by Dan Aiello –
Following today’s press conference timed to coincide with the visit of President Barack Obama to San Francisco, the City’s Democrat Assemblymember Tom Ammiano says he’s “pretty pissed off about this unwarranted attack,” referring to the multitude of federal raids orchestrated by the Obama administration’s Department of Justice on California’s medical marijuana dispensaries, their landlords and patients.
Ammiano is calling upon California’s congressional representatives and citizens to demand the Feds back off. “Nobody’s reining them in. Its un-Democratic and the worst case of thuggery.”
Assemblymember Ammiano says he expects to hear back from Senators Dianne Feinstein (D-CA) and Barbara Boxer (D-CA), who so far have remained publicly silent on the matter.
Calls to both Senators Dianne Feinstein and Barbara Boxer were not returned by press time.
Ammiano says he and his colleagues will respond with legislation to address what concerns the feds, but first the legislators need to hear what they are, and the feds have made no attempts to coordinate these raids with state authorities.
“We want to meet with the Department of Justice, the Attorney General and the Governor because If I do come up with legislation to provide statewide regulations to address their concerns we need to know what they are thinking,” Ammiano told California Progress Report.
“It’s not coordinated, it’s a mess, and we need answers and we need them yesterday.”
Ammiano, who is openly gay, is angered by what he sees as an attempt to destroy years of effort by the LGBT community to make medical marijuana available for compassionate use, which coincided with the AIDS epidemic. The Assemblymember sees the raids by the DOJ as an attack on those suffering from complications associated with HIV, assisting terminally-ill patients with appetite encouragement and relief from pain and nausea for those taking a litany of drug cocktails to thwart the virus.
“It’s a particular insult to our community, our involvement and all our efforts towards passing [proposition] 215,” said Ammiano, who noted that Dennis Peron, who led the campaign to legalize marijuana for compassionate use and Michael Goldstein, who is today at San Francisco General due to complications from AIDS and severe stress, are prime examples of the LGBT community’s close ties to the issue.
And Ammiano says that while he believes the use of Marinol by hospitals is not affected by the Fed’s crackdown, “I don’t know that anything is safe at this point,” he told CPR.
“Where are they going to go with this is not clear at this point. The Department of Justice is now leaning on banks about not financing dispensaries, telling them if they do they will be penalized.”
Ammiano flared at the apparent aggression of the DOJ’s efforts to close the state’s medical marijuana dispensaries statewide while the DOJ remains timid on issues more important to the state’s economic recovery, like bank foreclosures on California homes.
“They’re timid about foreclosures, giving no warnings to banks about them, but they warn banks that lending money to medical marijuana businesses will be punished – And sending letters to landlords saying we are going to put you in jail if you rent to dispensaries, that’s pure thuggery and un-Democratic.”
Ammiano challenged the statewide, indiscriminate nature of the raids, noting the abuses the department has identified are primarily in communities in Southern California like San Diego and Los Angeles that “brought chaos upon themselves by sticking their heads in the sand,” and failing to pass regulations regarding 215’s implementation anywhere during the last 15 years since passage of prop 215, as called for in guidelines by then-State Attorney General, Edmund G. Brown, Jr.
“Without regulations there are all kinds of people who will always take advantage. Without laws on the books it becomes the wild, wild west. And we want that to stop too. But we don’t want medical marijuana to be vitiated by thug mentality.”
Ammiano asks Californians to contact their congressional representatives and ask for accountability from the DOJ on the raids.
[quote]”We want to meet with the Department of Justice, the Attorney General and the Governor because If I do come up with legislation to provide statewide regulations to address their concerns we need to know what they are thinking,” Ammiano told California Progress Report.
“It’s not coordinated, it’s a mess, and we need answers and we need them yesterday.”[/quote]
Yes, the state’s medical marijuana law is a mess!
[quote]”Without regulations there are all kinds of people who will always take advantage. Without laws on the books it becomes the wild, wild west. And we want that to stop too. [/quote]
Then why haven’t you? It is the wild, wild west, and the problems should have been addressed long ago. Instead the state of CA has seemed to embrace the proliferation of pot shops as a convenient new source of tax revenue…
For me this is a mess on many levels. Primarily this is a medical issue and as such should be addressed by the medical community. This is after all not a marijuana legalization law, it is a “medical marijuana” legalization law.
The enablers of the proliferation of “marijuana clinics” are the doctors who are willing to provide prescriptions without any real assessment of the patient’s medical needs.
As a doctor, I feel it is entirely legitimate for a doctor to do a thorough assessment of a patient’s medical condition including past history with review of all medical conditions, behavioral and medical approaches tried to date, a relevant medical exam, lab work and diagnostic studies and come to the conclusion with the patient that medical marijuana, either Marinol, inhaled or ingested is the patient’s best medical choice and prescribe accordingly. Unfortunatley, this is not the case ( and yes, I have direct knowledge) in some of the “marijuana
clinics” where the assessment may be as little as asking if the patient has pain or loss of appetite and writing the script. This does not constitute an assessment with due diligence and in my opinion should be grounds for review by the state medical board and the physicians national board where there are policies in place for appropriate censure up to and including revocation of licensure.
What I do not think is a good approach is to use a “crack down” method which will prove costly, ineffective , arbitrary ,and fail to address the needs of those patient’s who are in genuine need of this medication as well as the prescribing rights of those doctors who are utilizing diligence in their prescribing.
As my family in the Ozarks say about the whiskey tax, “It isn’t a problem for those polite enough to ignore it !”
[i]”…part of an effort to stop the proliferation of for-profit dispensaries and prescribe-for-pay doctor’s offices that have sprouted up in California communities that have no local regulations for dispensaries of medical marijuana.”[/i]
I strongly support the legalization of marijuana for personal use and the legal availability of marijuana for medical purposes. I also strongly support this effort to stop the for-profit dispensary business. These are becoming a nightmare for cities. People should be able to grow their own marijuana, and get it from non-profit dispensaries. Doctors should use more care in prescribing it, and not become prescription mills. This is a targeted action by the DOJ and the Obama administration in response to the very real problems the state law is causing.
I can’t look at their books, but the dispensaries that I see around Sacramento did not seem to be particularly busy until the “crackdown” . If the feds have their way, all marijuana will be for profit and go un-taxed !
As someone who recently recovered from a serious illness that kept me hospitalized for more than 3 months and caused me to lose 82 lbs., I can tell you that my doctors genuinely believed that pot, before I was hospitalized, and Marinol while I was in the hospital, was their best chance to get me to gain weight on my own though I was kept alive with an IV cather feeding me TPN 24/7. My doctors were not hippies or drug dealers or potheads, they were medical professionals who believed strongly that marijuana stimulates hunger which, for someone who felt everything tasted horrible, was key to my recovery. I believe that I am here today, in part, because of medical marijuana.
[quote]As a doctor, I feel it is entirely legitimate for a doctor to do a thorough assessment of a patient’s medical condition including past history with review of all medical conditions, behavioral and medical approaches tried to date, a relevant medical exam, lab work and diagnostic studies and come to the conclusion with the patient that medical marijuana, either Marinol, inhaled or ingested is the patient’s best medical choice and prescribe accordingly. Unfortunatley, this is not the case ( and yes, I have direct knowledge) in some of the “marijuana
clinics” where the assessment may be as little as asking if the patient has pain or loss of appetite and writing the script. This does not constitute an assessment with due diligence and in my opinion should be grounds for review by the state medical board and the physicians national board where there are policies in place for appropriate censure up to and including revocation of licensure. [/quote]
Thanks for saying what needed to be said. Like you, at times I have problems with my own profession (lawyers).
[quote]As someone who recently recovered from a serious illness that kept me hospitalized for more than 3 months and caused me to lose 82 lbs., I can tell you that my doctors genuinely believed that pot, before I was hospitalized, and Marinol while I was in the hospital, was their best chance to get me to gain weight on my own though I was kept alive with an IV cather feeding me TPN 24/7. My doctors were not hippies or drug dealers or potheads, they were medical professionals who believed strongly that marijuana stimulates hunger which, for someone who felt everything tasted horrible, was key to my recovery. I believe that I am here today, in part, because of medical marijuana. [/quote]
And you are the very reason I voted FOR the medical marijuana law – but it is being abused to the point of becoming a real problem, as even advocates of marijuana use like Don Shor point out. The state needs to regulate medical marijuana properly, but I have no faith whatever that the state will be willing or able to do so.
And by the way, I’m glad you made it through da647!
Don and Elaine
What do the two of you see as the main problems being created by the for profit dispensaries, and what would you consider to be appropriate state regulation?
Colorado has for profit dispensaries and the feds don’t seem to be going after them . Is cannabis easier for them to tax in the for profit model ?
Actually, mandatory non-profit status is the first thing. I do not want to see marijuana dispensaries become large-scale pot distribution businesses. Local governments are having zoning issues as well. I don’t know the best answer to that problem. Personally I would prefer to see people getting marijuana only from their primary care physicians, if it is in fact a medical issue for them. And everyone should have the right to cultivate marijuana for personal use, within limits designed to minimize profit-seeking ventures and to reduce the likelihood of creating an attractive nuisance.
In the long run I would like to see marijuana de-listed by the federal government. I suspect it will take a critical mass of states adopting medical-marijuana statutes and decriminalizing it for that to ever occur. Congress will follow public opinion very slowly on this. But when a majority of states, and a majority in public opinion polls, effect decriminalization and provide for medical marijuana within genuine boundaries, the federal law may change.
Don
I also favor decriminalization of marijuana for several reasons. First I feel that laws against marijuana use are completely inconsistent with the lack of laws against medically proven far more dangerous substances, tobacco, alcohol and the narcotic pain medications to name three. This kind of societal hypocrisy breeds contempt for the law itself and for those whose job it is to enforce it.
My second major objection is the wasted resources that go into trying to enforce the unenforceable. I have no idea how much money has been spent on the local, state, and federal levels completely ineffectually trying to stop people from using this drug. But what I do know, is that this money could have been much more effectively used within the medical system for preventive measures, in the education system, in the justice system for rehabilitation and re entry, for infrastructure repair……pick your own favorite. When a law is being completely disregarded and or worked around by large segments of the society, it seems to me that our legislators have two options. They can take the “crack down” option which it seems to me has already been proven a massive failure over many years, or they can change the law. I obviously am fully in favor of the latter.
I agree with you that congress will follow public opinion very slowly on this issue. I find it a very sad commentary that our public officials are very quick to “lead” ,manipulate and shape public opinion when it comes to such issues as when to go to war, but will not show any courage or leadership when it comes to the threatened eviction of a dispensary, while allowing a liquor story and pharmacy providing far more dangerous substances to be sold on the same block. For the sake of consistency, if nothing else, I believe that medical marijuana should be available at Longs and recreational marijuana should be treated the same as alcohol.
[quote]What do the two of you see as the main problems being created by the for profit dispensaries, and what would you consider to be appropriate state regulation?[/quote]
Primary care physicians and specialists they refer the patients to must be the ones prescribing the medical marijuana. None of this “doctor shopping”. The state needs to set clear boundaries of what marijuana can be used for medically – in other words for a simple headache would be inappropriate. I’m sure the state can come up with some simple and general guidelines that work. I am totally against legalization of marijuana, and I suspect that has a lot to do with my East Coast upbringing… I find CA’s “liberalism” very troubling at times…
Vanguard: “It’s a particular insult to our community, our involvement and all our efforts towards passing [proposition] 215,” said Ammiano,
speak for yourself Ammiano! your community does not include me. I do not wish to see the community ripped apart from drug addiction and neither do the Feds.
Ammiano can go to hell. He acts as if he has the power to tell the Feds anything. Apparently he missed the part where Federal Law trumps state Law.
I have said this for the upteenth time but I’ll say it again, Federal Laws are supreme – and the State cannot pick and choose which ones they will follow.
Medwoman: ” Primarily this is a medical issue and as such should be addressed by the medical community.”
Wrong. The issue has nothing to do with the economy, medicine, compassion or any of that garbage. The real issue is marijuana advocates have tried to use the medical pot as a vehicle for complete legalization for general use, and the Feds are not letting them get away with it.
Don Shor: “I strongly support the legalization of marijuana for personal use and the legal availability of marijuana for medical purposes. I also strongly support this effort to stop the for-profit dispensary business. These are becoming a nightmare for cities. People should be able to grow their own marijuana, and get it from non-profit dispensaries.”
what ever happened to just say no? That’s all we need is a society full of drug addicts. how will that bode for economic recovery?
“what ever happened to just say no?” We all did, to the DEA . Just say no, The war on drugs, etc are slogans designed to appeal to our best moral sense, while needing no complex explanations of how they will (and they never do)work .
“I am totally against legalization of marijuana” So are the big cartels, Elaine .
[i]what ever happened to just say no?[/i]
Never worked, never will.
biddlin: We all did, to the DEA .
and you are now finding that a losing battle.
Don Shor: “what ever happened to just say no? Never worked, never will.”
wrong. it works everytime it’s tried.
so what is don shor saying? that “say no to drugs” hasn’t worked for don shor?
[url]http://alcoholfacts.org/DARE.html[/url]
Great link , Don . I think this describes the attitude of many drug war proponents . ” Leaders of DARE say the program shouldn’t be judged by evidence from empirical research studies. They tend to be indifferent to factual evidence and prefer to rely on feelings, impressions and hopes. As one DARE leader explained: ‘I don’t have any statistics for you. Our strongest numbers are the numbers that don’t show up.'”
91,
re: Ammiano’s remarks about prop. 215 “I do not wish to see the community ripped apart from drug addiction”
What specific effects from the use and/or abuse of marijuana (not the residual crime associated with selling, transporting, criminal orgs that profit from the criminalization of the drug, etc., but users alone) do you attribute to the “ripping apart” of communities?
One may point to the role alcohol use/abuse plays in domestic violence cases or rape, for example. Or how meth has plagued rural communities.
Elaine
I would be very worried about allowing the federal government, or any other government getting involved in what I can, and cannot prescribee a drug for. For instance, using medications for “off label” namely not yet approved by the FDA for that specific indication, is done on a daily basis. As an example, not so long ago, the birth control pill was approved only for birth control. But doctors found that it was extremely effective in helping women with extremely painful periods and those with such heavy bleeding that the might previously have required hysterectomy. Isn’t having the government get between the doctor and the patient exactly what many fear (unnecessarily in my view having worked within a federal health care provision program) about the Affordable Care Act ?
I totally get it about the importance of up bringing. I was raised in a very conservative small town in Wshington state in a conservative family.
It didn’t take long for me to start seeing inconsistencies in the beliefs with which I had been raised in regard to this issue. For example, it is objectively clear that tobacco, perfectly legal, has wreaked havoc on our society in terms of medical costs of the many forms of cancer it causes and promotes. The same can be said for alcohol, not only in terms of medical costs from treatment of addiction and alcohol related liver failures, but also in terms of drunk driving and it’s toll on our society. If we were being consistent, and promoting laws that truly protect our society, would we not be strongly advocating the criminalization of these drugs? I am not advocating for the legalization of marijuana to promote its recreational use. I simply believe that the laws against it are ineffective, expensive, demonstrably inequitable in terms of the legality of far more dangerous substances, and prevent some patients from getting care they truly need.
91 Octane
I am sure that what you have said is absolutely true from your point of view. As a doctor, I have a different point of view. I have had, in my own personal experience in my practice, patient’s who have had issues of loss of appetite and/or nausea, either because of their illness, or because of the medications that we use to treat them, severe enough to be life threatening. While it is true that many of these patients respond to the standard anti nausea medications, there are some who do not. Some of these folks, like da647 ( congratulations on your recovery), the use of medical marijuana can truly be life saving. For me, this makes the medical argument not “garbage” but a vital part of the discussion.
[quote]Great link , Don . I think this describes the attitude of many drug war proponents . ” Leaders of DARE say the program shouldn’t be judged by evidence from empirical research studies. They tend to be indifferent to factual evidence and prefer to rely on feelings, impressions and hopes. As one DARE leader explained: ‘I don’t have any statistics for you. Our strongest numbers are the numbers that don’t show up.'”[/quote]
So are you advocating that we “just say yes” to our children to use marijuana?
[quote]What specific effects from the use and/or abuse of marijuana (not the residual crime associated with selling, transporting, criminal orgs that profit from the criminalization of the drug, etc., but users alone) do you attribute to the “ripping apart” of communities? [/quote]
In our neighborhood, taggers have sprayed ugly graffiti on various walls, with specific references to marijuana use, along with racial epithets. Not nice…
Elaine- I’m saying we have a great example of a successful drug diversion program . The education of the public to the measurable dangers of tobacco has vastly decreased the number of tobacco users in this country . All the persecution of high-profile users and military operations, not just on foreign soil, but in the US, against citizens and the results, after nearly a century, is untold wealth down a rathole, ever growing disrespect and distrust of the agents entrusted to save us and no other meaningful effects on drug usage . BTW if I haven’t made it clear, I think marijuana should be legalized and other drugs decriminalized . Addiction and abuse are medical and social issues which have never been successfully dealt with in a penal context . Sorry to hear about the tagging, that’s a pain in the … 😉
ERM,
“In our neighborhood, taggers have sprayed ugly graffiti on various walls, with specific references to marijuana use, along with racial epithets. Not nice…”
That’s not what I consider to be a major factor in the “ripping apart” of a community, but rather something that’s “Not nice.” I was thinking more along the lines of how alcohol abuse has impacted Native Americans living on reservations, for example. From what I’ve read and heard, alcohol abuse is a major factor with regard to the plight of these communities (ie loss of life, domestic battery, sexual assaults, etc.).
I would like to present some facts about the effects of the use of various drugs in one medical setting, pregnancy, as a way of reframing the issue of where we might most effectively spend tax dollars to address harm caused by substance abuse.
My main source for the information is Up to Date based on last revision Jan. 2011.
In the United States, an analysis of the National Household Survey on Drug Abuse (NHSDA) from 1996 to 1998 reported that cigarettes, alcohol, and any illicit drugs were used in 20.3, 14.8, and 2.8 percent, respectively of surveyed pregnant women]. Marijuana accounted for almost two-thirds and cocaine for one-tenth of the illicit drug use.. Based on these results and the number of pregnancies in 1998 in the United States, 1.2 million, 0.8 million, and 0.2 million fetuses would be exposed yearly to cigarettes, alcohol, and any illicit drugs, respectively.
So looking at the numbers involved, we would be far more cost effective addressing the use of tobacco and alcohol than marijuana. But the statistics don’t tell the whole story. One also has to look at the relative risks to the baby. So I have included brief summaries of the demonstrated risks.
CIGARETTE SMOKING — The negative neonatal impact of prenatal maternal cigarette smoking is well established. Cigarette smoking during pregnancy has been associated with numerous complications and adverse effects at delivery including placental abruption, premature rupture of membranes, placenta previa, preterm labor and delivery, and low birth weight (LBW). These complications contribute to an increase in neonatal mortality of infants prenatally exposed to tobacco compared to unexposed infants (RR 1.2 to 1.4) [17,18].
For the babies who survive these medical problems there are ongoing risks:
Postnatal effects — “Several postnatal morbidities of maternal smoking during pregnancy have been reported. There is a well documented association between prenatal tobacco exposure and SIDS but with the other following conditions the relationship is less certain” but with an increasing body of supportive evidence
•Sudden infant death syndrome (SIDS) — Several prospective case controlled studies from different countries have shown that maternal smoking during pregnancy increases the risk of SIDS two to four-fold
•Diabetes mellitus — Cigarette smoking by the individual has been associated with an increased risk of type 2 diabetes 4 fold.
•Cognitive ability — suggested but less well documented due to confounding factors
•Behavioral problems — suggested but less well documented
•Increased incidence of asthma in adult offspring
Important to note that the most severe effects are seen with heavy smokers ( > 1 pack per day) but effects have been noted with even second hand maternal smoke exposure.
Alcohol use
Fetal alcohol syndrome — Fetal alcohol syndrome (FAS) is the most severe form of FASD and is one of the most commonly identifiable causes of intellectual disability (mental retardation). It is defined by abnormalities in three domains; poor growth, central nervous system (CNS) abnormalities including impaired brain growth or abnormal structure, and specific dysmorphic facial features
•Poor growth that begins in utero continues through infancy and childhood. In addition, the irreversible prenatal brain damage results in poor neurodevelopmental outcome. In infancy, CNS manifestations of FAS include irritability, jitteriness, and an exaggerated response to noise. In childhood, hyperactivity, developmental delay, hypotonia, learning disabilities, auditory and visual impairment, seizure disorders, and intellectual disability (mental retardation) are characteristic findings .
Important to note that FAS is not associated with casual use, but only with binge drinking.
( continued)
Drug effects ( part two)
Alcohol use
Fetal alcohol syndrome — Fetal alcohol syndrome (FAS) is the most severe form of FASD and is one of the most commonly identifiable causes of intellectual disability (mental retardation). It is defined by abnormalities in three domains; poor growth, central nervous system (CNS) abnormalities including impaired brain growth or abnormal structure, and specific dysmorphic facial features
•Poor growth that begins in utero continues through infancy and childhood. In addition, the irreversible prenatal brain damage results in poor neurodevelopmental outcome. In infancy, CNS manifestations of FAS include irritability, jitteriness, and an exaggerated response to noise. In childhood, hyperactivity, developmental delay, hypotonia, learning disabilities, auditory and visual impairment, seizure disorders, and intellectual disability (mental retardation) are characteristic findings
oops sorry for the repetition! On to Marijuana:
MARIJUANA — Although marijuana is the most commonly used illicit substance during pregnancy, it appears that there may not be any prenatal effect of marijuana on birth weight or gestational age of exposed offspring.
•When compared with infants not exposed in utero with infants exposed to marijuana in utero, there is no difference with regard to head circumference,
•or length
•There was no association between marijuana use and prematurity or congenital anomalies [95].
•In the Avon Longitudinal Study of Pregnancy and Childbirth, 2 to 3 percent of the 12,000 pregnant women surveyed reported using marijuana (cannabis) during pregnancy [96]. Marijuana use was not associated with an increase in preterm birth, neonatal intensive care unit admission, or perinatal mortality. Sustained weekly use, but not occasional use, appeared to be associated with a trend toward a slight decrease in birthweight, even after adjusting for multiple confounding factors. Mean birth length and head circumference were not affected.
In the neonatal period, one observational study of adolescent mothers reported that 26 term infants with isolated neonatal exposure to marijuana (ascertained by analysis of maternal hair and neonatal meconium, and maternal review) were more likely to be hyperexcitable, irritable and jittery, and have an increased arousal response compared to nonexposed healthy infants [97].
It is unclear whether prenatal marijuana exposure effects neurodevelopmental outcome. In the above mentioned longitudinal prospective study [94], patients were subsequently evaluated for neurodevelopmental outcome through childhood and adolescence [34,98-100]. These studies suggested that prenatal marijuana exposure does not affect global intelligence, but may impair sustained attention, and visual memory, analysis and integration in exposed preadolescents and adolescents. However, it is difficult to ascertain whether these findings were directly due to prenatal exposure to marijuana or other confounding variables such as home environment or exposure to other drugs of abuse as these were not controlled studies.
In contrast, a prospective study of 648 prenatally exposed children reported that heavy marijuana use had a negative impact on intellectual development at six years of age [101]. Heavy use during the first trimester was associated with lower verbal reasoning scores, second trimester use with composite, short-term memory, and quantitative scores, and third trimester use only with quantitative scores. However, caution should be used in interpreting these findings as these findings may be due to chance alone because of the number subset analyses and the variability of findings.
One could do the same type of risk comparison between use of tobacco, alcohol,
and marijuana for addictive potential, adult illnesses, societal impact in terms of medical costs such as association with various forms of cancer, motor vehicle accidents, liver disease, dementia, asthma. In each case, marijuana will be found to have much less risk, as statistically demonstrated, than either alcohol or tobacco. And yet we pour millions of dollars into the steadily losing “war against drugs”.
As biddlin pointed out, we have a successful drug diversion program which has been
“enforced” as people became aware of the hazards of tobacco and have become progressively less accepting of its use in public. For those who oppose the legalization of marijuana, which I believe they do for personal, social or moral,certainly not medical reasons, I would propose a similar approach to limiting the use of marijuana.
medwoman-Facts have never played much if any role in the drug debate . Much like your current water wars, the issue becomes simply another pony for candidates to parade .