1. Trends in State Medical Marijuana Policies Karen O’Keefe, Esq. Director of State Policies Marijuana Policy Project

2. Federal Law Marijuana is classified as a Schedule I substance “high potential for abuse” “no currently accepted medical use in treatment” in U.S. cannot be prescribed, but can be used for research Several petitions to reschedule have been filed, but ultimately rejected DEA Administrative Law Judge Francis Young found it would be “unreasonable, arbitrary and capricious” to fail to reschedule (1988)

3. Early State Therapeutic Research Laws From 1978 to 1995, 25 states enacted therapeutic research laws o Seven were operational at one point o They relied on federal approval and federal marijuana None were operational past the 1980s, and most were never operational

4. California and Arizona’s 1996 Initiatives California and Arizona voters passed medical marijuana laws on Nov. 5, 1996 Only California’s law was effective Removes the state’s criminal penalties from medical marijuana possession and cultivation by patients and caregivers Relies on a doctor’s recommendation, not a prescription. This was found to be protected by the First Amendment in Conant v. Walters.

5. Early Medical Marijuana Laws: Home Cultivation & Caregivers California (1996) Alaska (1998) Oregon (1998) Washington (1998) Maine (1999) Colorado (2000) Hawaii (2000) Nevada (2001) Vermont (2004) Montana (2004) Michigan (2008) Rhode Island (2006)

6. California Allows Collectives and Cooperatives (2003)

7. New Mexico Allows State-Licensed Producers New Mexico’s law, enacted in 2007, implemented in 2009, allows state-regulated “licensed producers” AG Holder: “For those organizations that are doing so sanctioned by state law and do it in a way that is consistent with state law, and given the limited resources that we have, that will not be an emphasis for this administration.”

8. Department of Justice “Ogden Memo” Pursing priorities of disrupting trafficking “should not focus … on individuals whose actions are in clear and unambiguous compliance” with state medical marijuana laws such as patients and caregivers Examples of “illegal drug trafficking activity of potential federal interest” such as violence, ties to criminal enterprises, and sales to minors Did not provide a defense in federal court

9. States Begin to Allow State- Regulated Dispensaries New Laws With Regulated Dispensaries New Mexico (2007, implemented 2009) New Jersey (2010, not yet implemented fully) D.C. (2010, not yet implemented fully) Arizona (2010, not yet implemented fully) Delaware (2011, dispensaries on hold) Expanded Laws, Adding Regulated Dispensaries Maine (2009, implemented 2010) Colorado (2010, implemented 2010-2011) Rhode Island (2009, not implemented fully)

10. Federal Intimidation Stalls Some Dispensary Programs Washington Gov. Gregoire vetoes dispensary regulation bill following U.S. attorney letter (May 2011) June 2011 DOJ “Cole memo” says only patients are not an enforcement priority; prosecutors could target commercial operations, large-scale production Delaware Gov. Markell suspends implementation of dispensary program following U.S. attorney letter (Feb. 2012) Arizona, Rhode Island, and New Jersey were temporarily stalled but are moving forward D.C. and Vermont are moving forward

11. Qualifying Conditions California: Physicians can recommend for any condition All, or almost all, of the laws include: Severe painSevere nausea Wasting or cachexia Seizures Muscle spasmsGlaucoma HIV/AIDS Cancer Some laws include: Crohn’s disease Hepatitis C ALS (Lou Gehrig’s Disease) Post-Traumatic Stress Disorder Agitation of Alzheimer’s

12. Marijuana and Plant Limits California: Any amount for personal use Usable marijuana Ranges from one to 24 ounces Federal patients receive 8-11 oz. per month Most recent: 6 oz. in Delaware/ 3 oz. every 14 days Plants Lowest: 2 mature and 7 immature (Vermont) Highest: 15 total in Washington state 12 mature, 12 immature in Rhode Island Some states have a defense for more

13. Recent Laws Generally Include More Regulations Requirements that marijuana be cultivated in enclosed, locked locations Stricter doctor-patient relationships Registry identification cards

14. Newer Laws Often Include Increased Patient Protections Employment protections Child custody protections Organ donations and other medical care Landlord-tenant issues Recognizing out-of-state ID cards Musician Timothy Garren of Washington state, 56, died after being denied a liver transplant in 2008.

15. 33 Medical Marijuana Laws

16. What’s Next? States continue enacting medical marijuana laws o 18 bills introduced for new laws, 10 still pending o As many as three ballot initiatives in 2012 o Most include both home cultivation and dispensaries, some one or the other Federal policy and preemption cases will affect the laws, including how well-regulated and safe access will be

17. For more information on state medical marijuana laws, please visit: www.mpp.org/statelaws