1. 1 Medical Marijuana: Around the Country Presented by: Anna Rau of MontanaPBS September 20, 2011

2. 2 STATE OF THE U.S. MEDICAL MARIJUANA LAWS 16 States & Washington, D.C. allow for medical use of marijuana Medical conditions covered by medical marijuana (MM) laws vary state by state and include, but are not limited to Agitation due to Alzheimer's, Anorexia, Arthritis, Cachexia, Cancer, Cramping, Crohn's Disease, Epilepsy & Seizure Disorders, Glaucoma, Hepatitis C, HIV/AIDS, Hospice, Inflammatory Bowel Disease, Lou Gehrig's Disease, Migraine Headaches, Multiple Sclerosis (MS), Muscle Spasticity, Muscular Dystrophy, Nail Patella, Peripheral Neuropathy, Post Traumatic Stress Disorder, Severe Nausea, Severe/Chronic Pain

3. 3 FEDERAL COMPASSIONATE USE PROGRAM Robert Randall 1976 lawsuit Proved medical necessity Gave rise to Investigational New Drug Program Federal government only legal source Contract with University of Mississippi as only legal grower Unknown total number patients at height of program IND Program shut down in 1992

4. 4 FEDERAL COMPASSIONATE USE PROGRAM Remaining patients grandfathered in Barbara Douglass – MS, 1991 George McMahon – Nail-patella syndrome, 1990 Corrine Millet – Glaucoma, 1990 Elvy Musikka – Glaucoma, 1988 Irvin Rosenfeld – Multiple Congenital Cartilaginous Exostoses, 1982 Anonymous – Condition Unknown, Year Unknown

5. 5 FIRST STATE TO PASS A MEDICAL MARIJUANA LAW CALIFORNIA 1996, Proposition 215 (56%) Doctor’s written/oral recommendation Voluntary patient registry 8 ounces/6 mature plants Dispensaries & caregivers allowed Estimated 1.1 million medical marijuana patients in CA New law allows cities to regulate dispensaries through zoning Some cities curbing or capping number of dispensaries

6. 6 STATES WITH SIMILAR PROGRAMS TO CALIFORNIA OREGON 1998, Initiative (55%) 24 ounces/18 seedlings Mandatory patient registry with ID card Bona fide Doctor/Patient relationship with documentation No dispensaries allowed, "grow your own"

7. 7 STATES WITH SIMILAR PROGRAMS TO CALIFORNIA HAWAII 2000, Senate Bill (First Legislative MM Law) 3 ounces/7 plants Mandatory patient registry with ID card Caregiver only allowed one patient at one time No dispensaries allowed

8. 8 STATES WITH ADDITIONAL CAREGIVER RESTRICTIONS ALASKA 1998, Initiative (58%) 1 ounce/6 plants Mandatory patient registry with ID card Caregivers allowed only one patient at a time Exception: related by blood to the 4th degree: cousins, aunts, uncles, grandparents, etc. Caregivers must not have felony drug convictions No dispensaries, collectives or cooperatives

9. 9 STATES WITH ADDITIONAL CAREGIVER RESTRICTIONS WASHINGTON 1998, Initiative (59%) 24 ounces/15 plants No mandatory patient registry Caregivers allowed only one patient at a time Expanded authority to prescribe beyond doctors Naturopaths Physician Assistants Osteopaths Registered Nurse Practitioners

10. 10 STATES WITH ADDITIONAL CAREGIVER RESTRICTIONS MONTANA 2004, Initiative (62%) 1 ounce/4 mature plants Mandatory patient registry with ID card Caregivers cannot be paid for marijuana Repeal effort in 2011 session failed with Governor Schweitzer’s veto

11. 11 STATES WITH ADDITIONAL CAREGIVER RESTRICTIONS MICHIGAN 2008, Initiative (63%) 2.5 ounces/12 plants Mandatory patient registry with ID card Caregiver may assist no more than 5 patients Caregiver must have no felony drug convictions In August 2011, Michigan court ruled dispensaries illegal

12. 12 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES MAINE 1999, Initiative (61%) 2.5 ounces/6 plants Mandatory patient registry with ID card Authorized 8 state-licensed non-profit dispensaries

13. 13 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES VERMONT 2004, Legislation 2 ounces/7 immature plants Mandatory patient registry with ID card Licensed physicians in neighboring states can recommend cannabis to VT patients Allows for 4 state-licensed, nonprofit facilities to dispense marijuana Each dispensary can have 1,000 patients Caregivers limited to one patient

14. 14 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES RHODE ISLAND 2006, Legislation 2.5 ounces/12 plants Mandatory patient registry with ID card Caregivers limited to 5 patients Allows for state-licensed nonprofit “compassion centers” that grow and dispense cannabis Patients can still grow their own Compassion centers on hold due to concerns of federal prosecution of state employees

15. 15 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES NEW MEXICO 2007, Legislation 6 ounces/16 plants Mandatory patient registry with ID card Allows for state-licensed “cannabis production facilities” Production facilities can grow up to 150 plants Patients can still grow their own 2011 – lawmakers introduced and eventually withdrew a bill to repeal state’s MM law

16. 16 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES NEW JERSEY 2010, Legislation Patients CANNOT grow their own Mandatory patient registry with ID card Creates 6 state-licensed, nonprofit “alternative treatment centers” Caregivers allowed one patient at a time Governor initially blocked implementation over concerns of federal prosecution of state employees

17. 17 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES ARIZONA 2010, Initiative (50.13%) 2.5 ounces/12 plants Mandatory patient registry with ID card Allows for 126 state-licensed nonprofit dispensaries Patients who live within 25 miles of a dispensary may not grow their own Dispensaries put on hold in June after Governor files federal lawsuit seeking declaratory judgment regarding the licensing of MM dispensaries

18. 18 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES WASHINGTON, D.C. 2010, Legislation [D.C. Council] 2 ounces Will include a patient registry Patients cannot grow their own Allows up to 8 licensed for-profit and/or not for profit dispensaries with no more than 95 plants each Caregivers limited to one patient In the process of accepting applications for dispensary licenses and setting up the patient registry program

19. 19 STATES (AND D.C.) WITH LARGE, LICENSED DISPENSARIES DELAWARE 2011, Legislation [Most recent state to pass MM law] 2.5 ounces/12 plants Mandatory patient registry with ID card Patients cannot grow their own Allows at least 1 state-licensed, nonprofit “compassion center” per county Patients can obtain up to 6 ounces from centers State began accepting applications for centers in July and is set to issue licenses within six months

20. 20 STATES WITH MM CONSTITUTIONAL AMENDMENTS COLORADO 2000, Constitutional Amendment (54%) 2 ounces/6 plants Voluntary patient registry with ID card Caregivers limited to 5 patients in areas where dispensaries are banned Colorado & Washington, D.C. ONLY – allow for-profit dispensaries Lawsuit pending

21. 21 STATES WITH MM CONSTITUTIONAL AMENDMENTS NEVADA 2000, Constitutional Amendment (65%) 1 ounce/7 plants Mandatory patient registry with ID card No dispensaries Law requires Nevada School of Medicine to seek federal permission for state run MM distribution program

22. 22 STATES WITH PENDING MM LEGISLATION MASSACHUSETTES 2 bills, testimony heard in August 2011 ILLINOIS Failed House in August (can be reconsidered) NEW YORK House Bill pending (legislature adjourned until fall) OHIO In Committee PENNSYLVANIA In Committee

23. 23 STATES WITH RECENT FAILED MM LEGISLATION BILLS DIED IN COMMITTEE Alabama Connecticut Florida Idaho Mississippi New Hampshire North Carolina Texas BILLS STALLED IN COMMITTEE Iowa Kansas Oklahoma West Virginia

24. 24 PENDING CONGRESSIONAL MM BILL States’ Medical Marijuana Patient Protection Act Protects individuals and entities acting in compliance with state MM laws from federal prosecution Directs administration to reschedule marijuana to Schedule III or lower Introduced May 2011 Referred to U.S. House Committee on Energy and Commerce June 2011