In November, Florida voters will likely approve Amendment 2 – a proposal that seeks to expand health-care options to include medical marijuana.
At that point, it will be incumbent on lawmakers to implement regulatory schemes that protect rather than exploit Florida’s health-care system.
Toward this goal, looking at the experience of other states can offer a roadmap of what to do or to avoid.
In terms of the latter, California offers a lot to consider.
My July trip to Los Angeles was not intended as an exploratory mission to delve into the issue. But in between In-N-Out Burgers and mosquito-free canyons, it was hard not to notice the overwhelming presence of cannabis dispensaries and clinics.
To buy weed in California, look a block in any direction for a green plus sign – a blend of the leaf’s color and the medical cross. A more appropriate insignia would be a giant hoop – as in, what a person must jump through, and easily, to become a legal marijuana consumer in the state. There’s not a grown soul from Del Norte to San Diego who wouldn’t qualify for a medical cannabis “recommendation.”
Why, then, did California opt to go through doctors at all? And, how does a state do this right the first time?
These are questions that Florida must consider as we sit on the doorstep of approving our own medical marijuana law.
To get there, it may help to agree on a few basics.
First, let’s say that marijuana has some legitimate medicinal value. Let’s also assume that for some people, this value is great, while for others it may be nothing more than a kitschy alternative to melatonin or Advil. We can also acknowledge that there’s potential for abuse, as with any substance. And that nobody knows exactly what all of those benefits and costs may be.
I did a little field research so that I could return to Florida with opinions based on something more than supposition.
My first stop was Google Maps, which offered a handful of options for cannabis doctors within walking distance of our rental in West Hollywood. I called the closest for an appointment and got one 30 minutes later, even after explaining that I was a Floridian on vacation. (California law requires medical cannabis users to be residents of the state).
The waiting room had five people in it – young, old, male, female, black, Hispanic, white. On the wall beamed a flat-screen playing new-agey music and rotating images of marijuana farms with messages such as: “It is fun to cultivate your own” and “If 6 plants is not enough for your condition, your doctor can write you a script for up to 99 plants.”
What kind of condition would that be, exactly? (Rhetorical question. There is no such condition.)
I didn’t have to wait long for service. A bearded guy got my weight and had me sign forms in which I acknowledged the potential risks of cannabis use. Then I was brought to the doctor.
He was young, and according to the diploma on the wall, just five years out of medical school at UCLA.
“So, what’s going on?” young doctor asked.
“Well, I’m here on vacation from Florida for a few weeks, and thought I may as well do this legally.”
There was no need to clarify the subject of that sentence.
“Uh-huh,” he said, preparing to take some notes. “Well, in terms of symptoms, what are you feeling?”
“I’m on proton pump inhibitors for acid reflux,” I began.
“And that condition can make you feel nauseous, right?” he asked.
“Yes, it can.”
“OK, what else?”
“I was in a car accident a few years ago and my neck still goes through periods of spasm,” I offered.
Young doctor then asked me to recline on the table. He pressed on my belly while going over my family history: a mother in remission with cancer and a father with GI issues, too.
“I’m going to recommend that you do some abdominal exercises like crunches each day to strengthen your muscles, which can help with acid reflux. And I am also going to recommend cannabis for you.”
That was it. He signed a diploma-looking document that would tell dispensaries and law enforcement alike that I am a legal weed smoker.
“Any particular kind of cannabis you recommend for me? Like, something non-euphoric maybe?”
He pointed to a poster on the wall that in a traditional doctor’s office would feature some set of human organs, but instead listed the comparative properties of sativas and indicas.
“Something higher in CBD may be good for you,” he said, already bored and ready for the next in line.
Whether it was this young doctor’s affect or my projected feelings about him, the room felt full of demoralization and cynicism.
Imagine: More than a decade of intense schooling and state-of-the-art training at a renowned medical college for this – spending days in a tiny, dim room listening to people’s unremarkable or fabricated complaints and offering nothing but a ticket saying your patients won’t get arrested for doing what they likely would do regardless.
I thanked him and went to the front with my certificate.
The bearded weight-taker greeted me again and snapped my picture for a State of California weed-legal wallet card, which is good for one year. The exam, $70, and the ID card, $20.
And then he handed me a lease agreement.
“You’re going to need this to get into dispensaries,” he said, handing me what normally a landlord would. “You can fill anything in for the names and addresses; they won’t check. Just say you moved here recently and haven’t changed your ID yet.”
How very … medical?
The first dispensary I visited made no effort to pretend that healing was involved. The three secured gates led to a man at a desk who in a thick Russian accent requested my ID and doctor’s note, then pointed me over to a faery-like girl behind a weed-filled glass counter.
“What are you looking for?” she asked.
“Something that is non-euphoric with lots of cannabinol,” I said. “That’s what my doctor recommended for my condition.”
“Oh,” faery said, seeming unsure of what that meant.
“Something very low in THC but high in CBD,” I said in a failed effort to clarify.
“How about this one?” she said, placing a glass container on the counter for my inspection. The label read “Trainwreck.” I opened my weed app, Leafly, to see what this strain was about, and found it to be the very opposite of what I had asked for.
Dismayed but not surprised by the lack of medical pretense about the place, and not about to spend $40 on the wrong stuff, I left.
It was a five-minute walk to the next dispensary. It was well lit, impeccably clean, nicely decorated, and full of books on meditation, yoga, massage and other therapies. After I was let in by security, the receptionist talked me through the rules and perks of membership at the cooperative.
Inside this dispensary’s main weed room was a menu of non-euphoric, high-CBD options, along with various edibles and oils that weren’t psychoactive. The salesman coached me through the differences in strains and their potential effects. I left with an eighth of an ounce of ACDC, apparently identical to Charlotte’s Web, the strain approved by the Florida Legislature for use by patients with specific, serious conditions.
I was also offered a joint of the regular stuff, just for having come in for the first time.
My adventures in marijuana tourism ended for the day, but my reaction has just started to really crystallize. (Pun intended).
The upshot is this:
Why create a law that uses doctors in ways that are a waste of their education and time, and take them out of circulation for patients who have actual medical needs? How, in California, is a doctor’s cannabis recommendation anything but a formality?
Many weed-smoking Californians don’t even bother to jump through the doctor hoops. They’re unafraid of arrest and unconcerned about where they buy their pot.
A Bay Area friend explained: “Why would I go through all that to get a prescription? It’s everywhere. You smell it on the streets, indoors, it’s everywhere.”
The seediness (no pun intended) of California’s “medical” marijuana landscape is dramatically increased by the pretense of medicinal use – not diminished.
If Florida’s voters approve Amendment 2, our state will have an opportunity to implement a marijuana law that avoids heading down this same cynical path. It will be a challenge, but the reward of fostering an honest, quality health-care system is well worth the effort.
Karen Cyphers, PhD, is a public policy consultant and an adjunct instructor at Florida State University. She lives in Tallahassee. Column courtesy of Context Florida.