CVIndependent

Mon11192018

Last updateTue, 18 Sep 2018 1pm

On July 13, California’s three state cannabis-licensing authorities—the Bureau of Cannabis Control, the California Department of Food and Agriculture, and the California Department of Public Health—announced the publication of proposed “non-emergency” regulations that would replace the rules under which the state’s marijuana industry has been operating.

Voters passed Proposition 64 in November 2016, legalizing the sale and use of recreational cannabis in California as of Jan. 1, 2018—meaning there was only a little more than a year to create an entire state agency, licensing guidelines and regulatory processes.

Given the size of this task—and the size of this state—it’s no surprise that California has gotten off to a bumpy start. High taxes, both on the state and local level, are a major problem. In Washington, Oregon and Colorado, marijuana consumers saw a drop in the price of cannabis for the recreational user as soon as the supply chain was able to catch up to demand—so much so, in fact, that the black and gray markets were largely put out of business.

In California, this has not been the case. Because of both the incredibly high taxes on legal weed and the big production costs California’s state regulations have created, legal marijuana has remained expensive—so the illegal cannabis market has been able to maintain lower prices and, therefore, flourish. Non-licensed retailers have also thrived, providing customers with much lower prices than the licensed competition. (In some parts of the state, I have heard of regulators not realizing that a shop is unlicensed until they asked to see permits.) On the Bureau of Cannabis Control’s own Facebook page, the day the new regulations were announced, people were bragging and/or complaining that they have returned to the black market. 

Medical-marijuana patients are also suffering under these taxes, and many have had to return to the illegal market in order afford the medicine they need to control their very serious medical issues. Small growers who have been in the cannabis industry for decades have suffered and been driven out of business because of the onerous regulations placed on them—and as of July 1, a number of dispensaries were stuck with inventory that was all of a sudden illegal for them to sell, because it did not meet state standards.

Thankfully, it seems like Lori Ajax, the chief of the California Bureau of Cannabis Control (BCC), recognizes that there have been problems, and she seems to be interested in fixing them. The proposed regulations, which can be viewed here, are now open to a 45-day public-comment period. State law stipulates that the non-emergency regulations must be in place by the end of the year.

I find some portions of the new regulations to be very encouraging. I am still in the process of digesting the information that the BCC wants to be able to award research funding. One of my biggest beefs with the medical-cannabis industry is its promotion of cannabis as a cure-all for many ailments, when there are so few peer-reviewed studies regarding the medical benefits of marijuana. This is not necessarily the industry’s fault—federal law has essentially prohibited the use of marijuana for all purposes, including scientific ones—so the state’s possible foray into scientific research funding is a step in the right direction.

The new regulations also get rid of the necessity for establishments to have two sets of licenses; as of now, dispensaries need one for medical marijuana, and one for recreational adult use. With only a few differences in the requirements, it seems unnecessary to require businesses to apply for two types of licenses to sell the same product.

I also find the proposed codification of enforcement to be encouraging. Under the emergency regulations, there was no significant list of grounds for disciplinary action, meaning each licensing authority had the ability to discipline on a case-by-case basis—a system that is open to abuses. The proposed regulations will create a framework for licensing authorities to use when initiating or undertaking enforcement.

Unfortunately, the BCC is proposing to keep in place its requirements around packaging. Retailers would still not be able to package product onsite, and would still be required to place cannabis products in a resealable child-resistant opaque package before customers leave the store. This requirement has always seemed rather ridiculous: If the goal is to protect children, why do we not see these same sorts of requirements around tobacco and liquor? Given California’s push for a greener future, adding a new type of plastic waste feels counterproductive.

While I believe the Legislature still needs to step in to make some legal changes to ensure California’s cannabis industry—particularly small and minority-owned businesses—can thrive, these new regulations are a start.

Any interested party is encouraged to participate in the public-comment process—although consider yourself warned that reading through the proposed rule changes is not an easy process. (The Initial Statement of Reasons from the BCC is 567 pages long!) Comments on the proposed regulations are being accepted in both writing (via email or snail mail) and at public hearings throughout the state, comments cannot be made by phone. The closest hearings will be held in Los Angeles and Riverside (find a list here), so written comments may be a Coachella Valley resident’s best bet. Regarding BCC regulations, comments can be sent to This email address is being protected from spambots. You need JavaScript enabled to view it.; in the subject line, type in the subject of the proposed regulation to which the comments apply. You can make your comment either in the body of the email or as an attached document. Physical mail can be sent to: Lori Ajax, Chief, Bureau of Cannabis Control, P.O. Box 419106, Rancho Cordova, CA, 95741. All information submitted becomes public information—so don’t include anything you want to remain confidential.

Published in Cannabis in the CV

On June 27, the California Department of Public Health issued its first data report on residents’ participation in the new End of Life Option Act.

The law was signed by the governor in 2015 and took effect on June 9, 2016. The report reveals that 258 terminally ill California patients—diagnosed as having less than 6 months to live—started the process as called for under the law, as of Dec. 31, 2016.

Of those 258 patients, 191 were prescribed the life-ending medications, by 173 unique physicians. The report states: “111 patients, or 58.1 percent, were reported by their physician to have died following ingestion of aid-in-dying drugs prescribed under EOLA, while 21 individuals, or 11 percent, died without ingestion of the prescribed aid-in-dying drug(s). The outcome of the remaining 59 individuals, or 30.9 percent, who have been prescribed aid-in-dying drugs, is currently undetermined, as there has been no outcome reported for these individuals within the time period covered by this report.” (Full disclosure: One of the 111 patients who passed away using the new law was my mother-in-law; see “Annette’s Story,” posted at CVIndependent.com on Dec. 20, 2016.)

Kat West is the national director of policy and programs at Compassion and Choices, a national support organization for medical aid-in-dying patients and their cause. The organization just released its own, independent report on the law, covering activity through May 31 of this year.

“We were actually very encouraged by the data that came out of the state, because it showed that (the participation rate) was in keeping with our previous experience in the other authorized states,” West said. “The one piece of data we were very happy to see was the ratio of the number of different doctors prescribing the drugs compared to the group of patients requesting. That was a really good indicator that medical aid-in-dying is being what we call “normalized” and basically mainstreamed into end-of-life care.”

According to the Compassion and Choices report, the organization knows of 313 prescriptions that were written for medical aid in dying in the first five months of 2017. Meanwhile, 498 health-care facilities and 104 hospice locations have adopted policies supportive of patient choice, while about 80 percent of private insurance companies have covered the cost of the medications, including Blue Cross Blue Shield, Kaiser Permanente, Sutter and all Medi-Cal plans.

“The additional 313 prescriptions issued (thus far in 2017) were only the ones that we know about,” West said. “There are plenty of doctors who did not reach out to our organization, and there are plenty of terminally ill people who did not reach out to us. As a result, we don’t know of all of the prescriptions that may have been written in the state of California.”

Not all of the news is good for proponents of medical aid-in-dying protocols. The federal House Appropriations Committee recently voted to block funding to implement a new medical aid-in-dying law in Washington, D.C.

In California, a Riverside County Superior Court judge allowed the Ahn vs. Hestrin lawsuit, which challenges the End of Life Option Act, to move ahead into the courts, although an injunction request to put the law on hold was rejected by the judge.

John Kappos, a partner at the O’Melveny and Myers law firm, is representing proponents of the law. He said he is not too concerned about the lawsuit.

“What I find most concerning is the fact that a purely voluntary procedure like medical aid in dying causes some people to try to impose their will on others,” he said. “People can decide that they want to do it, or they can decide that they’d prefer not to do it and just die of natural causes. There’s no one here who is telling the people who do not want to participate in medical aid in dying that they need to, or have any obligation to do so. It’s very concerning to me that there are people in California who feel that they need to tell others … they have to suffer at the end of life, and potentially die an excruciating death.”

Kappos said it could take a year or longer for the case to be resolved. “It’s hard to guess at these kinds of things, but in my view, these are purely legal issues, and eventually, that will come to light, and the case should be resolved on a motion (in the defendant’s favor).”

Here in the Coachella Valley, Eisenhower Medical Center continues to deny its staff and doctors permission to write medical-aid-in-dying prescriptions for its terminally ill patients.

“I try to take the long view, and that is that change is hard,” said West, of Compassion and Choices. “But look back 20 years as an example. If you were to bring up the subject of hospice care with a group of medical professionals, it would clear the room. That’s how taboo the topic of death and end-of-life care was then. Now, of course, hospice is completely mainstream, and everyone thinks it’s great. So it’ll be the same trajectory for medical aid in dying, especially now that California has authorized it.

“Eisenhower is just going to find itself out of step with the community’s needs and desires. It’s going to find itself out of step with its own doctors’ feelings about the issue, and eventually, it will change its policy. The community clearly wants it, so it’s just the administrators. The community is already stepping up their demands, and internal champions within Eisenhower are also calling us and letting us know what they think.”

West predicted change will come to Eisenhower sooner rather than later.

“I’d say they will change their policy within a year. I do believe that,” West said. “The administrators have to pay attention to what their community is asking for.”

West suggested that everyone engage in an end-of-life-treatment discussion with their own health-care professionals.

“Our big ask of everyone is to ask your own doctor now if they would provide the protocol legalized in the End of Life Option Act—whether she or he will support you if and when the time comes,” West said.

Published in Local Issues