Detroit Free Press Article on Medical Marijuana

Source: Detroit Free Press (MI)
Of marijuana, two things can be said with confidence: A significant majority of Michigan voters believe doctors should be allowed to prescribe the drug for patients to whom it provides relief from illness and pain.
The law those voters adopted in November 2008 to protect patients and doctors from prosecution for the prescription, cultivation or use of medical marijuana has overwhelmed the state bureaucrats charged with administering it, created loopholes for traffickers, left police and prosecutors too much discretion to harass authorized users, and spawned dozens of court cases that will effectively force judges to make policy as they go — unless state legislators do the responsible thing and fix the troubled statute.
Today, the Free Press examines some of the difficulties created by the Michigan Marihuana Act — and suggests how lawmakers can address them without thwarting the compassionate objective Michigan voters have overwhelmingly embraced.
How to Fix Michigan’s Medical Marijuana Law
Two years after Michigan voters legalized medical marijuana, 10 full-time workers in the state Department of Community Health are struggling to process 550 applications a day from Michigan residents seeking permits to cultivate and use the drug. The new law obliges the state to approve or disapprove applications within 15 days; last week, state workers were just processing requests that arrived in early December. So far the state has authorized about 64,000 patients to use marijuana and another 25,000 caregivers to grow and administer it. More than 24,000 applications are still pending — and DCH is already receiving requests for the annual renewals mandated by the new law.
Meanwhile, several Michigan counties are pressing criminal charges against — and being sued by — individuals who claim to be cultivating and selling marijuana for medical use, or providing venues for its consumption by registered users. In other counties, entrepreneurs doing the same thing face little threat of prosecution, much less official regulation. What a mess!
Almost everyone agrees that Michigan’s medical marijuana law isn’t working the way it’s supposed to. But there’s no consensus on how to fix it — or even on what needs fixing. A group of law enforcement officials spearheaded by Oakland County Prosecuting Attorney Jessica Cooper and Oakland County Sheriff Michael Bouchard contend that unscrupulous physicians are prescribing marijuana promiscuously for ill-defined maladies, and that opportunistic entrepreneurs are forging an extra-legal and unregulated market for a controlled substance whose sale and public use remains illegal.
Medical marijuana advocates counter that conscientious physicians and legitimate users are being harassed by law enforcement officials who refuse to reconcile themselves to a legal sea change supported by nearly two-thirds of Michigan voters. Caught in between are judges, criminal defense lawyers and bureaucrats who complain that the current law simply doesn’t address many of the practical questions they’re asked to answer every day: How can medical marijuana be lawfully obtained? Where can it be lawfully consumed? What restrictions can local governments, health care providers, employers and landlords impose on authorized users? How can registered users be certain the marijuana they’re ingesting is pure, safe and appropriate for treating their particular illnesses or symptoms? And how can a state that is scrapping for money to provide the most basic government services pay for the bureaucratic machinery required to make it all work?
Two simplistic solutions proposed by advocates at either end of the political spectrum seem equally unworkable. Those who favor outright repeal of the two-year-old medical marijuana law on grounds it has proved impossible to administer are flying in the face of an electorate that has overwhelmingly endorsed the principle behind the law. And while wholesale decriminalization of marijuana use would render many questions surrounding the new law moot, there is no public mandate for such a move, and plenty of problems associated with legalizing a controlled substance whose use remains proscribed by federal law. The challenge for legislators is to address the practical problems that stand in the way of the mandate Michigan voters have embraced.
Problem No. 1 Where Will Medical Marijuana Come From?
The Medical Marihuana Act clearly authorizes card-carrying patients and caregivers to cultivate marijuana plants in limited quantities for personal use. But it does not specify how plants or even seeds may be lawfully obtained, nor protect unlicensed parties who grow or provide marijuana for purely medical use. Dispensaries that provide marijuana on a wholesale scale appear to fall outside the scope of existing law — and some state lawmakers and municipalities want to outlaw them explicitly. But as a practical matter, the state will need to develop procedures for authorizing and licensing suppliers to meet the demands of legitimate users. Whether the mechanisms for distributing liquor or those for distributing other prescription drugs provide the better model remains an open question.
But the need for some sort of state-approved distribution system is clear — and the fees that could be imposed for the right to operate such lucrative franchises are a logical source of funds needed to administer the law.
Problem No. 2 Who Will Make Sure Prescriptions Are Appropriate?
Law enforcement critics complain that the state is rubber-stamping marijuana prescriptions without adequately investigating the medical claims on which they’re based. But it’s unreasonable to expect outmanned Department of Community Health workers to subject medical marijuana applications to a level of scrutiny beyond that required of pharmacists filling prescriptions for other drugs. Doctors who habitually overprescribe any medication should continue to face scrutiny and discipline by the medical licensing board, as they do now. But harassment or overzealous prosecution of physicians who appear to be complying with the law should be recognized as an illegitimate effort to thwart the will of the voters.
Problem No. 3 How Can Michigan Hold Up Its End?
The resources available to process applications for medical marijuana cards are clearly insufficient to comply with the 15-day processing deadline imposed by Michigan’s existing statute. “We’re having difficulty keeping up with the volume,” concedes Rae Ramsdell, director of the Bureau of Health Professions division that oversees the application process. And she foresees no let-up in the deluge now that the medical marijuana program’s first patients are beginning to seek annual renewals.
But it’s unreasonable to make patients endure lengthy waits for a treatment to which they’re legally entitled. What’s needed is a schedule of licensing fees for users and/or distributors that supports the costs associated with a reasonably efficient system, like pharmacies use to distribute other prescription drugs.
Problem No. 4 What About Rest of US?
The needs of medical marijuana patients should not supersede the legitimate demands of employers and communities who want to safeguard workplaces and roads, or of landlords who want to protect tenants from secondhand smoke. Some conflicts are doubtless destined to be sorted out by the courts, but lawmakers can help by establishing clearer boundaries between the rights of registered marijuana users and the rights of those around them.
Because the Medical Marihuana Act was enacted by voter initiative, substantive changes in the law will require a two-thirds super-majority of both the state House and Senate. That means policymakers seeking a viable fix will have to chart a reasonable path between prohibitionists who want to repeal the law outright and zealots who seek an accelerated path to wholesale legalization. The existing statute has established that voters are lousy draftsmen. But their desired outcome is clear: a state in which patients for whom marijuana offers relief from illness or chronic pain enjoy the right to obtain it without fear of prosecution or harassment. The job of our elected representatives is to realize that vision, not to sabotage it.
Applications to use or provide 111,451
Patients registered  63,869
Caregiver cards issued  24,976
Applications pending  23,617
Patient applications denied 8,510
Number of marijuana plants each patient is entitled to cultivate  12
Maximum number of patients per registered caregiver  5
Fee for application  $100
All figures as of March 15, 2011
Source: Michigan Department of Community Health

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