Following are three letters from members of the MassCann board of directors to the Department of Public Health concerning their proposed medical-marijuana regulations.
First, a letter from Bill Downing, MassCann treasurer. (The remaining letters are from Kathryn Rifkin, MassCann clerk, and Andy Gaus, MassCann press secretary.)
To the Massachusetts Department of Public Health:

Thank you for taking the time to consider the public point-of-view!

I realize the nature of this unfortunate situation DPH has been thrust into.
Due to the political nature of the prohibition of cannabis, the safest
therapeutic substance we know of must be regulated by DPH as though it were
very dangerous. I’m sure the irony of sealing-off leakage of medical
cannabis into communities already knee-deep in “marijuana,” despite the
prohibition, is not lost on you folks.

Though I have only a few specific regulatory issues to comment on, my
comments, I hope, may help you in understanding my perspective on the entire
regulatory scheme, which I have good reasons to believe are widely shared
among the citizenry.

Doctors know almost nothing about cannabis and ignorance breeds fear

I can tell you from personal experience. My family doctor knew almost
nothing about the safest therapeutic medicine known – AMAZING! How could
such a thing happen?

Input from the medical community suffers from a complete lack of knowledge
regarding the low relative toxicity and wide efficaciousness of cannabis.
The toxic dose of cannabis is projected to be 40,000 times greater than the
effective dose. I say “projected to be” because a toxic dose of cannabis is
not possible to administer and so no actual toxic dose level can be
established. This makes cannabis a far safer medicine than any other
medicines our society considers “safe”; medicines like aspirin, Sudafed,
Advil, etc. Even the water you down those pills with itself is more toxic
than cannabis. Consuming a few gallons can kill you.

As far as medical usefulness goes, as Dr. Lester Grinspoon of Harvard said,
if cannabis were to be found just today – it would be hailed as a medical
miracle plant. I agree, as any objective person who was informed regarding
this issue would.

Please consider the irony of having a relatively toxic medicine – aspirin
(which kills 6-7,000 annually) – available on store shelves in unlimited
quantities for purchase w/o prescription or ID or age restrictions or
anything; when compared with the intense scrutiny you propose for medicinal
cannabis, which is tremendously less toxic. The difference in your need to
control cannabis and our present control of aspirin is not science based.
This is not medicine. This is not “public health”. This is politics. This is
politics where it does not belong.

The Massachusetts medical community and the drug warrior professionals all
confuse how they feel about cannabis, which is the product of a
decades-long, government sponsored, misinformed, propaganda campaign used to
try to frighten children from using cannabis as though that was actually
knowing something about cannabis. This propaganda campaign has left many who
give you input under the guise of authority badly misinformed regarding the
science of medicinal cannabis.

Please base your regulations on science and not on the political mess
prohibition has created.

Science says no other medicine has been used safely as long as cannabis has
and no other therapeutic substance is as safe as medicinal cannabis.

Those facts should take precedence over unreasonable fears born of an failed
organized governmental propaganda campaign, which has led many to believe,
though it is not true, that cannabis fries your brain.

Doctors don’t know anything about cannabis and it is not because cannabis is
not medicine. It is because of politics.

Medical schools have neglected to educate students on the properties of the
safest therapeutic substance known. How could such a thing happen?

They only tell their student, “It’s illegal so we do not need to learn about
it.” Where pharmaceutical companies make sure students are made aware of the
usefulness of their products (even “off-label” uses), no pharmaceutical
company has any interest in making sure students are aware of the usefulness
of cannabis. No broad long-term studies are financed for studies of cannabis
– not because it is not efficacious – but because it is not patentable.

There is no well-heeled corporate campaign with samples and studies and
literature and perks for doctors, when it comes to medicinal cannabis.

Patients most often are poor and denying them or their care giver friends
the right to grow their medicine for free or almost for free is immoral and
illogical.

Try being sick or injured for a long time and you will probably find – it is
hard to be ill or injured and make a good living. From my experience most of
the people who will need medical marijuana are not well-off. Even if they
are of independent means, $400 an ounce for medicine that would cost $25 an
ounce if not for the artificial price inflation associated with prohibition
is neither necessary nor is it reasonable.

Forcing patients to buy cannabis from Treatment Centers will create an
unnecessary and avoidable financial burden upon many of those who can least
afford it.

What I read in your Draft Regulations is just not true. Your draft
regulations postulate it will be less expensive for patients to buy cannabis
from Treatment Centers than it would be for a caregiver or the patient
themselves to produce. This is just not possible. If not for Reefer Madness,
a patient could grow his or her own medicine for the cost of dirt, sunlight
and rain ($0). CareGivers do it at the cost of goods sold, which for caregivers is very low.

Evan though they will be “nonprofit,” consider the cost structure associated
with running a full-time cannabis grow and sell operation, with:

Employees – healthcare, vacation pay, retirement and other benefits packages
on top of uncapped salaries

Facilities – Industrial grow and commercial retail facilities with all their
attendant overhead

Marketing – Treatment Centers will have incentives to market their service
to patients, which will be paid for, ultimately, by the patients.

CareGivers are nonprofit VOLUNTEERS and have no incentives to re-invest any
margin above costs-of-goods-sold in employees. facilities or marketing. I
recall you mentioning that the postulation that Treatment Centers would
lower patient costs was inspired by those looking to open Treatment Centers.
Their incentives to purposefully deceive you are readily apparent.

With only one patient per caregiver, there will not be enough capable caregivers to properly serve the patient population.

Those you should be most concerned with seem to have the least impact on
your regulatory rule-making process. If you had taken the time to make
yourselves aware of issues the patients are facing, you would know that
there is, already, a severe lack of caregivers. You know Treatment Centers
will not have cannabis on the shelves for many, many months. If you care at
all for the interests of the patients, you would not limit the number of
patients a caregiver can help.

Patients – not poorly inform and even misinformed doctors, not bureaucrats,
not politicians, not those who profit from cannabis- should have the lion’s
share of the say regarding regulations

For instance, the regulations you propose show little regard for a patient’s
financial situation. Most patients are poor. Whenever possible patients
should be allowed to grow their own medicine for free. If they can grow a
tomato, they can grow medical cannabis. Any other scheme shows disrespect
for the patients’ best interests.

Unfortunately the law will not allow patients to grow their own cannabis for
free or nearly so, if a Treatment Center opens in their area. This is a
terrible injustice that will be corrected in 2016 with the regulation of
adult cannabis use. For now, it seems, the only way to continue to allow
patients to grow their own medicine nearly for free is to stall the
licensing of Treatment Centers and regulate Treatment Centers as onerously
as possible.

The same is true of the patients’ use of caregivers, who would sell their
homegrown for much less than a Treatment Center could. Eliminating a
patient’s ability to access inexpensive medicine from a caregiver is not
reasonable or moral.

Legalization makes all this moot in 2016 – so lighten-up.

Twice the people have had their say regarding how our state treats cannabis
use and twice they have overwhelmingly instructed the state to leave
cannabis users alone. Perhaps twice is not quite enough. Perhaps a third
directive is what it will take to convince drug warriors that the public no
longer tolerates uninformed attitudes toward cannabis.

Frustration over the intolerable restrictions you propose will bring
patients to support the push for legalization which is coming in 2016 and
will, undoubtedly, pass. Thank you for inspiring action for the regulation
of adult cannabis use. At the same time, shame on you for making it clear
that medicinal control of cannabis makes it too hard for patients to get
cannabis and keeps the price of cannabis for patients in black-market range.

If you make the regulations this restrictive, many patients will continue to
do what they have done until now. They will get their medicinal cannabis
from their local black-market dealer. Many less well-off patients will grow
their own cannabis illegally, as many do now. And why not. This silly,
unenforceable prohibition is all but gone. Jury trials will no longer
convict patients who are growing.

The state will look like jackasses if they prosecute patients for growing
their own.

Cannabis prohibition is a cornered, doomed, wounded animal. Try not to be
used as a tool by what remains of this misguided prohibition beast.

Thank you again!

Bill Downing
*****************
Letter from Kathryn Rifkin, MassCann clerk:

Hello, Ms. Stanton,

Thank you for taking for testimony on Medical Marijuana. I must protest the unduly harsh nature of the proposed regulations – the regulations are geared more for the health and welfare of dispensaries and police action, and less for patients. By restricting the use of the herb to those who are dying, or to a few obvious maladies, these regulations are no incentive to come in out of the cold.

There are a couple of issues one must address before talking about cannabis – 1. Our respect for laws on the books, 2. The nature of prohibition. 3. The invasion of our privacy when one registers with the government, an entity that isn’t always trustworthy.

1. Living in a civilized society, we respect our democratically elected legislators and we trust that they do their due diligence when they legislate. We trust that the laws on the books have been carefully considered and will be for the betterment of society. When we see gross injustice at every turn concerning a law, then maybe the law was a bad one. And indeed, when we go back and study the tenor of the times, we see the yellow journalism vilifying cannabis is rank with racism and opportunism. Reefer Madness was a cynical ploy and trusting people believed what they heard in the media. Even the very name marijuana was used, evoking the fear of ‘wetbacks,’ instead of the medical name of this herb, cannabis. For this very reason, the medical establishment was blindsided, not realizing the proposed prohibition was to outlaw an herb that had been in the US Pharmacopoeia for 100 years, and millennia in the ancient Chinese Materia Medica, among others.

2. The horrendous violence and criminality wrecking our communities are characteristics of Prohibition, not of Cannabis. It’s elementary economics – when access to a valued thing is restricted, its price goes up. When risk of jail and property forfeiture is added, price skyrockets. When that much money is in the game, everyone wants a ‘piece of the action,’ as the mafia would say. Cartels spring up and banks will happily launder money. By keeping prohibition on the books, even law-abiding entities can ‘get a piece of the action,’ and these would include prisons-for-profit, the choice of paying for drug rehabilitation instead of going to jail, property forfeiture enriching police departments (who actually look for valuable properties with no mortgages). The corruption is rampant and is killing us. All this ends as soon as prohibition is stricken from the books, as we saw when the alcohol prohibition was repealed.

3. We all would like to come in out of the cold, but not for a situation that leaves us vulnerable to the vagaries of politics, and forced into a harshly restricted, expensive market. The paradigm is still escalating punishment, not least harm, SWAT teams still smash in doors and shoot the family dog and anyone else that moves. We want the violence to end. We want to be able to grow our own herb.

So you ask, why all the bother over cannabis? For a ‘high?’ A silly moment of ‘whee’ like the feeling of going over the top on a ferris wheel? Just to be able to relax and laugh a little? And the answer is that cannabis is a profoundly safe and effective medicine. It is fundamental to the regulation of one’s body’s functions, does not destroy the function of one’s organs like use of pharmaceuticals will, and will not kill anyone like alcohol, tobacco, and pharmaceuticals will.

Here is the science part;

All vertebrates, including humans, have a regulatory signaling system that triggers responses to external stimuli, and that will turn off the response in order to return the living being back to calmness, ‘homeostasis.’ So there are two parts to this regulatory system – an ‘on’ switch and an ‘off’ switch. Adrenalin, inflammation, etc, are responses to scary situations, to injuries and infections. However, if the ‘off’ switch is not triggered, one can get stuck in a chronic state of stress, or inflammation, etc.

Humans make two substances (this is new research, being done overseas and not here in Boston because of US prohibition, DEA, NIDA, etc) that work as the ‘off’ switch and they are called endo-cannabinoids, so named because they are very much like the active components, called phyto-cannabinoids, found in the plant cannabis. So, if your endo-cannabinoid system is running a quart low, you can top off by ingesting photo-cannabinoids.

As I mentioned above, this plant has been revered since ancient times, and humankind has been conducting a kind of Manhattan Project during the last several millennia, carefully selecting and planting the seeds of superior plants, and feeding the seeds of inferior plants to the family poultry flock. (PS, there is an entire discussion of the nutrition found in the seeds and leaves – as easy as this plant is to grow, there should not be any hunger anywhere on earth.)

Senator Susan Fargo expressed her concern to me about ‘self-titration,’ and I was so flummoxed that this was even a concern after millennia of use, that I didn’t know how to respond right away. I now have two responses. 1. The issue is a non-issue because there is no lethal dose. 2. Serving size of edibles is tricky because it takes an hour before any high manifests, while smoking provides immediate feedback as to a sufficiency. Also, if one doesn’t want to feel the high, one can get a strain with lower THC levels – that is, when we can safely take a sample to a lab without getting arrested.

Thank you for taking this testimony, and I will be present to testify in person on the 19th, if the creek don’t rise.

**********************
Letter from Andy Gaus, MassCann press secretary

Thank you for providing this forum to comment on the proposed DPH regulations on medical marijuana.

Two provisions in particular appear to make it virtually impossible for caregivers to provide the marijuana patients need while dispensaries are slowly organizing themselves:

1) Each caregiver must provide marijuana for only one patient.
2) The caregiver is not supposed to receive any compensation whatever from the patient for providing the marijuana.

Put these two provisions together, and very few people can practically step forward and become caregivers.

Bear in mind that growing marijuana indoors requires investing several hundred dollars in equipment to get started, paying high electrical bills in the ensuing months as well as ongoing costs for soil and fertilizer, and putting in hours of very real physical labor. If a patient grows for herself, these costs are repaid by the marijuana harvested and the relief it brings. But if a patient cannot grow for herself, the very considerable costs and burdens of producing the marijuana fall totally on the caregiver, with all compensation prohibited. This isn’t just unfair: it has the practical effect of making it virtually impossible to be a caregiver, which means no one can help the person who cannot grow for herself. If you wish to limit the ability of a caregiver to profit from their cottage industry, you could set a maximum number of patients (but not a maximum of one), or a maximum price per ounce, or both. A limit of, say, 20 patients per caregiver and $100 per ounce would keep caregivers and their homes from turning into for-profit dispensaries but would not leave patients with no one to turn to during a long period when cities and towns are enacting moratoriums and potential dispensary operators are clearing numerous legal hurdles.

The provision that a patient must have no more than two total sources of marijuana is also unnecessarily onerous. If all providers are supposed to use a common state database, any user of the database should be able to verify that the same patient isn’t filling the same prescription multiple times at different locations. If a further check is needed, patients could be issued something like a ration book.

One senses in all these regulations the underlying assumption that a set of air-tight regulations is both necessary and sufficient to prevent medical marijuana from being diverted to healthy recreational users, and that without such air-tight regulations, large-scale diversion is inevitable, with disastrous social consequences, particularly the increased availability to minors.

Let’s be realistic: recreational users, including minors, already have total access to marijuana if they want it. Kids themselves, when surveyed, report that marijuana is easier to get than alcohol. Those who get their dope from dealers needn’t fear being rejected as too young, and most of them get it, not from dealers, but from each other, in a vast informal network where everyone is both a user and a distributor. Likewise, almost all Massachusetts adults who wish to consume marijuana recreationally have found or could find a connection: marijuana prices have actually come down in recent years due to market saturation.

As officials responsible for public health, your first priority must be to make sure that patients who need marijuana for relief of painful and debilitating conditions can get it.

Minimizing diversion cannot be the main goal: it will never be effective for its stated purpose and is certain to cause unnecessary stress and pain for patients who need relief now and for the caregivers who would like to provide it .

Respectfully submitted,
Andy Gaus

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