Moderate Lifetime Marijuana Use Associated With Reduced Risk Of Head And Neck Cancer, Study Says

Providence, RI: The moderate long-term use of marijuana is associated with a reduced risk of head and neck cancers, according to the results of a population-based case-control study published online by the journal Cancer Prevention Research.

Investigators at Rhode Island’s Brown University, along with researchers at Boston University, Louisiana State University, and the University of Minnesota assessed the lifetime marijuana use habits of 434 cases (patients diagnosed with head and neck squamous cell carcinoma from nine medical facilities) compared to 547 matched controls.

Authors reported, “After adjusting for potential confounders (including smoking and alcohol drinking), 10 to 20 years of marijuana use was associated with a significantly reduced risk of head and neck squamous cell carcinoma … [as was] moderate weekly use.”

Subjects who smoked marijuana and consumed alcohol and tobacco (two known high risk factors for head and neck cancers) also experienced a reduced risk of cancer, the study found.

“Our study suggests that moderate marijuana use is associated with reduced risk of HNSCC,” investigators concluded. “This association was consistent across different measures of marijuana use (marijuana use status, duration, and frequency of use). … Further, we observed that marijuana use modified the interaction between alcohol and cigarette smoking, resulting in a decreased HNSCC risk among moderate smokers and light drinkers, and attenuated risk among the heaviest smokers and drinkers. … Despite our results being consistent with the point estimates from other studies, there remains a need for this inverse association to be confirmed by further work, especially in studies with large sample sizes.”

A separate 2006 population case-control study also reported that lifetime use of cannabis was not positively associated with cancers of the lung or aerodigestive tract, and noted that certain moderate users of the drug experienced a reduced cancer risk compared to non-using controls.

By contrast, a study published earlier this week in the journal Cancer Epidemiology reports that even the moderate use of alcohol (six drinks or less per week) is associated with an elevated risk of various cancers – including stomach cancer, rectal cancer, and bladder cancer.

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, “A population-based case control study of marijuana use and head and neck squamous cell carcinoma,” will appear in Cancer Prevention Research.

California: Oakland Voters Approve Nation’s First Marijuana Business Tax

Oakland, CA: Municipal voters on Tuesday overwhelmingly approved the nation’s first ever business tax on retail marijuana sales.

Approximately 80 percent of Oakland voters approved the new tax (which appeared on the ballot as Measure F), which imposes an additional tax for “cannabis businesses” of $18 for every $1,000 of gross receipts beginning January 1, 2010.

Presently, Oakland’s medicinal cannabis dispensaries are taxed at the same rate as other retail sales businesses ($60 per year for the $50,000 of gross receipts, plus $1.20 for each additional $100,000).

Four dispensaries are licensed by the Oakland City Council to sell and dispense medical marijuana.

According to a financial analysis by the Oakland City Auditor, Oakland’s new cannabis business tax will generate an estimated $300,000 in additional annual tax revenue. Other proponents have estimated that the new tax could yield up to a million dollars yearly.

Representatives from the Oakland City Council, the California Nurses Association, and the dispensary community publicly advocated for the new tax, which had no formal opposition.

“The passage of this first-in-the-nation tax further legitimizes cannabis-based enterprises in Oakland and elsewhere,” NORML Executive Director Allen St. Pierre said. These outlets are contributing to the health and welfare of their local communities, both socially and now economically. At a time when many municipalities are strapped for tax revenues and cutting public services it is likely that public officials in other cities will begin considering similar proposals.”

City officials in Los Angeles, San Francisco, and Berkeley may also impose a cannabis-business tax on certain retail dispensaries.

For more information, please contact either Allen St. Pierre, NORML Executive Director, at (202) 483-5500, or Dale Gieringer, California NORML Coordinator at: (415) 563-5858.

Thoughts on abuse as substitute for missing nutritional components

The paper that I wrote suggests that ALL chronic smoking of marijuana is a symptoms of malnutrition, that the cannabis plant is a ‘symbiote’ to the human being, similar to the way that bamboo is to the panda bear and the eucalyptus  is to the koala. We evolved from a form that was more like a slothy bear. I would imagine that drinking and anything else is a substitution  for trying to find what is missing- Cannabis.

PARENTS: KEEP YOUR KIDS AWAY FROM FDA APPROVED DRUGS

mjvspharmies

Deaths from Marijuana v. 17 FDA-Approved Drugs
(Jan. 1, 1997 to June 30, 2005)

  1. Background
  2. Cause of Death Categories & Definitions
  3. FDA Disclaimer of Information
  4. Summary of Deaths by Drug Classification
  5. Deaths from Marijuana & 17 FDA-Approved Drugs
  6. Sources & Disagreement on Marijuana Deaths
  7. Full Text of All 17 FDA “Adverse Event” Reports

I. Background

Much of the medical marijuana discussion has focused on the safety of marijuana compared to the safety of FDA-approved drugs. On June 24, 2005 ProCon.org sent a Freedom of Information Act (FOIA) request to the US Food and Drug Administration (FDA) to find the number of deaths caused by marijuana compared to the number of deaths caused by 17 FDA-approved drugs. Twelve of these FDA-approved drugs were chosen because they are commonly prescribed in place of medical marijuana, while the remaining five FDA-approved drugs were randomly selected because they are widely used and recognized by the general public.

We chose Jan. 1, 1997 as our starting date as it is the beginning of the first year following the Nov. 1996 approval of the first state medical marijuana laws (such as California’s Proposition 215). The FDA reports we read from Sep. 13, 2005 to Oct. 14, 2005 included drug deaths “to present”, which was the date each report was compiled for our request. We cut off the counting as of June 30, 2005 to provide a uniform end-date to the various reports.

On Aug. 25, 2005 the FDA sent us 12 CDs and five printed reports containing copies of their Adverse Event Reporting System (AERS) report on each drug requested. These reports included all adverse events reported to the FDA, only a portion of which included deaths. We manually counted the number of deaths reported on each drug from the FDA-supplied information.

A review of the FDA Adverse Events reports also revealed some deaths where marijuana was at least a concomitant drug (a drug also used at the time of death) in some cases. On Oct. 14, 2005 we used the Freedom of Information Act to request a copy of the adverse events reported deaths for marijuana/cannabis. We received those reports on Aug. 3, 2006 in the form of three additional CDs.

II. Cause of Death Categories & Definitions

The FDA AERS reports rely on health professionals to detect an “adverse event” and attribute that event to the drug, and then to voluntarily report that effect to either the FDA or the drug manufacturer. The drug firm, by law, must report that event to the FDA. The FDA states “ninety percent of the FDA’s reports are received from drug manufacturers” on page one of its “Adverse Event Reporting System (AERS) Brief Description with Caveats of System.” (PDF 2.7 MB)

Select instructions on how to report adverse events, as per the FDA’s AERS Form Instructions (PDF 65 KB), are provided below:

  • Adverse Event: Any incident where the use of a medication (drug or biologic, including HCT/P), at any dose, a medical device (including in vitro diagnostics) or a special nutritional product (e.g., dietary supplement, infant formula or medical food) is suspected to have resulted in an adverse outcome in a patient.
  • Death: Check only if you suspect that the death was an outcome of the adverse event, and include the date if known. Do not check if:
    • The patient died while using a medical product, but there was no suspected association between the death and
    • A fetus is aborted because of a congenital anomaly (birth defect), or is miscarried

  1. Suspect Product(s): A suspect product is one that you suspect is associated with the adverse event.Up to two (2) suspect products may be reported on one form (#1=first suspect product, #2=second suspect product). Attach an additional form if there were more than two suspect products associated with the reported adverse event.
  2. To report: it is not necessary to be certain of a cause/effect relationship between the adverse event and the use of the medical product(s) in question. Suspicion of an association is sufficient reason to report. Submission of a report does not constitute an admission that medical personnel or the product caused or contributed to the event.
III. FDA Disclaimer of Information

Included in the 15 CDs and five printed reports from the FDA was the following disclosure:

“The information contained in the reports has not been scientifically or otherwise verified. For any given report there is no certainty that the suspected drug caused the reaction. This is because physicians are encouraged to report suspected reactions. The event may have been related to the underlying disease for which the drug was given to concurrent drugs being taken or may have occurred by chance at the same time the suspected drug was taken.

Numbers from these data must be carefully interpreted as reported rates and not occurrence rates. True incidence rates cannot be determined from this database. Comparisons of drugs cannot be made from these data.”
— July 18, 20/05 – FDA Office of Pharmacoepidemiology and Statistical Science, “Adverse Event Reporting System (AERS) Brief Description with Caveats of System”

[Editor’s Note – ProCon.org makes no claim that the data below reflects occurrence rates. The information is presented for our readers’ benefit who may feel that the relative comparisons have value. ProCon.org attempted to find the total number of users of each of these drugs by contacting the FDA, pharmaceutical trade organizations, and the actual drug manufacturers. We either did not receive a response or were told the information was proprietary or otherwise unavailable]

IV. Summary of Deaths by Drug Classification

DRUG CLASSIFICATION

Specific
Drugs per
Category

Primary
Suspect of the Death

Secondary
Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

A. MARIJUANA
also known as: Cannabis sativa L

0

279

279

B. ANTI-EMETICS
(used to treat vomiting)

196

429

625

C. ANTI-SPASMODICS
(used to treat muscle spasms)

118

56

174

D. ANTI-PSYCHOTICS
(used to treat psychosis)

1,593

702

2,295

E. OTHER POPULAR DRUGS
(used to treat various conditions including ADD, depression, narcolepsy, erectile dysfunction, and pain)

8,101

492

8,593


F. TOTALS of A-E
Number
of Drugs
in Total

Primary
Suspect of the Death

Secondary
Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

  • TOTAL DEATHS FROM MARIJUANA

1

0

279

279

  • TOTAL DEATHS FROM 17 FDA-APPROVED DRUGS

17

10,008

1,679

11,687

V. Chart of Deaths from Marijuana and 17 FDA-Approved Drugs
A. Marijuana

DRUG (Year Approved)

Primary Suspect of the Death

Secondary Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

1. Marijuana (not approved)
also known as: Cannabis sativa L

0

109

109

2. Cannabis (not approved)
also known as: Cannabis sativa L

0

78

78

3. Cannabinoids
(unclear if these mentions include non-plant cannabinoids)

0

92

92

Sub-Total – Marijuana

0

279

279

FDA-Approved Drugs Prescribed in Place of Medical Marijuana

B. Anti-Emetics


DRUG
(Year Approved)

Primary Suspect of the Death

Secondary Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

1. Compazine (1980)
also known as: Phenothiazine, prochlorperazine

15

30

45

2. Reglan (1980)
also known as: Metaclopramide, Paspertin, Primperan

37

278

315

3. Marinol (1985)
also known as: Dronabinol

4

1

5

4. Zofran (1991)
also known as: Ondansetron hydrochloride

79

76

155

5. Anzemet (1997)
also known as: Dolasetron mesylatee

22

5

27

6. Kytril (1999)
also known as: Granisetron hydrochloride

36

24

60

7. Tigan (2001)
also known as: Trimethobenzamide

3

15

18

Sub-Total – Anti-Emetics

196

429

625

C. Anti-Spasmodics


DRUG
(Year Approved)

Primary Suspect of the Death

Secondary Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

1. Baclofen (1967)
also known as: Lioresal, 4-amino-3-(4-chlorophenyl)-butanoic acid

72

33

105

2. Zanaflex (1996)
also known as: Tizanidine hydrochloride, Sirdalud, Ternelin

46

23

69

Sub-Total – Anti-Spasmodics

118

56

174

D. Anti-Psychotics


DRUG
(Year Approved)

Primary Suspect of the Death

Secondary Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

1. Haldol (1967)
also known as: Haloperidol, Haldol Decanoate, Serenace, Halomonth

450

267

717

2. Lithium (1970)
also known as: Lithium Carbonate, Eskalith, Lithobid, Lithonate, Teralithe, Lithane, Hypnorex, Limas, Lithionit, Quilonum

175

133

308

3. Neurontin (1994)
also known as: Gabapentin

968

302

1,270

Sub-Total – Anti-Psychotics

1,593

702

2,295

E. Other Well-Known and Randomly Selected FDA-Approved Drugs


DRUG
(Year Approved)

Primary Suspect of the Death

Secondary Suspect (contributing to death)

Total Deaths Reported
1/1/97 – 6/30/05

1. Ritalin (1955)
also known as: Methylphenidate, Concerta, Medadate, Ritaline
(used to treat ADD and ADHD)

121

53

174

2. Wellbutrin (1997)
also known as: Bupropion Hydrochloride, Zyban, Zyntabac, Amfebutamone
(used to treat depression & anxiety)

1,132

220

1,352

3. Adderall (1966)
also known as: Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate USP, Amphetamine Sulfate USP
(used to treat narcolepsy or to control hyperactivity in children)

54

12

66

4. Viagra (1998)
also known as: Sildenafil Citrate
(used to treat erectile dysfunction)

2,254

40

2,294

5. Vioxx (1999)
also known as: Rifecixub, Arofexx
(used to treat osteoarthritis and pain)

4,540

167

4,707

Sub-Total – Other Popular Drugs

8,101

492

8,593

F. TOTALS of A-E

Primary Suspect

Secondary Suspect

Total Deaths Reported
1/1/97 – 6/30/05

  • TOTAL DEATHS FROM MARIJUANA

0

279

279

  • TOTAL DEATHS FROM 17 FDA-APPROVED DRUGS

10,008

1,679

11,687


VI. Sources & Disagreement on Marijuana Deaths

Has marijuana caused any deaths?

General Reference (not clearly pro or con)

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2003 report Mortality Data from the Drug Abuse Warning Network, 2001 (1.5 MB) stated:

“Marijuana is rarely the only drug involved in a drug abuse death. Thus … the proportion of marijuana-induced cases labeled as ‘One drug’ (i.e., marijuana only) will be zero or nearly zero.”
2003 – Substance Abuse and Mental Health Services Administration

PRO (Yes)

CON (No)

Thomas Geller, MD, Associate Professor of Child Neurology at the Saint Louis University Health Sciences Center, et al., wrote the following in their Apr. 4, 2004 article titled “Cerebellar Infarction in Adolescent Males Associated with Acute Marijuana Use,” (560 KB) published in the journal Pediatrics:

“Each of the 3 cannabis-associated cases of cerebellar infarction was confirmed by biopsy (1 case) or necropsy (2 cases)… Brainstem compromise caused by cerebellar and cerebral edema led to death in the 2 fatal cases.”
Apr. 4, 2004 – Thomas Geller, MD

Liliana Bachs, MD, Senior Medical Officer at the Norwegian Institute of Public Health, et al., wrote the following in their Dec. 27, 2001 article titled “Acute Cardiovascular Fatalities Following Cannabis Use,” published in the journal Forensic Science International:

“Cannabis is generally considered to be a drug with very low toxicity. In this paper, we report six cases where recent cannabis intake was associated with sudden and unexpected death. An acute cardiovascular event was the probable cause of death. In all cases, cannabis intake was documented by blood analysis… Further investigation of clinical, toxicologial and epidemiological aspects are needed to enlighten causality between cannabis intake and acute cardiovascular events.”
Dec. 27, 2001 – Liliana Bachs, MD

[Editor’s Note: Dr. Bachs clarified the findings from her Dec. 27, 2001 study reported above in a Nov. 28, 2005 email to ProCon.org, as quoted below.

“Causality is a difficult assessment in forensic toxicology. It is often an ‘exclusion diagnosis,’ and so it is in our cases. I’m therefore not sure about how to classify those deaths.

At the time I published that study I would probably not classify [the cannabis] as primary causation because it was not broadly accepted that [a death from cannabis] could occur at all. Today I see reports coming all the time that acknowledge cannabis cardiovascular risks, and the situation may be different.”]

Stephen Sidney, MD, Associate Director for Clinical Research at Kaiser Permanente, wrote the following in his Sep. 20, 2003 article titled “Comparing Cannabis with Tobacco — Again,” published in the British Medical Journal:

“No acute lethal overdoses of cannabis are known, in contrast to several of its illegal (for example, cocaine) and legal (for example, alcohol, aspirin, acetaminophen) counterparts…

Although the use of cannabis is not harmless, the current knowledge base does not support the assertion that it has any notable adverse public health impact in relation to mortality.”
Sep. 20, 2003 – Stephen Sidney, MD


Joycelyn Elders, MD, former US Surgeon General, wrote the following in her Mar. 26, 2004 editorial published in the Providence Journal:

“Unlike many of the drugs we prescribe every day, marijuana has never been proven to cause a fatal overdose.”
Mar. 26, 2004 – Joycelyn Elders, MD

VII. Full Text of All 20 FDA “Adverse Event” Reports

[Please note that some of these PDF files exceed 5 megabytes and may take several minutes to load]

  1. Adderall (PDF 495 KB)
  2. Anzemet (PDF 1.5 MB)
  3. Baclofen (PDF 755 KB)
  4. Cannabinoids (PDF 65 KB)
  5. Cannabis (PDF 330 KB)
  6. Compazine (PDF 1.6 MB)
  7. Haldol (PDF 1.5 MB)

  1. Kytril (PDF 2.2 MB)
  2. Lithium (PDF 2.4 MB)
  3. Marijuana (PDF 220 KB)
  4. Marinol (PDF 535 KB)
  5. Neurontin (PDF 6.3 MB)
  6. Ritalin (PDF 1.6 MB)
  7. Reglan (PDF 1.5 MB)

  1. Tigan (PDF 2.4 MB)
  2. Viagra (PDF 7.6 MB)
  3. Vioxx (PDF 31.5 MB)
  4. Wellbutrin (PDF 8.3 MB)
  5. Zanaflex (PDF 6556 KB)
  6. Zofran (PDF 1 MB)

California: Marijuana Smoke Added To State’s List Of Carcinogens

Sacramento, CA: The Office of Environmental Health Hazard Assessment (OEHHA) and the California Environmental Protection Agency have added marijuana smoke to the state’s list of official carcinogens, pursuant to Title27, California Code of Regulations, section 25305(a)(1).

Under state law, the Governor’s office is required to publish an annual list of chemicals that possess potential carcinogenic properties and/or are associated with reproductive toxicity, such as arsenic, lead, and tobacco smoke. Products containing such chemicals are required to carry warning labels. Business establishments with ten employees or more are also are mandated to post signs indicating whether there is a likelihood that an individual may be exposed to such chemicals while on the premises.

State environmental regulators determined that there is “limited” evidence “suggestive” that marijuana smoke exposure may be associated with an increased cancer risk in humans. Their review added, “[T]he similarities in chemical composition and in toxicological activity between marijuana smoke and tobacco smoke, and the presence of numerous carcinogens in marijuana (and tobacco) smoke, provide additional evidence of carcinogenicity.”

Presently, over 300 separate chemicals – including aspirin and alcoholic beverages – are designated as carcinogens under California law.

Labeling requirements for marijuana smoke will not take effect until June 2010. Neither marijuana nor edible products containing marijuana will be designated as carcinogens under state law.

Regulators made no official determination regarding the status of cannabis vapor, which does not contain combustion gases and has been determined to be a “safe and effective vehicle” for cannabis delivery in clinical trials.

Authors of the review did note that the largest population case-control study ever to assess the use of marijuana and lung cancer risk did not find a positive association between long-term cannabis smoking and cancer.

California NORML Coordinator Dale Geiringer said that the ruling did not come as a surprise because it has been well known for years that cannabis smoke contains known carcinogenic chemicals. However, he noted that the intake of these noxious chemicals “can be completely eliminated by vaporization or by consuming marijuana orally.”

NORML Deputy Director Paul Armentano said that it remains unclear what effect, if any, these new regulations will have on the dispensing of medical marijuana in California. “Since it is marijuana smoke, not marijuana per se, that is at issue here, it is not clear that legally operating medicinal cannabis dispensaries will have to alter their actions to comply with Prop. 65,” he said – noting that few such facilities allow patients to smoke cannabis on the premises. “Liquor stores are not required to post warnings on the premises just because they dispense alcohol, so why would medical cannabis dispensaries be treated any differently?”

Marijuana bills intorduced into congress

Today, Congressman Barney Frank (D-Mass.) introduced a bill in the U.S. House of Representatives to eliminate all federal penalties for marijuana possession. This came only one week after he also introduced a bill to protect medical marijuana patients.

Would you please take one minute to ask your U.S. representative to support these two bills? MPP’s easy online action center makes it simple — just enter your name and contact info, and we’ll do the rest.

The Personal Use of Marijuana by Responsible Adults Act of 2009 would eliminate the threat of federal arrest and prison for the possession of up to 3.5 ounces of marijuana and the not-for-profit transfer of an ounce of marijuana — nationwide.

What’s more, last week Congressman Frank introduced the Medical Marijuana Patient Protection Act, which would allow states to protect medical marijuana patients from arrest and jail without federal interference, as well as allow pharmacies to dispense marijuana to patients with a doctor’s recommendation. You can take action on this bill here.

MPP has worked closely with Congressman Frank’s staff in past months, helping to craft both pieces of legislation and build political support for the proposals on Capitol Hill.

Now members of Congress need to hear from their constituents who want to see it passed — that means you! It takes only a minute or two to use MPP’s online action system to send a quick note to your member of the House, so would you please send your letter right now?

Eliminate threat of federal arrest and prison for marijuana possession

Protect medical marijuana patients nationwide

U.S. Physicians Announce Founding Of American Academy Of Cannabinoid Medicine

Santa Barbara, CA: A coalition of US physicians and researchers has founded a new organization dedicated to promoting ethical standards in therapeutic cannabis treatment.

“The American Academy of Cannabinoid Medicine … is a professional medical organization dedicated to the clinical and scientific understanding of the endoccannabinoid system and the therapeutic application of cannabis and cannabinoids,” the group states in a press release.

It continues: “The Academy serves as an authoritative information source for doctors, state medical boards and the media on the medical application and research related to the clinical use of cannabis and cannabinoids. We are dedicated to educating physicians about the clinical therapeutic usefulness of cannabis to relieve symptoms of the myriad of diseases that respond to this class of medications.”

Members of the organization “will promote high medical ethical and practice standards in the approval and recommendation of cannabis for medicinal purposes.” According to the organization’s website, the AACM has “developed certifying practice standards and guidelines for practicing physicians who recommend and approve the medicinal use of cannabis acting within state law.”

“Our mission is to foster the highest standards in the practice of cannabinoid medicine,” the website states.

For more information about the American Academy of Cannabinoid Medicine, please visit: http://aacmsite.org.

Michigan to begin marijuana program

thoughts from the maji-

“The vague nature of the way that the initiative was written allows for law enforcement and government officials to control the rate at which the program deploys, the same thing was done here in California.. The answer to this?  STARK Raving and Rabid prescience and tenacity when it comes to communicating and pressuring officials to adapt the initiative to accomplish the true goal of balancing the health of the State.

HASSLE them until they do not want to hassle you anymore and are SICK of the issue, and just want to be left alone again in their tired little deadend lives….  this is the latest big chance to have the public’s attention on them, let’s make the attention uncomfortable, let them remember that their positions in government and law enforcement are not theirs to use for power-mongering, influence-peddling, or personal political agendas.  It is time for All Americans not just Michiganers to take back their personal Constitutions and in the process the collective Constitution will be restored… Not rocket science here folks, just have to step up and show for yourselves with courage, tenacity and steadfastness.

Thousands of people expected to sign up starting today
DETROIT (AP) — The first wave of what could be tens of thousands of people signing up for Michigan’s medical-marijuana program is expected in Lansing today.
For Greg Francisco, of Paw Paw, who is organizing the mass submission in the state capital, it will be a sweet moment after a decade of working to legalize medical marijuana.
“In a year, we’re going to look back and say, ‘What was the fuss all about?'” said Francisco, executive director of the Michigan Medical Marijuana Association. “People have been using medical marijuana in this state all along. All this does is give them some legal protection.”
Rules for Michigan’s medical-marijuana program went into effect Saturday, and the state begins taking applications today. The first cards will be issued to patients later this month. But questions linger about how the program will work in practice, and resolving all the confusion may require additional legislation or intervention by the courts.
Michigan residents can get a doctor’s recommendation to use marijuana to relieve pain and other symptoms. Patients can register with the state and receive a card protecting them from arrest for growing, using or possessing the drug, which remains illegal under federal law.
Twelve other states have similar programs.
An analysis by the House Fiscal Agency estimates between 2,000 and 55,000 patients may sign up for Michigan’s program.
John Hazley, 39, plans to register “as soon as possible.” The Detroit man says he smokes marijuana to relieve pain in his knee and back from old injuries, and worries about becoming dependent on pain pills.
“Usually when I take the pills, I’m tired and sleepy, and when I take the marijuana it gives me a boost,” Hazley said.
In the five months since voters approved the measure, there’s been confusion about what the law will mean for police, prosecutors and patients.
For instance, Michigan’s law doesn’t say how patients will obtain marijuana or seeds to grow their own, nor does it address whether employers can enforce drug-free workplace rules if workers are registered to legally use marijuana. It also leaves unsaid how police will enforce the limit of 12 mature plants and 2.5 ounces permitted each patient.
Advocates and officials say many of those issues may end up in court. The state legislature also can modify the law with a three-quarters vote in each chamber.
“There’s going to be a lot of litigation here, there’s going to be a lot of court time … to answer these unanswered questions and put some solid color in those gray areas,” said James McCurtis, spokesman for the Department of Community Health, which runs the program through its Bureau of Health Professions.
State officials initially sought to head off many of those questions by writing some of the strictest rules in the nation for patients in the program, according to documents obtained by The Associated Press under the state’s Freedom of Information Act.
Among the proposals were random inspections of growing sites, mandatory inventories of marijuana grown by patients or their designated caregivers and allowing the release of patients’ names and other information to law-enforcement agencies. Many of the rules went beyond the law approved by voters.
The officials drafting the rules were trying to plug perceived holes in the law, said Rae Ramsdell, director of licensing for the department’s Bureau of Health Professions.
“You’re trying to anticipate what kind of problems you’re going to have and address those problems before they happened,” she said.
In an internal e-mail two days after the Nov. 4 election, one official described the law as “a hopelessly short-sighted and simple-minded ballot initiative” with “some really poorly worded language.”
McCurtis said the official, Kurt Krause, then-acting director of the Office of Legal Affairs and now deputy director of the department, was referring to areas of confusion in the legislation and was concerned about the department seeming to offer legal advice to the public.
When draft rules for the program were released last December, there was an immediate backlash from patients and their advocates. Many turned out for a public hearing in January to blast the proposed rules.
A review by the State Office of Administrative Hearings and Rules dated Dec. 1, 2008, also determined a number of early rules “exceed that which is required” under the law. It called one on denying incomplete applications “somewhat harsh” and another “arbitrary and capricious.” Random inspections of growth sites were deemed a possible violation of the Fourth Amendment, which protects against unreasonable search and seizure.
“The comments from all the different groups made us go back and re-examine what the law said, and looking at what the law said drove the decisions to remove a lot of the enforcement-type language and not to try to anticipate the problems that might come up, but to work within the very tight statute that we had,” Ramsdell said.
The final draft of the rules, unveiled in February, pulled back on almost every point of contention.
“We had to kind of go away from the enforcement perspective and think about how we could get these people registered and use marijuana for medical purposes,” Ramsdell said. “That for us is a huge shift because we are used to enforcing laws that are put into place. And in this case, all we are responsible for doing is putting into place a registry.”