I am on my way to Denver today to accept an award from the Drug Policy Alliance, one of Americans for Safe Access' allies in the fight for patient rights. The event will certainly be a celebration for most. The federal government has finally given the green light to regulated marijuana distribution. Gallup's latest polling shows a rapidly changing public perception on marijuana prohibition, with a solid majority now favoring making it available in a regulated market. These would seem to be good times to be a medical cannabis advocate. But what is unfolding in Washington State is weighing on me.
Over the years, we policy-reform types have spent some time speculating about what would happen to patients who use medical cannabis when and if marijuana were simply legal. Washington State is showing us how wrong it can go. In November voters approved a measure to allow anyone over the age of 21 to purchase and use cannabis. That initiative, I-502, promised voters that there would be no effect on the medical access program voters established in 1998 and that it would produce $215 million in tax revenue.
After passing I-502, the state of Washington hired BOTEC Analysis Corp to help guide the implementation, specifically to ensure that WA received the $215 million in revenue, and assembled a working group to implement the law. It seems that while the promise of leaving the medical marijuana program stand was the intent (the state's medical marijuana web page still flat states "the initiative does not amend or repeal the medical marijuana laws in any way."), the focus on funds has turned the conversation from implementation o dismantling the medical cannabis program.
This began when the company BOTEC Analysis Corp began reporting issues with I-502's ability to deliver the promised revenue to the voters. BOTEC concluded: "I-502 stores may not compete well on price with medical access points if they have similar production processes but face higher taxes. The medical market could be hobbled by legislative intervention, but another and perhaps even greater concern is competition from the black market."
On Monday, the state's official work group on implementing I-502, comprised of representatives from the Liquor Control Board, Department of Revenue and Department of Health, recommended effectively scrapping the medical access program and rolling patients into the adult-use market. That would be a mistake of historic proportions, one that would do a disservice to both patients and voters.
The work group has proposed kicking all patients out of the program, creating serious barriers to getting back in, and eliminating so much of what made the medical marijuana program successful that few patients would want back in, even if they could qualify. That's a dishonest way to try to make good on revenue promises. Worse, it makes a mockery of the compassion Washington voters showed when they passed the medical initiative, one of the nation's first.
While there is a consensus in WA that the 1998 medical initiative is in need of updating to better define and regulate medical cannabis access, no one has discussed anything as severe as what the LCB is now considering. In 2011 the state legislature passed SB 5073, a bill that would have created a regulatory system for access. Unfortunately, after pressure from the U.S. Attorney's office, then-Governor Gregoire used her line-item veto power to strike dispensing centers from the law. Since then, cities have been passing legislation to try to accommodate their ill citizens. Revisiting that proposal is a far better solution than discarding a system that is serving the needs of patients.
Return to Compassion:
In working with patients over the past decade, I've met many who grow their own medicine because that's the only way they can afford it. Sometimes that's because they're on limited income; sometimes it's because their condition requires substantial amounts of medicine; sometimes it's both. In any case, requiring patients in Washington to both purchase their medicine and pay the steep excise taxes that get tacked on at every step can mean bankrupting them or forcing them to go without relief.
By way of perspective, two of the long-term patients in the small federal Investigational New Drug program receive nine ounces of cannabis a month from the government. At the projected Washington state retail price of $15/g, that would mean an annual out-of-pocket medication cost of almost $46,000. For patients with such serious conditions and no access to free federal cannabis, cultivating for themselves or cooperatively is the only viable option.
While many patients may currently prefer to purchase their medicine, that's because dispensaries typically provide both a variety of strains and staff who can provide guidance on choosing one that meets a patient's treatment needs. A commercial vendor serving a recreational market is unlikely to provide either service. In fact, I-502 stores are forbidden to talk to their customers about medical benefits.
As it stands, the work group recommendations on medical cannabis appear opportunistic and cynical -- a bald attempt to drive patients into the commercial market where they can be taxed.
Americans for Safe Access, along with our Washington members, has launched a campaign called Health Before Happy Hour in an attempt to bring the patient's voice to the table. I will be leaving Denver bright and early on Sunday to join our Washington members in a tour of the state to both gather comments on the recommendations and work to build a consensus amongst patients about how they think the state should move forward in protecting their rights.
It is my hope that the Liquor Control Board will better consider the needs of patients as they prepare final recommendations to submit to the legislature January 1, 2014.
After all, when was the last time anyone asked the tax man for medical advice?
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