cannabinoid compounds that are produced in the laboratory are preferable to plant products because#ieyr deliver a . consistent dose and are made under mnhdled concttiors. Research should contirnte into the physiological effects of both synthetic and plant derived compounds and the natural fundian of those found in the body, the report says.New drugs w7l only be developed from rnaryuarra's compourttts if public investments are made in research,or if the private sector has enough incentives to develop and market such drugs In addition to the medical questions,the IOM was to assess off" issues mated to mar*mna use.The report says that although nuartjuana use often precedes the use of harder drugs,there is no corrdusive evidence that maryuana ads as a'gateeW drug that actually causes people to make this progression.Also, there is no evidence that approving the medical use of marijumna.would increase its use among the general population, particularly if marnuarra were regutabed'as. closely as other mediations with the potential to be abused The study was funded by the Office of the National Drug Control Policy, Executive,,Office of the President.The Institute of Medicine is a private, limo-profit organization that provides health policy advice under a congressional charter granted to the National Academy of Sciences. Pre-pubficafion copies of Wariivana and Meuane:Assessirg the Science Base are available from the National Academy Press at the mailing address in the letterhead;lei. CAM2)3343313 or 1-80G-624-6242- The -800524-6242The cast of the report is$44.95(prepaid) plus shipping urges of$4.50 for the first copy and$.95 for each , 1 5 o rat copy. Reporters may obtain a copy from the Office of News and Public Information at the letterhead address(contacts listed above). Ccp. o r"0 Naffmad A=d�r Zi sae. AM dgim reared THE N i4M ACAlrME4 CME9 Pa84sa8ons MMCWMS SZWCr Mb Map Fea bad http://www org%newsn rain/0309071-:50,-70pcnDocumm 1IP-7/1999 o,nc�nc�ctm p� Page 1 of 2 • •NLINE :�" MEbLINE0 r. Title Medical marijuana and its use by the immunocompromised. Author McPartland JM; Pruitt PL Address Vermont Alternative Medicine in Middlebury, USA. Source Altem Ther Health Med, 3(3)39-45 1997 May Abstract BACKGROUND: Those immunocompromised by AIDS or cancer chemotherapy use marijuana to allay symptoms of their disease or treatment. Some researchers believe that marijuana may further suppress the immune system. A list of immunological hazards that may be present in marijuana was collated and assessed, and clinical recommendations regarding the use of marijuana by immunocompromised individuals were made. METHODS: Databases and other sources from 1964 to 1996 were searched using keywords (e.g., cannabinoids, cannabis, hemp, marijuana ). This was supplemented by a manual search of bibliographies, nonindexed books, and journals, and by consultation with experts. All reports were analyzed for antecedent sources. Data validity was assessed by source, identification methodology, and frequency of independent observations. RESULTS: Substances implicated as potential immunological hazards in marijuana include endogenous constituents(cannabinoids, pyrolyzed gases, and particulates) and a longer list of exogenous contaminants, both natural (fungi and their metabolites) and synthetic (pesticides and adulterants). CONCLUSION: Burning of marijuana creates toxins of combustion. Particulate.toxins (tars) are reduced by the use of vaporizer apparati. Gas-phase toxins are filtered by water pipes, but water pipes also filter some tetrahydrocannabinol, making this strategy counterproductive. Viable fungal spores in marijuana pose the greatest hazard to immunocompromised patients, though they can be sterilized by several methods. Pesticide residues and other adulterants may be present in black-market marijuana ,but are absent in sources of marijuana that are approved by the Food and Drug Administration. Language Eng Unique Identifier 97286104 MESH Headings Cannabis * ;Human ; Immunosuppression * ; Immunotoxins ; Plants, Medicinal * ; United States ; United States Food and Drug Administration Publication Type JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL ISSN 1078-6791 Country of Publication http://www.infotrieve.com/freemedline/cgi-bin/std_format.cgi?med95-97+439707+(ma...:MH 10/27/99 All Aiounders 23' States are Jamaica,Brazil,Belize,Gua temala, Trinidad, and Tobago. In Asia Thailand, Laos, Cambodia, and thi Philippines are big growers. In Afiia • and the Middle East, Morocco, Le bacon(greatly reduced in recent years) Nigeria, and South Africa produce mostly Cannabis indica. In southwes and central Asia,Pakistan and Afghan. istan are the big producers(DEI,,1998). The average street price of mari- juana in the United States rose steadily from about $6 per gram in 1981 to t peak of about S18 per gram in 1991 (Fig. 6-3). Retail paces fell over the This indoor marijuana- next decade but began to level off tc growing operation was abort$10 per gram from 1996 to 1998, busted by JACNET a drag Since the common unit of sale for mar- taskfom-e run by the%mFs ijuana is one ounce(called a"lid"),the Depa rmmit in Jamison average street price by the end of the *County, Oregon Grow= 1990s was about$300 per"lid"(ONDCP, can use grow lights or fel- 1999;Marzwl1997) tared sunlight to avoid detec- aan by law�ar`me7 t PHARMACOLOGY 4Senaes or passers-by ...................... At last count researchers had dis- covered some 360 chemicals in a single Americans grow their own maajaana, (in water)gruwnng of marijuana has lei Cannabis plant.At least 30 of these either a few plants for their own use or to very high-potency plants grown all chemicals called "cannabinoids" have hundreds, even thousands for large- aver the United States, from Maine to been studied far their t psychoacactivetive of scale dealing. Because of stiffer penal- Alaska(Marcell,1997).Worldwide,mari- facts. The most potent psychoactive ties and greater surveillance by law en- Juana production is widespread. Some chemical is considered to be the forcement agencies, more growers are of the major growing countries in the cannabinoid called "" When smoked moving their operations indoors. western hemisphere besides Mexico, or ingested, or`"IHC." When smoked The indoor and even hydroponic Columbia, Canada, and the United or ingested' thus potent psychoactive cbemir..11 is converted by the liver lino over 60 other metabolites, some of which are also psychoactive.In addition the widespread use of the sin_emi la- Ma ijuana gage Prim 1981-1998 . growing technique has increased the (Average price,only-no pota=y data) average concentration of THC from 1-3%in the 1960s to 6-14%in the late gZ5 a '70s, '80s, and '90s (DEA,1997). Mgh- y _ mon THC marijuana has been arodad for many years—t just hasn't $10 What this been so readily available. s _• * '2 means is that a user world have to '"3 r' smoke 5 to 14 of the weak`Joints"from 65 � , z `r} the 1960s to equal Just 1 of the stronger joints" available in the 1990s. Unfor- r Umately many of the early studies on 81 82 83 M 85 86 87 M 89 90 91 92 93 W 95 96 97 98 marijuana and many of the attitudes of -Year the counterculture about the effects of the drug were based on the weaker .. i Ure 6-3 • plate.Luckily there has bees a great in- maryuana be=m so expensive in the 1990s that heroin was used as a means to spike cheap crease in research over the last few years mar*uana "joints,"so the buyer thirds it is the more potent variety(ONDCQ;1999). using the higher-potency marijuana- wou/dsit there with a' e SHORT-TERM EFFECT,., sperm motility in chronic "pot" us, eta/p pe ad a hlce sack of b j Physical Effects ('dam rt al., 1998; rey, Watson, & Bens, GAranic ha /nsand fry to su.low Mach 1999;MsaeLL 199 . tt/cou/dsmoktandbasica/ / euro The immediate Physical effects of marijuana often include physical relax- Mental Effects "WHY ail ation or sedation, bloodshot eyes, tht�loor %veJat thePiPc rn my band coughing from lung irritation, an in- Within a few minutes of smokir /eat+barely keep my ryes°Pen,and/ crease in appetite, and a loss in mursw-, "'jam the user becomes a bit ca lar coordination. Other physical effects fused and mentally separated from tl assume fhatt6rat's as h jb as/m I environment. t Produces a feeling c Jain-f �" include an increased heart rate, de- J.o -f 9 creased blood pressure, decreased pres- I deja vu where everything seems familL sure behind the eyes(Marinol®capsules but really isn't. Additional effects i oe marijuana`joints are used as a treat- clade detachment, an aloof feeling Marijuana Receptors & meat for glaucoma), increased blood drowsiness,and difficulty concentrating Neurotransmitters flow through the mucous membranes of In 1990 at Johns H the eye resulting in conjunctivitis or red /ts kurd llke l' wrlhnut a colrerert °P U�'�- eye, and decreased nausea (capsules 1*,9 fk 1ts,6W likeanescape /f's sity,receptor sites in the brain that were and`joints"are also used for cancer pa- G e svhar ou o to specifically reactive to the THC in mar- y J aP,y°u�rJ� � y treats undergoing chemotherapy)• abut fhin s/fs like et'A+ Aimy0 ijuaaa were.discovered(Howlett,Evans,& �•� . J Houston 1992). This discovery implied J impairs tracking ability dreanrlrkt an o(Jhgre ars no res6aurts (the ability to follow a moving object, that the brain had its own natural neu- such as a baseball)and causes a trailing an arytbur9 you rmr hate freedom to rotransmifters that fit into these recep phenomenon where one sees an after- sa}� atyou want tosa)a". toe sites that affected the same areas of image.of a moving object Impaired the brain as marijuana tracking ability,the trailing phenomena, In 1992 researchers at the National and sedating effects make it more difii- Stronger varieties of marijuana can Institute on Drug Abuse announced the cult to perform tasks that require depth Produce giddiness,stimulation with in- discovery of anaadamide, the natural perception and good hand-eye coordi- mrased-alertsiess,and major distortions neurotransmitter that fits into the re- nation, such as flying an airplane, and perceptions of time, color, and ceptor sites (Devine,Nanus Sinter, a re catching a football,or driving a car. sound Very strong doses can even peo- f un Receptors for anandamide were duce a sensation of movement under found in several areas of the limbic s- Marijuana can act�a stimulant as sY well as a depressant depending on the ones feet, visual illusions, and even tem including the Ply cen- variety and amount of chemical that is hallucinations. One of the most fre- ter. Other parts of the brain with anan- absorbed in the brain, the setting in quently mentioned psychological prob- damide receptor sites are those which it is used, and the personality of leafs with smoking marijuana is para- regulating the integration of sensory the user noia and a deeper depersonification experiences with emotions as well as (detachment from one's sense of self). those controlling function of learning, lMar uana is nota Wowner for me, motor coordination, and some auto- its a speed syrixJ /hamp6rfy o f R/i/keye s nokin�and keep smaki t� ananmatibody f receptors The presence of fria+ds urho smoke uarra and and��`smokix and/'d et a►rr- anandaatide receptors means that these nary Y'1 9 J P are the areas of the brain most affected become yuiei Tbty can?jmk #Writ!/fyou'rt not relaxed axd lravrny by marijuana It is important that there fie}'biome immobile T5icy're tots/ fis{y rtsMms rainy Insane to keep are less anandamide receptors in the Wiere4you,6WW,sd.Yi#Yamundand dou!fd And/didkertod°inJd for brainstem for marijuana, compared to canna MV,W, whereas/become mare a loo trine /had k " kephalin receptors for opioids, and �9 " stn►ted dtvelaP- ^� IIorePinepbrine receptors for cocaine in that Part of the CNS (central nervous system):Since involvement of this area Marijuana also causes a small tem- of the brain that controls heart rate,res- sloe most psychedelics the mental porary disrupti°n of the secretion of the effects of marijuana are very dependent piration, and other body function, is male hormone testosterone.That might on the mood of the smoker and the sur- the reason dangerous overdoses can be important to a user with hormonal ro occur with cocaine and opioids,it hel s Maj a acts somewhat as P imbalance or somebody in the throes of a mild hypnotic. Charles Baudelair,the explain why is so difficult to phYsi- Puberty and sexual maturation. The nineteenth century French poet, re- ij aL, overdosea withh marijuana(SmSh et testosterone.effect also results in a fen-ed to it as a"mirror that magnifies.- � 199a). slight decrease in both sperm count and It exaggerates mood and personality All Arounders 235- and makes smokers more empathetic to and/or leaves are harsh, unfiltered u- rzylrt behind the wary!a a.As soon others' feelings but also makes them regular in quality, and composed of as/gat done with a joint'or two, 1W more suggestible. many different chemicals. Therefore, smoke et rid when it is inhaled and held in the lungs, a cardte to g °ftyre Ixtean somcawes, in somerelatron- smoking four to five "joints" gives the smell Then Wide it from my wi fe helps mein think about and same harmful exposure to the lungs and andoo outside axd smoke outside on ,„sybe/come up with a sa/ution for my mucous membranes as smoking a full the perrlr or outside ix my woodshu(." Pmb(em or wlrahmrrbid somekma nt pack of cigarettes according to studies , ,/d MWL_r by Dr. Donald Tashkin at UCLA urouldn'4 Sousa vayhad and fordh (TasWdn, si:irrions &Clark, 1988, 1997). For In the series of slides, the normal iOedeal, ttGould o either these and other reasons, a major con- y V. ciliated surface epithelial cells in the Aso cera of health professionals is the dam- mucous membranes of a nonsmoker of aging effect that marijuana smoking has either cigarettes or marijuana (Fig. Marijuana disrupts short-term on.the respiratory system. Marijuana 6-4a) show healthy densely packed memory but not long-term memory. smoking on a regular basis leads to cilia that clear the breathing passages symptoms of acute and chronic bron- of mucous,dust,and debris. •al be do 'oand aU sud- chitis. In microscopic studies of uuJ the/ b �a idif th The breathing passage of a chronic /en!illook up and freere and not mucous membranes, Dr. Tashkin has smoker of only marijuana (Fig. 6-4b) found that most damage occurs in the know what to do./wouldhave.a shows.increased numbers of mucous- handfulofchecks in myhandandjust lungs of those who smoke both ciga- secreting surface epithelial cells that do rettes and marijuana.This is significant not have cilia, so phlegm production is lack at the nwcAine fora while and because most marijuana smokers also ,��u��and increased but is not cleared as readily last drink to mysal f smoke cigarettes. from the breathing passages.The resull what do/do with it?'A is increased coughing and chronic bron- ,2-)=r-%/riWI t Amryr aAa.dGet -It s just hke ci9arettem/.starts( chitis.Some of the changes involve the smoking ugarettes at the aye e13 cell nucleus, suggesting that malig- The loss of a sense of time is re- sponsible for several of the perceived effects of marijuana Dull repetitive w '� jobs seem to go by faster. In Jamaica some cane field workers smoke"ganja" (marijuana)to make their hard monoto- nous work pass by more quickly.On the other hand students who smoke mari- juana while studying get easily bored and often abandon their books. The effects of mental confusion, distortion of the passage of time, im- paiedjudgmant, and short-term mem- ory loss result in a user's inability to perform multiple and interactive tasks, like programming a VCR,while under (a) (b) the influence of marijuana (wilbus, Frgart 6-4 Conner, & Gorelick, 1998; joy et sl., 1999; (a)Healthy mucous membrane of non- M=rA 1997;Stafford,1992). smoker. LONGTERM EFFECTS (b)Mucous membrane of a marijuana smaker Respiratory Problems (c)Mucous membrane of a man jumna and crgwvae smoker. THC is a bronchodilator, it opens. Courtesy ofDt DonaldTashlca Ch1et; up the airways, at least initially. As polruaa y Remeaach Department,UCLA smoking becomes chronic,so does irri- Medical Center,Lm Angeles tation to the breathing passages. Because marijuana is grown under a wide variety of conditions and is unre- fined, the `.Joints" made from the buds (c) aaacy may be a conseo---ice of regular aur stop " marijuana smoking sii Mme of these q y yet edbe�°re i\_ y Well when/u,5eW w d' ou knc changes are precursors of cancer. h,7wework-you re never9oirry to qd like/was really depresse /was your homework done" % "%m sure I'M done same damage to my Hjh sdmolsG.da t `may a`_f�r/y�'deMybody-=-like M hwf-s /mea,;you can?put that kind `lam"rd's%you mow,/was1ust' oftardowninyourrystr heatedtar Marijuana bas been shown to slow 4,9ryaeMewrr/d//ratedmyself aril imfo our stem learning and disrupt concentration.Part wanted to commit saicide!was so 9 9 y sy constant�yfnr of this influence comes from Mari- hawser ustsmo %re Z3yearsandsithere axWsaydrozs juaaa's effect on short-term memo /`oto nvdr' wro andnath' Short-term memo memory '�Of`�1W5hW1 ' � ' "J `9 my�d memory, in contrast to hed iveittomG ydads weed°r happened swysom,-66fhas long-term memory, is a processing of 9 happen�r information to be retained for only a shorteriod of time, such as a grocery � a P en come to de proper assortment users properPassortment of tools fora Pend Finally certain job, or facts crammed into the this method for gaining pleasure passage of a chronic marijuana5 4c) and cigarette smoker ghead for an upcoming exam.Marijuana avoiding Pain rather than learning b gay intPpersons abilit shows thar the airs ato receive Pleasure and satisfaction a normal sury TO re ` orally or face rip to and deal w face cells have been completely re- tam mf°rrr�ahon. However, it has: Pied by nonciliated cells resembIin �'little effect on long-term memory, painful situations directly,they w$1 I skis,so the smoker has to g which is the Processing and o f bitttate their minds and bodies to tl mucous from the lungs smm the to clear cilmied information for a long period of e, chemical solution. cells are gone. This leads to acute and such as a theory in Physics that has "/( (ty dO Asa much chronic bronchitis. Mari been studied for.several weeks.This ex- it's like, Nana and mga- plains why some students have been why not do¢?/cov*1d+r't fi+rda reason retie smokers also have a able to maintain ood rides while creased risk for developing c of g g NOt day a/t was too en�oyafi/a the tongue, cancer of the. using marijuana on a regular basis /t was like a" cancer of the lung(Soy et y� 1999;1azras ;n while others end up flunking out Mr., rr�riyeraEor andsm Ig�laakeeimf ,,�40 oyoour 1999;Tasbkiq 1987;Wilkins a aL,1998). Massaro, L996). cream arida thin Hersh �a Although more research is needed y� ry Immune System into what some researchers call an c1r°calatesyryandyou3 No, /'m "amotivational syndrome,"a number of 9°r"y tO hama k-an M"Oul in s/iad Some evidence suggests that heavy patients treated at the Haight-Ashbury Why?Y014 can have ice cream and the use of marijuana can depress the mi- Clinic for marijuana addiction do show mune g users more sus- system making a lack of motivation. They have a ten- C-4oco(atesyrupri raK Thais wlratyou ceptible to a cold,the flu,and other vital icy to avoid problems, u'apd '•AI All tyoa have d infections. If such were the case, it would he a mistake for people who are `)'ou know how fhl y tej/you, v to already immune depressed, either as a 5O°l to yet an education ser ou can Since marijuana can be"the mirror result of AIDS or as a result of chemo eta oad ob?Th y that magnifies,,' smoking often exag- therapy for can=cer, to smoke man 9 y / ry did tell me haw to Berates natural tendencies in the u� for Nana yeEa job,so tis /rthours a day Thus if a person really isn t interested =suppressing a. The smoker is /tinea.how to sly, that's eiylrf'haurs in working,studying,having a relation- further suppressing an already de- pressed immune � g ad /hadamd1weiy ship, or reading a book and smokes sYscem and sin �' hihaurs a day the lungs to pathogens, such as fungi :d✓drdn'tknow how to ftllarrd/ marijuana, his or her primitive brain is and bacteria,found in marijuana smoke. aced m uana to //{haul given the edge over the new brain and H°wCVcr,thehealthimpactofmarijuana how,s " /~ 7"` says, You don't have to do those on the immune system remains unclear P LOd things° So rather than the new brain, from lack of definitive research(Soy of ai., _a3F^&N&,,dm, the neocortex,giving guidance and say- 1999;1101b t ,1992) in& "These are necessary things that The way this mechanism operates You're going to have to do,"the primi- Learnmg&Emotional is similar to the effects of other.psy- tive brain takes over and says, -Forget Maturation ch0active drugs.What happens is that a it,let's not do this." drug can be used as a shortcut to a /f�O4yo/tome andlravehomework to Plosing Physical sensation or as a way "Whe"/yothayh/thought/was tfie nyhtandyaa say pK �„r to counteract boredom or emotional Pte' smartestperson in 46e word/knew/ /rad the answer to eve7E6ry and one All Arounders 243 down widr du tape records pie who, after experiencing a bad trip, don't come all the way down and may Mlu�a—Blood Level Versus rattling o f�'a/l t{tis brit- Urate Level(a roximations) and!started have problems going on with thea lives. ,once that/had and dee next day They experience continued confusion, who/woke up in the mornix9 and/ concentration difficulty, memory prob- it bacA it was almost like/ lems,and feel as if their mind is always Waso,t even speaking bty/tsh.' in a fog. BLod .V,W" M'�01T""9f01f "`m'�" ' '/was w,,( with a T3 year-old With marijuana many thoughts and dtent who had no premorbid symp-- e feelings are internalized. Long-term toms that could he idenhfWW prior tr marijuana smokers feel that they're has fjdt birthday when hrs friendsthinking, feeling, and communicating /hitoa %aneyb/wxfbetter but often theyre not whirl,is a ciyarpacicedwits marl-sans soaked in bon and triol ft _ 0 20 30 `When/have worked wA couples � enea(to be honey an sirtenil(a Days after��tg when ane a f dteprfnaipalPartners in aPP '�' y Ike rda6anship leas been using marl- and ha axperieneed an acuie anxiety Figure 6-5 lua"a for a long perrod o f Limy the ►=mon followed by a past-ha(lucino- This chart shows.the blood and urine levels exit drsarder indud- of marijuana over time The mariltrana per- Jiy complaikd is that He never i "9P� sists in the urine longer.Most drug testing s 'or Slhe neve s i++if aPira faand dyaressmn an-Wan in- ,telly only measww marijuana ability w coneerttrata we don't know in the urine thing. we don't talk We don't wwmu- haw/any these problems will 14A M niudz'8at far dee maryuam user, dratperson fats sultan they',ander �Sdr.�jk-�ary��^" some physiological, mental, and emo- dw ut ce that fey arc 9 to tional functions for a longer period Even seasoned veteran smokers comman4w&So the inteitims are who've been smoking some low-grade Rq1thdrawal there,dee �s arc diary and the "pot" and then get some strong "Buddha Tbae'smseniilla may feel that Because there is not the rapid onset tinotions are Chert but its' al/internal of withdrawal from marguana as wit, .y delic like PCP or LSD. Th begin to alcohol or heroin, many P y somebody has.slipped them apsyche- people/t"ever cis out to 16,otherpersan. p den) /da,p&Da„aa4 cawsebr, �DeA" experience anxiety and paranoia that that withdrawal occurs.The withdrawal then create more anxiety than what from marijuana is more drawn out be. they were feeling. Eventually they cause most of the THC has been re. Acute Mental Effects could have an acute psychotic break. tamed in the fat,cells and only after r period of abstinence will the with. Lasting mental problems from drawsl effects appear. short-term use are unusual but in some- TOLERANCE,WITHDRAWAL, brie with preexisting mental problems or &,ADDICTION Someirria people who've bean smak- with latent emotional problems,pardm- Tolerance in,y for jSz yea's decide to quit They larly if marijuana with high THC levels is smoked, acute anxiety or temporary Tolerance to marijuana occurs in a stop ony two, dh6eeday4 even a week psychotic reactions can occur (NDR, rapid and dramatic fashion. Although and they say*dd4 those who 1997).Individuals believe that they have- high-dose chronic users can recognize think maryuana is benign),_'wow, lost control of their mental state.There's the effects of low levels of THC in their l falgreat Mwr ana's no problem. often paranoia or a belief that they have systems,they are able to tolerate mach /have no withdrawal les,wiring at severely damaged themselves or that higher levels without some of the more ally Oya in. May their underlying insecurities are instr- severe emotional and psychic effects mountable. These acute problems are experienced by a first-time user. never experience witrdrawal We usually treatable but what is problematic One great concern about marijuana ser that wit/rdrawa(.ymptoms to is when the symptoms persist Coun- is that it persists in the body of a mar�xana are delayedso►netiwtes selors at the Haight-Ashbury Clinic chronic user for up to three months farseveral woks to a,na►tdr it fora have seen a number of cases of what though the major effects last only.four mcdicino calls a "post-hallucinogenic to six hours after smoking.These resid- person stops drug perceptual disorder" where peo- ual amounts in the body can disrupt Cwsder,Ha#t-Ashba7D,mxc&nw The delayed withdraws``{'ects of mar- that marijuana depends occurs bu s_, ijnana include more rapidly thank BK4)'� wii me /�ust P Y previously sus- 0 anger or irritability and aggression; pected. This experiment, which com- xvtsz�p 0 achespressed the withdrawal to minutes in_ �""-°�'�"R"9"�Y' =ddut per'cam' stead of weeks, allowed the addictive 0 depression; potential of cannabinoids to be more Finally all available researc 0 inability to concentrate; clearly understood.(Aceto,Seater,Lowe,& manluana was based on a THC cal 0 slight moors; Martin, 1995;Rinaldi-Carmom et aL, 1994; tion of 20 mg per marijuana riga 0 ceps Tsou,Patrick,&walker,1995;NIDA,1995), (considered in the 1960s to 1 Further, human studies have high-dose exposure). Current n 0 decreased appetite; demonstrated rapid eye movement Juana"joints"used forreseatch cor 0 sweating, (REM) sleep changes similar to those 40 mg of THC, still below most E 0 czaving. seen in other drug addictions.They in- Wit'street`Joints"but closer tba clude decreased REM while smoking the P� (The marijuana for these Not everyone will experience all of marijuana and increased REM timing petal "' ims" , grown ata 1 these effects but everyone will expert- withdrawal. ernment farm in Mississippi) ence some of them, especially craving_ Recent human research demonst-dlad Addiction '7he m z61,pr4&m we're dea/uty un that irritability,anxiety,aggression,and a that tndays potdrt farm o evenstomachstomach pain caused by marijuana al 440uydt/could4oM6ro1rtdecaase �uaxa rs causixy a lot moreprnble„r withdrawal occurred within three to "al/make up ur the marxdny/ thaw we sau,w the 196oa /never seven days of abstinence Xowi et al., drdx'tydhi hArtlre frrstlruuranda &ratedasixy/emarywoxase f 1999;Haney et aL,1999). duff. l fry"Yedax hourana a half— adrxdttrdaddictix the aim&throay `/worddbreak urfo a sweater the thatpr°ves that/'m Rd hookedox thds out the $O'ftar the '705 axdpretiy shower. /could Drat maurtadx my because/dax'treaf e xeul tit 8y meed dhr7uyh the Bos buddy t/re/ai coxtexiratiox fur the fust maxed or ilre.sanre token, 7x40/smoked that 804 we star�5*%c ypeop/e comury iwa. To really treasure mysodr:ef�;tt /°" l did noisome back down m• i`veryme of them came dx an thedr took me about d rre or fear months uxtdl/woke up` own v7/dtdo4 sayury Help me/wait before/really came auto fthe f°y and R"""`"9 AW`"m'^%""'°A" n wp to stop smokury pot'/tis ucusdx9 me rea!!y startedyettixy a yras7°f wdm` these pmdlems,causing me to hate was youry OR around me` The 1990s have made us take a dif- me+xoryprodlem4 causLiy me to be to ferent view of the addiction potential of spmccdO"4 not to function in my war, this substance. Today many people /cax'tcoxrpfete UsL/ts causury me The discoverysmoke the drug in a chronic, compul- to do stick ur the morrtury and cough / by ist that scientists sive way and have difficulty discontin_ in blocks c an antagonist that instantly have wiflydrawalsymptoms /want to blocks the effects of marijuana enabled umg their use.bike cocaine,heroin,al- cobol, nicotine, and other addictive stdvAE"d/ca'rtst°p.'At ourp r1ram researchers to search for true signs of tolerance,tissue dependence,and with- kgs' marijuana does have the ability ur Sax Francisco,we now have adaut drawal symptoms in long-term users. to induce compulsive use in spite of the 100 patitxts every m7xth ur/ro are ur Experiments detnensuated that cessa- negative consequences it may be cans- tion of marijuana freatnrextspecr fia/�!fo. ,,tar�,ra„Q rue could cause true m the user's life. adclu�zox So people who claim that physical withdrawal symptoms. Dr. ' am/dom uaxa cs harmless have to sit ' Billy Martin of the Medical college of �ifrds. Whats wrox y do�anti/britt to tlrasc eo Virginia gave the THC antagonist rim me?Wh'V We/have to keep dowry 'v ple ui{r"0' SR14176A to rats who had been ex- h67Axd/ddbibis farayo7dB—to Atrr&C""`rdf4wIZdWeeaffJhe Posed to marijuana for four days in a guru /used to buy rt dy yu pow "W"swou+rded or the casualties MW The antagonist negated the itr - and ihex/AIw4rallira wkle&at/ film ma+3uana use. For Mem mart= ence of the marijuana Within I0 min- w"&WJV mai derox C � %""a has ta"MWsomeproblesxs— utes the rats exhibited immediate phys- "ry""/ not ro orotder eo !e tr/!' l withdrawal behaviors that included . smoke So/started duydxy bunt bays, s pmblc,s e tdry it bag shakes" and facial rubbing, fy"►�r9 rt would cost a lot mora andhue rich is the rat equivalent of with- tlrur e✓urtua// / 7t to the Dort tkemselves "r9 ds so.` . These-experiments indicated where itds6Jir'tworkljustkyptox bw7"Ifik D 170Hm�e'A6.y&zr ARAroanders 243 is!Marijuana a Gateway Drug? In antidrug movies like Reefer Madness and Marijuana, Assassin of °�QlllitF6nM _ Youth, the claim was that marijuana physically and mentally changed users, ed using so they start g heroin and co- Caine and became helpless addicts.The exaggeration of this idea led to an un- . dermining of drug education because people who smoked marijuana didn't `' d become raving lunatics or depraved o 1 dope fiends. The experimenters who had tried marijuana said,"I tried mari- juana and that didn't happen,so I guess 00 they're lying about all the drugs" J� This exaggeration and resultant ridicule, particularly by the younger — generation' of propagandistic or scare er SMon TWo 30114TS AND GALL ME IN TNS MORNIKG..." films and books probably caused more drug abuse than it prevented.It also ob- scured an important idea, that is, the BILL SCHORR Reprinted by permission of United Feature Syndicate,Inc. real role marijuana use plays in fixture a ...........I........................................................ drug use and abuse. 'I've snrakisry iucec 'they'rz snrokixy zau�' but it�T�not very plentiful.)Lust as bern to a 1Z-SJrFprvyr'am the refinement of coca leaves into co- [&znw its AmanymousJ1or a Iddc °r`{yin "'y'/m notsayur_f thry .,, Caine and opium into heroin led to omr s6gwrs axd/m not yoiny to say an had omp/e but Md s jkd how it 1k gear abuse of the drugs, so have bet- 307=r^nWf4drmy•w1 IJdv 'J f- 7 ter cultivation techniques increased the like one and orre eyua/two but jusi ,&,F. 4 4f dWI#Jrg compulsive liability of marijuana use. about evn yhody/mut to the 72-styv There is also an increase in the practice program started out wdh athtr Viewed from this Perspective, it is of miixing marijuana with other drugs uarra or not surprising that most users of other like cocaine, amphetamine, and PCP. r IVY illicit drugs have used marijuana first �_vj,5x"'I"""`� but only after they began using alcohol Some users even smoke `joints" that have been soaked in formaldehyde and m the and or nicotine (Joy at al., 1999;K=tw& embalming fluid ("clickems") or even Marijuana gateway drug Yamaguchi, 1993;Kandel,Yamag=hi,& en sense that if people e smoke it, they will Chen, with Raid Roach Killer® probably hang around others who 1992)' ("canaid')for a bigger kick smoke marijuana or use other drugs,so MARLTUANA(Cannabis) & the opportunities to experiment with Marijuana,Driving,&Drug TEUE LAW Testing other drugs are greater. Incidentally the history of most addicts clearly Marijuana is one of the drugs that In more.and more arrests for reck- demonstrates that the first drug they has never been out of favor and is still less driving or tests at the scene of an ever used or abused was either tobacco popular at the start of the twenty-first accident, the driver is tested for mari- or alcohol—the more usual gateway century.Internationally,marijuana is the jlignn and other drags.Four of the Fob- drugs. most widely used illicit drug in coon- lems testing for marijuana are that No two people will have the exact tries such as Canada, Mexico, Costa same reaction to marijuana but what Rica, El Salvador, Panama, Australia, 0 it persists for a number . days in has been observed is that those who and South Africa (NIDA, 1998). The flay body and can still bee .detected continue to use it regularly establish a biggest change in this drug is the in- days after use; pattern of use and begin to find oppor- crease in the availability of highly po- 0 the elimination rate varies radically. tunities where drugs other than mari- tent marijuana(up to 14 times as strong compared to alcohol that has a de- juana are available. as varieties available in the'70s)and the fined rate of metabolism; increase in price that has gone up 10-to 0 there is a scarcity of good data yr�peop/t that/know, 30-fold since the early '70s. (Higher- about the level of marijuana in the Mai/hang would with,i f they ain't potency marijuana was always available blood and the level of impairment; 0 and most importan' ad most :. illegal.There are also people and plat often),there is another g besides s such as marijuana buyers clubs that P, marijuana in the system, especially cure marijuana for those who are ill. alcohol, so even if marijuana has a2 additio ,_. 4 Marinol® a synthesized for relatively small effect it is magni- -.. u s of THC, is theoretically available f fled by polydrug use and abuse. . treatment of these and other health pro Added to the fact that 65% of lems but in practice is rarely prescribe heavy drinkers also use marijuana People say they Prefer manjuana in i G (s.A1v1FiSA,1999),it's no wonder that pos- ', '• � '- smokable form because it works fast.than Marinol®. If they smoke they itive polydrug test results are the rule ca and not the exception in drivers ar- smoke just as much or as little as the rested for DUI or need to relieve toms DWI Gierm 1988 symptoms,( se4 As with alcohol, driving impair- r' :, they take a Premeasured Marinol®cal ment is directly related to the amount sole,it may not be enough or may be to of THC in the body. One study found much for their condition.A major obsta �. :" j that 60% of smokers failed a field- ,` -?`: ,'_ cle with smoking of ingesting marijuana sobriety test 2 1/2 hours after smoking :'' for medical purposes is the great varix moderate amounts, while other tests tion in the amount of active ingredient have shown some impairment 3-7 in any given marijuana plant Variation, bolas after smoking, while even others in A-9-THC potency, the relative con. A second major area is whether it centnttion of other active cannabinoids, showed minimal impairment 3-8 hours should be available for medical use. and the later(Reeve et a1, 1983;Smiley,198( Holli m tency of other botanical 1986). Testing machines can measure ffistorically marijuana has been used factors make it difficult to rely on this mintrte amounts of THC but are go=- 0 to treat insomniasubstance to treat medical problems For, ally calrbtated to start registering at 50 0 to calm anxiety, example,some forms of marijuana have nanograms per milliliter (ng/mL) in 0 to cure venereal disease, been shown to increase intraocular urine samples. Some measurementsPres, making someone's glaucoma have registered levels up to 800 ng7mL. 0 to relieve coughs(antitussive), worse, although normally most forms 0 to calm who co of marijuana will lower intraocular Generally if a person has been a long- whooping ' 1 0 to control headaches, pressure, term smoker, it would take about 3 weeks before they wouldn't register on 0 as a childbirth analgesic, But beyond the physiological ef- a test with a 50 ng/mL cutoff and an- 0 as a topical anesthetic, fects, there are the meatal effects of other 3 weeks to be completely nega- 0 to control asthma, marijuana that are the real issue. Luke tive. In a few instances it has taken 10opium cure-alls, such as theriac and 0 to treat nerve pains(neuralgias)and weeks for the drug to clear completely. migraine headaches, laudanum, it is the mental effects of For someone who smoked a"joint"at a calming, anxiety relief, or mild eupho- party but is not a long-time 0 to treat withdrawal from opiates ria that make people feel good and she usuallytests negative user, he or and alcohol, think they are getting better even if the after use. 24 48 hours 0 as an antibiotic, drug isn't actually helping the illness_ Generally marijuana 0 to control spasms and convulsions, Th= is however reluctance in the medical community to prescribe or 0 unpami 'the ability to react 0 and to induce childbirth. � ProP�'kY (1rtlklmira, 1973;Aldrich.1997;Cnaiey,a,�nw, even approve of marijuana for medical to complex situations; &KatA 1998) use'for several reasons,including those 0 induces drowsiness and impairs already stated Recently it has been recommended judgment '1996); for some types of glaucoma, nausea 0 There are a number of drugs on the 0 and appears in the blood and urine control, andto help a patient who has market that physiologically have three to five times more frx;uently lost too much weight(wasting disease) the same therapeutic effects or even in fatal drivers than in the ge:zieaal to gain it back by stimulating bungee better effects than marijuana or population(cie inm 1988). There is evidence.that marijuana Marinol®. does reduce intraocular pressm, does 0 The THC content and even the po- The Medical Use of Marijuana calm nausea,and does encourage people tency of all the other chemicals Controversy has always existed to eat,though there are other drugs that vary from one"joint"to the next,so 12lLd m are as effective or in some cases betbx even if a few puffs worked a certain marijuana. One major area of Many people smoke marijuana theca- way one time, there's no guarantee �°n is whether it should be le- peutically for their glaucoma, cancer, the reaction would be the same the gar"4 Criminalized, or kept illegal. AIDS, or other illness even though it is next time. L I 24' 0 Marijuana smoke contains a number Base �was released. It was commis- 0 Withdrawal symptoms can be ob- of irritants, carcinogens, pathogens, sioned in August 1996 by the White served in animals but appear to bt and other chemicals,most of which House Office ofNatioual Drug Control mild compared to opiates or benzo- have not been studied. If marijuana Policy.The Office asked the Institute of diazepines, such as diazepam is baked in brownies or otherwise Medicine of the National Academy of (Vklium®) eaten, the respiratory effects are Sciences to conduct a review of the sci- avoided but the 360 compounds entific evidence and to do field re- Efficacy of Cannabinoid Drags contained in marijuana remain, search concerning the health benefits 0 Scientific data indicate the poten- along with all their side effects. and risks of marijuana.We present,ver tial therapeutic value of cannabi- 0 Marijuana does somewhat impair batim,their major conclusions and mc- noid drugs,primarily THC,for pain the immune system, thus making ommendations. We do this because reliet control of nausea and vomit- the user more vulnerable to other when the report was originally released ing, and appetite stimulation; illnesses in 1999, both sides of the argument smoked marijuana however is a (pro-and antimarijuana forces)went in crude THC delivery system that 0 Marijuana is a psychoactive drug front of the media and translated the re- also delivers harmful substances. with abuse and addictive potential, port colored by what they thought the. which is particularly dangerous for report said. The result was that unless Influence of Psychological Effects on those who are recoveringfrom one read the original report, the public Therapeutic Effects abuse or addiction. couldn't know what it really said. 0 The psychologipal effects of canna- Contrary to popular belief,medical binoids; such as anxiety reduction, sedation, and euphoria, can influ- research about marijuana continues in Conclusions of the Report ence their potential therapeutic many countries. Since the 1970s there have been more an 12,500 scientific Cannabinoid Biology value.Those effects are potentially than studies conducted on marijuana Yet re- 0 Cannabinoids likely have a natural undesirable for certain patients and sults continue to be conflicting,making role in pain modulation, control of situations and beneficial for others. it difficult to substantiate appropriate movement,and memory. In addition psychological effects medical use of marijuana can complicate the interpretation of 0 The natural role of cannabinoids in other aspects of the drug effect immune systems is likely multifac- 1999 REPORT FROM THE eted and remains unclear. Physiological Risks NATIONAL ACADEMY OF 0 The brain develops a tolerance to 0 Numerous studies suggest that mar- SCIENCES'INSTITUTE OF cannabinoids: ijuana smoke is an important risk MEDICINE TO THE OFFICEfactor in the development of respi- OF NATIONAL DRUG 0 Animal research demonstrates the ratory disease. "CONTROL POLICY potential for dependence but this ONDCP potential is observed under a nar- Marijuana Dependence and � rower.range of conditions than with Withdrawal In 1999 a study entitled Marijuana benzodiazepines, opiates, cocaine, 0 A distinctive marijuana withdrawal and Medicine:Assessing the Science or nicotine. syndrome bas been identified but it Doonesbury BY GARRY TRUDEAU B.D.,7AV PC/Nrf5, NV C4LIAWV14.QERi CAVaZ�Jp�/��,7�feryl}��,A',' .,/� AAyh,�5�1U7H��C4JW- �� , :,- y7f�f�E��l�40!8;8;Ate,/'.iylf�7yM��!� NIGYMROr(A , IY, JIW !IW 6VrARO M /(XJAAVX A5TH 0V0 YLP/10V5V 4zTl76NT ViWMISW AM WINk �Y57a%RNV7NB � AB�r. Siff t�. 00r? I AMOSS12YA � dr-7t6+>59attgs AS 57p>EtsdOW705wr caiW f i AWweresrr v rM5 rr S 711113 i DOONSBURY 01998 G.B.Trudeau.Reprinted by pernussion, UNIVERSAL PRESS SYNDICATE.All rights reserved. is mild and short-live. The syn- ommended for long-tern -dical 5• Clinical trite of marijuana use drome includes resi less, irri- use. Nonetheless for cc. i' pa- medical tabiiity, mild agitation, insomnia, tients, such as the terminally ill or ducted underthe efollowin ould be it sleep EEG disturbance,nausea,and those with debilitatingsymptoms, g limit Ymp circumstances: be conducted in p cxamping• the long-term risks are not of great tients with conditions for whip Marijuana as a"Gateway"Drug concern. Further, despite the le there is social, and health problems associ- efficacy; be nableapproved expectation 0 Present data on drug use progns- ated with smokingmarl' approved by instiq sion neither support nor refute the marijuana, it is tional review boards; and rolls, widely used by certain patient data about efficacy. suggestion that medical availability cY• would increase drug abuse. How- groups- 6- Short-term use of smoked mar, ever, this question is beyond issues Recommendations of theort Rep Juana (less than six months) fc normally considered for medical I. Research should continue into the patients with debilitating symptom uses of drugs and should not be a physiological effects of synthetic (such as intractable pain or vornh factor in evaluating the therapeutic and plant-derived cannabinoids and mg)must meet the following condi Potential of marijuana or c annabi- the natural function of•cannabi- tions: noids. noids found in the body. Because failure of all approved pproved medics. Use of Smoked Marijuana different cannabinoids appear to tions to provide relief has beer 0 Because of the health risks associ- have different effects, cannabinoid documented; ated with smoking, smoked mari- research should include, but not be • the symptoms can reasonably be juana should restricted to, effects attributable to expected to be relieved by rapid. generally not be rec- THC alone . onset cannabinoid drugs; 2• Clinical trials of cannabinoid drugs • such treatment is administered 1�1 L1► � adjuana for symptom management should under medical supervision in a GL J be conducted with the goal of de- manner that allows for assess- patch' MAY veloping rapid-onset, reliable, and ment of treatment effectiveness; safe delivery systems. • and involves an oversight strategy Aid Cancer I Psychological effects of canna i- comparable to ail institutional re- noids such as anxiety reduction and view board process that could tl uenvt sedation,which can influence med- provide guidance within 24 hours Trea, ical benefits,should be evaluated in of a submission by a physician to clinical trials, provide marijuana to a patient for From Assocrated PrW 4. Studies to define the individual a specified use. .k N , N.y.—A "marc- health risks of smoking marijuana (Ius°wt`ofM=Uciae,1999) juana patch', am• similar to the should be conducted, particularly (The full report is available from the. patches that help smokers among populations in which magi- National Academy Press, Tel: (800) k ek the habit could help re- juana use is prevalent 624-6242.) lieve the pain and side effects of canes',researchers sag. The p inenc3n Cancer So ciety is funding a three-Year, $361,0W grant for research into a"marijuana,ad patch"that trxbv at. HEALTH-SCIENCE The MaR Tribade,Friday,Mamh 3.2000 9C Study: Pot makes heart attack more like) ft�, a MUEY Tea eassheeaatla wm ar.oseeomh Amey u�y�1m� 37 WW U,* Y M aeemae,p„� da aea9uamhahm tea as ehb as hemtafd�adtlaoadO afminYIDali� ie�Shue �a�L more V�eNa Wh%maMUme duml®faW oimam 3WIUM-�Ma be WW � �gmed*Dr-Umvto' r 'hhe.MWn en has et;a inwl ma>mm,' rt nil-M hhthe,ehe moamm 7aa mtidta�hum [hk Mmro�7 attmy dildo h,¢o+o b 9mmd.0emmihomamWen intim shires BaBdb seematPohsh rhe *ofa em atahoed Wm moa vdh In the Dim andv m sod a Iihk hm•® amYtbaed hw&sMwW the honk ret ora 6emt aVxk h Oce tree W!&h m amhlemnaaahaWs WM mmh¢e® " emm seas hors skeb tem deer hent aIftftW etm,d(�,pt� �,� a �m fO hRhe*dodoithehae•aamudaLmagjvF L,eW'me to ret ora hems arrack attmtvk:tlmto bea m•ea tand=ftw �khaen�that sae ret eta hent loo Beat AmdatlmID�of On Anew m Aum m hoe,me.ret hY,h Mee hamsMW=K t o XI o of a h nemot- tmf,M dw•me ha apt.to have dh- ft'elma�Paiointllmuaulinthe' Z7,e,��3=heart Whmhr flwhld.ft o u�6� b , a°°d�moe m'Ea�'tlofyrd ,OM hmmL 1@eb'b he bw.lmahmm said that . mq ehr,amQ®a lm eo bem meth todm,a aemm,oe am vaeam -td= dav�®�°,athrewh has oWm its a 1m�' �tY advice m do m,��emehemlNamq®ccatler"0o: WFih and mord thm�jb t,f news r rids fa�i.aaLa h10 W'd h,mev ac mmSlnava h.9mZ•• '�4 hambm Myhm iheh' tl6mt7 hmR patimb� for=WM XL Ho�this Whue PW The�w'ryw,d, Wa e�m��0 �t�d'or�a.rdttll t amlmpLoaler- �. orderap 9)saai thq emtlx It .aegwp. _ eWboma�� n� a Omm amv mole nmi- -, Page 1 of 1 SLO Citycouncil-another vote for local cannabis club From: 'Tommy Welch" <tominatorl 3 @earth link.net> � !. 5 ZU-04 To: <slocitycouncil@slocity.org> SW CITY CLERK Date: 10/15/2004 10:54 AM Subject: another vote for local cannabis club To whom it may concern, My name is Tommy Welch and I was diagnosed with Morbus Meneires Syndrome in Dec.2003. It is a chronic and uncurable disease. I have been to over 11 doctors and none of them really knows what causes it or how to treat it.This disease effects the inner ear, giving me random vertigo attacks and drop attacks. Vertigo is the worse, it hits me fast and leaves me unable to walk, nauseous, vomiting, sweating; unable to see clearly, ringing in my ears, and to top it off, I am going deaf because of it. I take meclizine for nausea, valium for the dizziness, and if that dont work I have to take phenogren. Most of the time these work if I dont throw them up, if that happens I have to go to the emergency room. I have been to the emergency room eight times in the last year. The drop attacks have not only made driving impossible, it has also left me with a broken nose, black eyes, dislocated shoulder, and numerous cuts and bumps on my head. Now, the cannibis I am prescribed is the only thing I have found that keeps my weight up and gives me at least an appetite. When I was first diagnosed, I went from a healthy, but thin, 155 lbs.to 136lbs. in three months and I was still going down. Once I started eating cannabis my weight has increased to 145 lbs. and when I have cannabis I can maintain my weight, have an appetite, and at least feel better. The problem is that the only cannabis clubs are in the big cities and the price is the same as the street. I have been forced to deal with somewhat seedy people to get what I need to survive. It is a eight hour round trip from here to Oakland.That is quite a long ways especially when I am not suppose to drive at all. I hope you vote to open the cannabis club in San Luis Obispo and make sure that quality is good and prices are fair. If I dont have any money it wont really matter. Right now , I am SSI pending and will be without any funding for at least six months. Since clubs opened, I thought prices would go down, but I guess there is not enough competition or maybe city council could put cap on cannabis prices. With a cap quality might go down though.I try not to take any medicine at all unless I absolutely need it, especially valium cuz I hate the way it makes me feel. Cannabis when eaten can help me feel somewhat better and l am all for Clubs opening on central coast. If you were in my shoes, I think you would do everything possible to get this going. I cant drive, so I am not attending meeting on Tues. Oct. 19th, but l will be paying close attention to results.Thanks for your time! I am off to email the Editor of the Tribune about this matter. Sincerely, Tommy Welch 2200 Traffic way Atascadero, 93422 (805) 461-0911 RED FILE P,�i=ETING AGENDA Tommy Welch [--.`TE!9WC4 ITEM # PQL tominatorl3@earthlink.net Why Wait? Move to EarthLink. ,� COUNCIL DD DIR ICAO f-1N DIR �L�IACAO sFIRE CHIEF �✓ATTORNEY .-PW DIR Y_ CLERK/ORIG r, POLICE CHF ❑ QL-PT HEADS Z-�REC DIR r, UTIL DO COA&JAAL3 %I'n hr file://C:\Documents%20and%20Settings\slouser\Local%20Settings\Temp\GW}00001.HTM 10/15/2004