In Their Own Words: Peter Kilmartin

What are the chances Rhode Island will be the first New England state to proceed with cannabis taxation and regulation? While there is a push by proponents in all New England states to legalize recreational marijuana, it is my hope that Rhode Island does not go down that path. There are too many unknowns associated with legalizing recreational marijuana, which in essence is a whole new industry. The Massachusetts Senate Special Committee on Marijuana recently issued a report citing public health, public safety and economic and fiscal concerns with legalization of marijuana in that state. In addition, the Massachusetts Governor Charlie Baker and Attorney General Maura Healey and Boston Mayor Marty Walsh are all opposed to legalizing marijuana in that state. While I am personally opposed to the legalization of recreational marijuana, if policymakers in this state want to proceed with it, I urge them to move slowly and take a “wait and see” approach. We are still learning many lessons from those states that have legalized recreational marijuana. In fact, those states that have legalized marijuana are still learning from the experiment, making changes each year to the program to address dangerous unintended consequences. Would legalization make the job of the police easier or harder? Without question, legalization will make the job for law enforcement more difficult. I am concerned that under legalization, more drivers will be operating a motor vehicle under the influence of marijuana, and there is currently no equivalent test for an alcohol breathalyzer for law enforcement to use. In addition, states that have legalized marijuana have seen a spike – not a decline – in the black market of marijuana due to significant profits to be gained from meeting demand, as well as the ease of growing marijuana and the difficulty law enforcement would face in enforcing home growing limits. Recently, the United States Attorney and my office announced the arrest of several individuals who caused explosions due to BHO production, killing one person and injuring others. States that have legalized recreational marijuana have also seen a significant increase in BHO lab explosions, despite laws prohibiting them. Unregulated production of BHO in our communities is a significant public safety problem, putting families, neighbors and the general public at risk. It is dangerous and can be deadly, as it was with the BHO lab explosion last year in South Kingstown. The increased production and use of BHO is yet another example of how our existing marijuana laws and regulatory structure has led to dangerous unintended consequences. We need to get a handle on this problem now, before more lives are lost, by giving law enforcement the tools they need to investigate and shut down these death labs. That is why I filed legislation that would prohibit extracting THC from marijuana using a flammable liquid, the method used in making BHO. The legislation would allow compassion centers to extract THC using a flammable liquid only within rules and regulations to be promulgated by the RI Department of Health. How would marijuana legalization impact the heroin epidemic and the use of other illegal drugs? Opioid abuse and addiction crisis in Rhode Island can be attributed to, in great part, over prescription of opiates by healthcare professionals and the cheap cost of heroin. However, there is no scientifically recognized evidence that legalizing recreational marijuana would reverse the numbers of those addicted to opioids. What scientists and the medical community can agree on is that marijuana has a significant impact on the development of the brain. Youth marijuana users face serious health and brain development risks. Rhode Island already owns the dubious distinction of high rates of marijuana use by youth. And, youth users of marijuana are more likely than their peers to become addicted to other harmful substances like opioids. While the proponents of legalization insist marijuana use will be for adults only, it is a naïve and convenient answer to a question they don’t want to answer: How do we ensure youth do not have access to or use marijuana? Do you think marijuana legalization should be decided by lawmakers or public referendum? If Rhode Island policymakers choose to go down the path of legalization, and it remains my hope they will not, I believe it is a matter that is best be decided by the General Assembly. A referendum would open up the state to an influx of out-of-state interested parties to throw millions of dollars at a campaign to convince voters to support legalization. Are there any legal industries in our state that would be hurt by the legalization and taxation of marijuana? One area that I am concerned with is how businesses would handle employees who are under the influence of marijuana. Much like drunk driving, it would be difficult for an employer to dismiss someone from work without a means to prove they are under the influence. It could open up a wealth of legal issues for employers of all businesses. Another area of concern is the impact on property values. If a marijuana grow or cultivation moves into the neighborhood, what will it do to property values? We have examples here in RI where rental properties are virtually destroyed due to a marijuana grow in the residence. What rights will homeowners have should the state legalize recreational marijuana? To that extent, what rights will cities and towns have if they would like to opt out of legalization of recreational marijuana? The proposal being put forth by Regulate RI would not allow cities and towns to opt out of allowing marijuana businesses in their respective communities. Shouldn’t our cities and towns have a say if they want to allow an expansion of marijuana in their community? What do you think of the governor’s proposal to tag and tax each plant grown for medicinal purposes? I have been, and continue to be, a supporter of the use of medicinal marijuana for those Rhode Islanders who suffer from debilitating conditions. Throughout my administration, I have worked to provide greater safeguards to inhibit those who take advantage of this program for their own financial benefit through black market diversion and to ensure that marijuana cultivations are maintained safely. I commend Governor Raimondo for acknowledging that Rhode Island’s medical marijuana program, especially the caregiver model, needs to be strengthened. However, I am concerned about the financial implications to those patients who are suffering from and paying for the medical treatment of debilitating diseases. Any change to the medical marijuana program should keep costs to the patients in mind.

In Their Own Words: Scott Slater

Do you believe that cannabis will be legal in RI at some point in our future? For me, the question of legalization is not so much about if but when. The prohibition of cannabis has been one of the great stains on our nation’s history, and has negatively impacted so many people from a social justice and public health perspective. We have seen other states effectively implement legalization measures, and we know that a majority of Rhode Islanders support this idea. I am confident that state leaders and my colleagues in the General Assembly will recognize the benefits and follow the lead of states like Colorado, Washington, Oregon and Alaska. What do you think would be the advantages of being the first state in New England to legalize? The advantages of being the first state in New England to legalize are significant. A rather large industry has emerged in other parts of the country around cannabis economies, and this industry will make investment decisions based on first-to-market policy decisions. The industry includes organizations that will have direct contact with cannabis production, along with companies that have indirect ties to the industry like suppliers, financiers, security firms and technology companies. Tradesman, labor unions and workers seeking opportunity in a new and emerging market will also benefit. The investment and jobs associated with taking cannabis out of the black market and into a taxed and regulated arena will be significant. RI can absorb the incredible interest that exists for an East Coast base for these activities, and by taking legislative action now we can beat our neighboring states to the punch. What do you think the disadvantages would be? Rather than call them disadvantages, I would highlight some challenges that we should focus on when dealing with legalization. First, it is essential to establish a regulatory framework that allows the state to see the most benefit. This includes a tax structure that is enticing to new investment, but also substantial enough to help our state economy grow. Putting in place regulations, controls, oversight and state personnel to make this happen is not easy, but we have the benefit of seeing what other states have done well. I also share the concerns of law enforcement and public health professionals about legalization, specifically the concerns about use rates among young people. That is why my bill directs a portion of taxes collected on legalized cannabis to drug education and prevention efforts, as well as toward training police officers on drug recognition (see more on page 22). These are challenges that we should not take lightly. Fortunately, we have a very good sense of how legalized markets have developed in other states, and can make sound public policy decisions based on these experiences. That is also why I feel so strongly that the time to act is now, so RI can begin the process of getting the regulatory framework right, while also gaining benefits from this policy decision before our neighboring states. Many government officials have supported a “wait and see” philosophy – to see what happens in Colorado and elsewhere before deciding about RI. Colorado voters passed the legalization measure in 2012 and commercial sales began in 2014. In that four years we have seen the state develop responsible regulations and rules that have resulted in the taxation of over a billion dollars of legal cannabis sales in the last year alone. That is a billion dollars that used to go to the black market cartels and drug dealers. I do not believe there is any need to wait any longer to see what this public policy decision will look like. We know quite clearly that Colorado has raised significant dollars in new tax revenues for things like school construction and drug prevention. We know that drug cartels have seen an enormous drop in their operations, which are often violent and put the public at risk. And we also know that public polling of Colorado residents shows that the change continues to enjoy significant majority support since it was enacted. The Colorado experiment is the strongest reason for taking action on legalization in Rhode Island as soon as possible. What does it say about the culture in the states that have voted to legalize marijuana? How are those states culturally or philosophically different from RI? I’m not sure it is a question of culture or philosophy. I think it is more about the way in which laws can be passed in states that have already embarked on legalization. Colorado, Washington, Oregon and Alaska all made the change by a vote of the people. Rhode Island requires the legislature to act on behalf of the public. Based on the last few years of public polling, I am quite certain that if our state allowed for a binding ballot question, we would already have the legalization of cannabis in place.

In Their Own Words: Andrew Horwitz

What are the chances Rhode Island will be the first New England state to proceed with cannabis taxation and regulation?

I wish that I could say that I was optimistic about passage this year, but I am concerned that pervasive public misconceptions and misinformation will get in the way. The Providence Journal has exacerbated these misconceptions and perpetuated this misinformation in some editorials on the subject. Sadly, at this stage I expect that other New England states – most likely Massachusetts – will see the light before we do.

Would legalization make the job of the police easier or harder?

Legalization and regulation would make the job of our police officers easier. Right now they must make judgment calls about whether to devote our scarce law enforcement resources enforcing low level non- violent offenses. The unfortunate reality is that officers, in the exercise of this discretion, often wind up making judgment calls in a racially discriminatory fashion. Eliminating this discretion by legalizing the conduct would he lp reduce racial discrimination and make it easier for police officers to concentrate on serious and violent crime.

How would marijuana legalization impact the heroin epidemic and the use of other illegal drugs?

Legalization and regulation of marijuana would mean that people seeking to purchase marijuana would no longer have to encounter drug dealers. This strikes me as particularly important when we think about our youth. Less interaction with drug dealers should reduce the ability as well as the temptation to access other drugs. The concept that marijuana is some sort of “gateway drug” has been long ago disproved in the medical literature.

Do you think marijuana legalization should be decided by lawmakers or public referendum?

Lawmakers are better equipped than the general public to look at complicated and potentially incendiary public policy issues. Our founders developed a representative democracy for a reason: We elect the people we trust to gather information and make informed decisions based upon our collective bests interests. Any public referendum would likely be decided based on misinformation.

Are there any legal industries in our state that would be hurt by the legalization and taxation of marijuana?

I don’t think there is any question that legalizing and regulating marijuana would enhance our local economy. New businesses would develop and thrive and our tax base would increase exponentially. I do not see any reason to believe that any industries other than the illegal drug trade and the prison industrial complex would be harmed. What do you think of the governor’s proposal to tag and tax each plant grown for medicinal purposes? The proposal to tax medicinal marijuana strikes me as both senseless and cruel. We do not tax medication for a reason, and taxing medical marijuana makes as little sense as taxing blood pressure medication. There is no reason to try to raise money on the backs of the infirmed.

Cannabinoids and the Human Body

While most people are familiar with THC and CBD, cannabis contains upward of 85 different cannabinoids with different properties and potential medicinal benefits. Cannabinoids are the chemical compounds produced by the flower and located in the resinous trichome glands. All mammals have an endocannabinoid system (ECS), which is composed of lipids and receptors located in the brain and central and peripheral nervous systems. The endocannabinoid system moderates appetite, nausea, pain, mood, memory, sleep and more.

There are two identified receptors in the body; CB1 receptors are located primarily in the brain (not including the brain stem), and CB2 receptors are located primarily in the immune system and more sparingly in the liver, bones and nervous system. The endocannabinoid system works like a lock and key — the receptor is the lock, and the cannabinoid is the key. The key can be a naturally occurring endocannabinoid (such as anandamide), its phytocannabinoid equivalent (such as THC) or a synthetic cannabinoid (such as Marinol).

A majority of cannabis strains have been bred to have high amounts of THC – tetrahydrocannabinol – which is the compound that produces the feelings of euphoria or “high” that most people associate with cannabis. An increasing number of growers are seeking out and cultivating strains that are higher in CBD – cannabidiol — which is the non-psychoactive compound that is growing in popularity and has been associated with helping a multitude of medical problems such as chronic pain, epilepsy, autoimmune diseases, rheumatoid arthritis and more. These two cannabinoids have taken center stage for cannabis research and public knowledge, but there are many other compounds of equal importance, the most notable listed below.

CBN: Cannabinol makes certain strains more sedative. CBN is important for pain reduction, and is an anti-inflammatory, antibacterial and appetite stimulant.

CBG: Cannabigerol has been known to reduce anxiety and depression, as well as have anti-inflammatory properties beneficial to patients with inflammatory bowel syndrome. It can also be used to reduce ocular pressure, which is helpful in the treatment of glaucoma.

CBC: Cannabichromene is one of the least popular cannabinoids, despite its highly beneficial effects. CBC has anti-inflammatory properties and stimulates bone growth. Perhaps the most important thing about CBC is that it is believed to inhibit the growth of cancer tumors. It also has somewhat of an “entourage effect,” enhancing the effects of other cannabinoids. CBDa: Before CBD is activated through decarboxylation, it is found as cannabidiolic acid. CBDa can reduce inflammation, vomiting and nausea, and potentially inhibits cancer cell growth.

THCa: The acid form of THC, tetrahydrocannabinolic acid is an anti-inflammatory, neuroprotectant and appetite stimulant. Like CBDa, THCa is found in raw and live cannabis.

The idea of clinical endocannabinoid deficiency (CECD) was introduced in 2004 by Dr. Ethan Russo of GW Pharmaceuticals. The notion behind CECD is that since cannabis can help with a large (and constantly growing) number of medical problems, perhaps the underlying problem is a deficiency of endocannabinoids. The practice of juicing raw cannabis flowers and leaves is becoming popular with patients, which allows them to intake a very large quantity of cannabinoids (acid forms like THCa and CBDa) without any psychoactive effects. The amount of activated cannabinoids someone could take on a daily basis is limited due to the psychoactive components, so this is a way of flushing the body with cannabinoids and still maintaining daily activities.

Understanding the power of all the cannabinoids is important, as the current public perception of cannabis as medicine is that THC and CBD are the only cannabinoids worth looking at. Hemp CBD products are quickly growing in popularity, since they are legal and can be sold online. However, CBD- only products are missing all of the other beneficial cannabinoids and aren’t as powerful as a whole plant extraction. With more research being done in the future, more and more uses for cannabis will become evident.

Where Do the Presidential Candidates Stand on Pot?

With the presidential primary in Rhode Island next month, we take a look at where the currently remaining presidential candidates stand on medical marijuana and full legalization. All candidates who were in the race as of Super Tuesday, in early March, were included. Although it will not be until the end of April — on the 26th — that we finally get our say in the race, there are plenty of opportunities to contribute to and otherwise cheer on your candidate as they make their way through nearly a dozen other primary contests between now and then.

DEMOCRATS

Hillary Clinton Medical marijuana: Supports it, but remains cautious. “I think we need to be very clear about the benefits of marijuana use for medicinal purposes. I don’t think we’ve done enough research yet,” Clinton told the National Journal. Last November, Clinton proposed moving marijuana from a Schedule I drug to Schedule II to allow more research into its benefits and effects.

Legalization: Opposed for now (see above).

Bernie Sanders Medical marijuana: Supports it. He was the co-sponsor of the States’ Rights to Medical Marijuana Act in 2001.

Legalization: Supports it. Earlier this year, Sanders introduced a bill in the US Senate to legalize marijuana at the federal level. At a CNN debate on October 13, 2015, in Las Vegas, Sanders was asked if he would vote for a marijuana legalization initiative on the ballot in Nevada this year. “I would vote yes because I am seeing too many lives being destroyed for non-violent offenses. We have a criminal justice system that lets CEOs on Wall Street walk away, and yet we are imprisoning young people who are smoking marijuana. I think we have to think through this war on drugs, which has done an enormous amount of damage,” Sanders said.

REPUBLICANS

Ben Carson Medical marijuana: Open to it. In an interview on Fox News in January 2014, the noted neurosurgeon seemed open to medical marijuana. “Medical use of marijuana in compassionate cases certainly has been proven to be useful,” Carson said.

Legalization: Opposed. In that same Fox News interview, Carson said that marijuana was a gateway drug and that legalization would contribute to the moral degradation of society. “I don’t think this is something we really want for our society,” Carson said. “You know, we’re gradually just removing all the barriers to hedonistic activity. …We’re changing so rapidly to a different type of society, and nobody is getting a chance to discuss it because it’s taboo.”

Ted Cruz Medical marijuana: No specific position. Cruz had previously called for the federal government to crack down on states that had legalized marijuana or allowed its use for medical reasons. But he later changed his position on legalization (see below).

Legalization: Would leave it to the states. At the Conservative Political Action Conference in 2015, Cruz said that, despite his personal opposition, legalization is a matter for the states. “If the citizens of Colorado decide they want to go down that road, that’s their prerogative. I personally don’t agree with it, but that’s their right.”

John Kasich Medical marijuana: Cautiously open to it. “Medical marijuana, I think we can look at it,” Kasich said at a town hall in New Hampshire.

Legalization: Opposed. Kasich has called it a “terrible idea.” While campaigning in Michigan last September he elaborated on his position: “It sends mixed messages to young people about drugs. I don’t think we should do that. We need to tell young people to stay off drugs,” Kasich said. Kasich opposed a failed ballot measure in his state of Ohio that would have legalized medical and recreational marijuana.

Donald Trump Medical marijuana: Supports it.

Legalization: Has changed positions. Currently favors leaving it to states. “In terms of marijuana and legalization, I think that should be a state issue, state-by-state,” Trump said at a campaign stop in Nevada last October. Marco Rubio Medical marijuana: Limited support. Rubio supports marijuana for medical purposes as long as it’s non- euphoric. He remains concerned about the potential for abuse. “You’ve seen how this has been abused in many parts of this country. It’s the reality that there are states now that you go in and can have a doctor write you a prescription for something that you are really just using for purposes of acquiring legally a recreational drug,” Rubio told reporters in an interview in 2014.

Legalization: Opposed. “Marijuana is illegal under federal law. That should be enforced,” Rubio told ABC News on May 15, 2014.

Sources: In addition to various media reports, sources included www.theweedblog.com, and marijuanapolitics.com, and blog.mpp.org.

Medical Marijuana Tax Protest Rally

A large crowd, initially about 100 but growing to about 150 despite wind-whipped bitter cold and light snow that began falling an hour into the event, assembled on the Smith Street side of the Rhode Island State House for a scheduled rally at 4pm on Tuesday, February 23, to protest Governor Gina Raimondo’s proposed changes to the state’s medical marijuana and cannabis laws that would, among other things, require independent growers to purchase tax tags costing hundreds of dollars for each plant under cultivation. (See “Medical Marijuana in the State Budget,” by Michael Bilow, Feb. 10, and “News Analysis: Taxing Medical Marijuana,” by Michael Bilow, Feb. 17.)

The rally was organized jointly by the Rhode Island Patients Advocacy Coalition (RIPAC) and the Responsible Caregivers of Rhode Island (RCRI401), groups advocating on behalf of patients and caregivers, respectively, active under the current legal regime for medical marijuana. Joanne Leppanen, executive director of RIPAC, introduced a series of speakers who sounded similar themes.

There was unanimous agreement by patients and caregivers that the governor’s proposal would make individual growing infeasible, effectively reducing by 75% the number of plants under cultivation per patient and requiring up-front payments for per-plant tax tags costing $150 each from patients who grow for themselves or $350 from caregivers who grow for particular patients. Another major objection that emerged was the proposed prohibition against “gifting,” currently allowed between authorized patients and caregivers as long as no money changes hands. No one thought the governor’s projection of $8.4 million in revenue from the tax tag program was credible.

Krista Brack, a patient who said she has Ehlers–Danlos syndrome, an incurable condition that causes debilitating chronic pain, and is about to undergo her 14th surgery, read from a prepared statement. She said that she is barely scraping up the $3,000 per year that it costs her for independently grown medical marijuana, and that if she had to pay compassion center prices the cost would skyrocket to an unaffordable $16,000 per year. She said the governor’s proposal that reportedly computed the prices for per-plant tax tags “based on the idea that I somehow make $17,000 by growing my own medication, is flawed. I cannot make money on something I am consuming as my medication. I do not sell it. I am not a corporation to be taxed but a real live human with a catastrophic disease that causes constant pain and medical emergencies, and I am just barely getting by as it is.” The reduction in plant count to 6, instead of the current limit of 12 mature plants and 12 immature seedlings, would make it impossible for her to sustain her medically necessary supply, she said. “Plants are susceptible to mold, rot, bugs. They get damaged from too much humidity, heat fluctuations and interruptions in electricity. This is farming, anything can happen. If I only have one or two plants to work with at each stage I can’t possibly have a perpetual grow that provides my medicine year round, it just won’t work with those numbers.” She credited gifting as helping her get started in the medical marijuana program and also with bailing her out in an emergency: “If gifting hadn’t existed when I first started out, I wouldn’t even know what medicine helps me and what to avoid. I’ve also benefited from the gifting program when I lost my garden to a bug infestation.” If per-plant tax tagging for individual medical growers takes effect, she said, “I will be forced to either move to a friendly state like Maine or Colorado, or stay in Rhode Island and become a criminal growing outside of the program.”

Ellen Lenox Smith, a patient who said she was a former middle school teacher and formerly coached high school swimming as a master swimmer but has since had 23 surgeries for two separate incurable conditions, bluntly said that the costs of obtaining medical marijuana would become unaffordable to her, which would mean “the end of my life.” She had been very grateful until now to be in Rhode Island, which she described as a “state of compassion,” but “this proposal makes me feel as if my life doesn’t matter” to the governor. Her medical condition makes it impossible for her to work and earn the additional money she would need to pay compassion center prices, she said. “My job is to keep myself alive. I’m alive today because of this medication. I’ll be gone tomorrow without it.”

Patrick Rimoshytus, director of Green Cross of Rhode Island who said he is both a patient and caregiver, wore a firefighting helmet while speaking because, he explained, he was a former firefighter. (See “Green Cross of Rhode Island: Educating Cannabis Patients,” by Devin Fahey, Jan. 13.) More than half of his patients are undergoing cancer chemotherapy, he said. “We don’t need to reinvent the wheel because we have a program that works.” Medical cannabis users are not abstractions, but “It’s your neighbors. It’s your friends. It’s your co-workers.” Interviewed after his speech, he said that “23 other states have medical marijuana, but none tax it.” He predicted that the proposal if it takes effect “would push the caregivers who are already leery back into the underground market.”

Donna Hackett, who described herself as a patient and activist, said she survived stage 3 breast cancer and stage 3 lyme disease at the same time and had no success with conventional painkillers. “I was virtually a cripple for many years. The person you see standing here is only possible because of medical marijuana.” She said, “I cannot live without cannabis. I have not taken prescription drugs for years, because I wanted to live.” Rather than increase restrictions and impose taxes on medical users, she advocated legalizing recreational use: “Make it legal and leave us alone.” If nearby states legalize but Rhode Island does not, she predicted “a mass exodus to Massachusetts like there is for everything else.” Jared Moffat, executive director of Regulate RI and state political director of the Marijuana Policy Project, said that the proper way to obtain tax revenue from marijuana was to end prohibition against recreational use so that it could be regulated and taxed like alcohol, not to burden the medical program and impose additional costs on patients. (See “Cannabis: Jared Moffat, RI Point-Man for Legalization,” by Michael Bilow, Dec. 16, 2015.)

James Fortier, of the newly formed Legalize Marijuana in RI group, was the most critical of the speakers. He alleged that through researching public records he had obtained evidence that compassion centers, although non-profit, were purchasing services from for-profit consulting and real estate firms, and that the governor’s proposal masked an attempt to replace independent growers and set up commercial growing operations that would then be in a position to capitalize on eventual legalization. He cited interlocking or overlapping directorates shared between the non-profit and for- profit sides of the industry.

Several state legislators attended, all supportive of the protesters. Rep. Robert Nardolillo from Coventry, a Republican representing District 28, had previously on Feb. 16 released a statement strongly condemning the proposals and he echoed that statement even more emphatically when interviewed, describing them as a “huge overstep by the governor” and “deplorable, absolutely deplorable.” Professionally a funeral director and involved in the hospice care movement, Nardolillo said, “Patients now can barely afford it on their own…This medication [medical cannabis] is a miracle in some sense. The evidence is there: What you shut down will be patients in chronic pain.” In answer to a question whether the proposal seemed calculated to discourage an individual caregiver model and replace it with a compassion center model, he said, “The relationship between caregivers and patients is very important, one of trust and friendship.”

Rep. Scott Slater from Providence, a Democrat representing District 10, succeeded his father, Thomas C. Slater, in the General Assembly. The elder Slater died in office while publicly advocating and using medical marijuana to combat the side effects of cancer chemotherapy, sponsoring the original law authorizing its use, and the Providence compassion center is named in his memory. The younger Slater said he was opposed to the governor’s proposal: “I don’t think we should tax sick people.” But, he said, “I have the solution” to the revenue problem, referencing a separate bill in the House, the “Marijuana Regulation, Control, and Taxation Act,” for which he is a principal sponsor that would legalize and tax recreational use under regulations similar to alcohol. (See “Cannabis – Another Shot at Legalization,” by Mike Ryan, Feb. 12.)

Rep. Doreen Costa from North Kingstown, a Republican representing District 31, expressed unequivocal opposition to the governor’s proposal regarding medical cannabis. “I hope this gets pulled from the budget,” she said. “You can’t tax the people who need this help the most,” describing the proposed per-plant fees for tax tags as “astronomical.” With regard to ending prohibition against recreational use, she said that her support was conditional depending upon how the expected tax revenues would be used. “Where is that money going to go? The big drain called the general fund? We never know where that money goes,” she said, but would support legalizing recreational use if the proceeds went “anywhere but the general fund.”

Ricky Bonilla, who was holding a sign but did not speak at the rally, said when interviewed that he was an Army veteran who served as a medic in the early 1990s. “I served my country, I did everything I was supposed to do, I have a bachelor’s degree, a master’s degree, and a law degree,” he said, but he got off prescription drugs with the help of medical cannabis. “I don’t know of a single vet who uses cannabis who even thinks of suicide.” Patients can grow their own medicine without having to disclose their entire medical history to an insurance company, he said, which was a significant advantage to many.

Surprisingly, the most conciliatory note toward the governor came from Zach Allen, the vice-president of RCRI401, a co-sponsor of the protest representing caregivers. He said “caregivers are essentially extensions of their patients,” and that the proposal “seems as if it was an attempt to control and regulate,” general goals that he does not necessarily oppose. He said that the governor’s office had reached out to him, but “I don’t think the state had the proper guidance” on the specifics of the current proposal. “We would like to work with them, not against them. It’s up to us to educate them.”

News Analysis: Taxing Medical Marijuana

Few issues have proven hotter controversies than the proposal by Rhode Island Governor Gina Raimondo to impose per-plant taxes and other restrictions on individual growers of medical marijuana. As a journalist, I’ve been asking fundamental questions about the proposal, and I’m not getting a lot of answers.

Spokesmen for the state have pushed back against even describing the new fees as a “tax,” but the proposal comes as part of the annual budget process that necessarily focuses on money to the exclusion of everything else and to a great extent defines and constrains the nature of the debate. For one thing, the governor projects additional revenue of $8.4 million in the first year, and the legislature cannot just ignore this by discarding the proposal to throw the budget out of balance. On the other hand, I’ve been unable to obtain any data or study from the state justifying that estimate, which seems to be somewhere between a wild guess and outright fantastical wishful thinking. I’m willing to review and fairly consider any evidence if I could get it, but I can’t get it.

It seems implausible on its face that medical marijuana patients and caregivers would be in a position to each pay up-front annual fees ranging from $900 (6 tags x $150 for patients) to $2,100 (6 tags x $350 for caregivers) even before they can begin to grow anything legally. People who obtain certification from a medical professional to use marijuana are by definition pretty sick, typically undergoing cancer chemotherapy, treatment for HIV/AIDS, experiencing chronic pain, or afflicted by one of the similar conditions specified by statute for eligibility in Rhode Island. In short, they generally cannot work and either are applying to be or are already approved as disabled. Insurance does not cover medical marijuana as it does for prescription medications, so patients have to pay out of their own pockets. It would be the rare medical patient who has this kind of cash available.

The vast majority of medical marijuana growing is what the average person would employ if they were growing tomatoes or any other ordinary plant, except that marijuana for legal and security reasons must be grown indoors hydroponically, greatly increasing both difficulty and cost. Yields are low and crop failures are frequent. Many growers struggle to control spider mites and other pests that destroy a crop to make it useless. Yet tax tags would be required for failed crops as much as for successful ones.

Why is there a difference in tag fees between patients growing for themselves ($150 per plant) and caregivers growing for a patient ($350 per plant)? Why is the number of plants per patient cut in half? Why are seedlings that in the past have been exempted from plant-count limits made subject to them, which in combination with the direct 50% reduction in plant count turns it into an effective 75% reduction? Why is a patient to be allowed only one caregiver, reduced from two? I haven’t been able to get answers to any of these questions.

Despite protests to the contrary and claims by the state that the goal is improved access for patients, from what I can see of the proposal – and I am open to the possibility that the state may be able to produce evidence to convince me otherwise – the real goal has nothing to do with revenue but instead is to pressure medical marijuana patients to obtain their medicine from compassion centers, squeezing out individual growers. Consider the evidence.

The original statute adopted by the General Assembly was drafted with evident skepticism that the executive departments responsible, particularly the Department of Health, would carry it out. To prevent bureaucratic obstructionism, the law commanded the creation of exactly three compassion centers to supply those patients who were unable to grow their own plants or to find a caregiver to grow plants for them. The law even provided that if a compassion center closed, another would have to be opened. Without rehashing the entire history of this, even with explicit commands from the legislature the process did not go smoothly within the Department of Health, but eventually the mandated three facilities were opened and are now operating.

However, compassion centers are an expensive way to obtain medical marijuana. They are corporate entities, albeit non-profit, that must pay rent and wages, and they necessarily incur all of the added expenses of their corporate infrastructure. This is not a criticism of compassion centers, but simply a recognition of what they are. It doesn’t require a sophisticated understanding of economics to know that you can grow your own tomatoes with your own labor more cheaply than you can buy them from the supermarket.

Part of the new proposal would allow the Department of Health to decide how many compassion centers would exist, and as I read the proposed statutory changes they could allow zero or hundreds depending upon whatever criteria they choose. New classes of licenses would be created, including “licensed cultivators” who grow for compassion centers with no association to any particular patient and “authorized purchasers” who can buy from compassion centers on behalf of a patient who is too sick to go in person. Bluntly, what is proposed is an entire system in support of the compassion center model intended, it appears, to replace the private growing model.

And, of course, there is the coup de grâce: Compassion centers and those growing for them, unlike individual patients and their caregivers, will not have to pay for tax tags.

If the proposal is adopted, what seems likely to happen is a set of results that will do enormous harm to the public interest: Patients who can afford compassion center prices will abandon private growing, while patients who cannot afford compassion center prices will go back to growing illegally as they did before the original medical marijuana law was adopted in 2006. Almost no one will buy the new tax tags because the economic assumptions behind them seem absurd.

I’m not suggesting that there is any grand conspiracy motivating the proposal, but rather that it seems a cobbling together of concerns from numerous disparate parties. Police have never liked the medical marijuana law — not because they oppose marijuana as medicine, but because they believe much of the medical growing activity is a subterfuge that feeds the illegal market. Many doctors still see marijuana as a substance abuse problem and prefer prescribing traditional drugs — not because they are being paid off, but because they genuinely trust the pharmaceutical industry more than homegrown plants. Is it possible that the governor was convinced by a confluence of such interests to believe that she can really get $8.4 million from people who are not as sick as they claim to be?

If there is one thing I am virtually certain about from covering her, it is that Governor Raimondo is not an idiot. Does she really expect $8.4 million from medical marijuana tax tags?

If the real goal of this proposal is to get rid of individual growers, that should be openly stated and considered in a transparent legislative hearing process, not slipped through the back door by an article buried in the annual budget.

Cannabis – Another Shot at Legalization Rep Scott Slater

Truck tolling got all the attention this week at the statehouse, but stalwart efforts to introduce a legislative change that would likely have 1000 times the financial impact on daily lives in RI also took a small step forward, if mostly under the radar.

Tax and Regulate legislation was proposed and will be reviewed in committee. It’s the 5th year (imagine how far ahead of the curve we might have been 5 years ago!) that this bill has been proposed, with only small improvements and details happening from year to year. It has yet to make it out of committee, but there are a few reasons hopes are higher that this could be the year it finally reaches a vote:

Massachusetts is committed to voting on similar legislation this year. The “wait and see” contingent can now review 2 years of data from Colorado and Washington where impact on consumption has been negligible but impact on economies has been enormous. Numerous polls by different organizations all indicate that the public overwhelmingly favors this course. Although this has been true for a few years, one assumes that in an election year fewer litigators will choose to ignore the views of their constituents. Taxes on medical marijuana, proposed last week in the Governor’s budget, which threaten the health of many medical marijuana patients, have a lot of people reacting with thoughts along the lines of: “Maybe we shouldn’t tax medicine, maybe we should tax recreational consumption the way we do alcohol.”

New elements this year are mostly refining the packaging and labeling requirements for edibles containing marijuana, including stricter allowances for childproof packaging. There are also new allowances for taxes raised from local establishments to make their way back to those community funds.

The legislation is being proposed by House Representative and Deputy Majority Leader Scott Slater (D District 10) and Senator Josh Miller (D District 28). This time out, the bill has the support of 17 sponsors – almost half – of the senate chamber including Senator Majority Leader Dominick Ruggerio (D District 4) and Judiciary Committee Chairman Michael McCaffrey (D District 29).

This is the year to write your rep or state senator and show your support for this overdue legislation.

Medical Marijuana in the State Budget

The Rhode Island medical marijuana law has been on the books since 2006 but still remains controversial. As part of the fiscal year ending 2017 state budget proposed by Governor Gina Raimondo on Feb. 3, although structured as a budget bill, H. 7454 Article 14 (pages 194 through 229) makes numerous substantive changes to the state’s medical marijuana program.

Michael Raia, communications director for the state Executive Office of Health and Human Services, said the proposal is “an attempt to improve the integrity and quality” of the program. Patient cardholders would be able to buy from any compassion center without having to designate it as their caregiver (as currently required), which he said would improve accessibility. Instead of a caregiver who grows for them, patients could designate an “authorized purchaser” allowed to buy for them from a compassion center. (A patient who grows for himself or herself could designate neither an authorized purchaser nor a caregiver.) Raia also pointed to other provisions that would encourage expedited consideration of patients in hospice care.

However, the main change attracting attention from patients and caregivers is the proposed chapter (21-28.6-15, p. 220) that would require “every marijuana plant, either mature or seedling” to be “accompanied by a physical medical marijuana tag” purchased from the Department of Business Regulation. The per-plant tags would cost $150 each for patients who grow for themselves and $350 each for caregivers and others, although no reason is given for the price difference.

A tag would be valid for one year and could be transferred among different plants and seedlings throughout the year, although only one at a time.

Fees from licensing cardholders would be put into a restricted fund to cover the costs of the medical marijuana program, but the revenue from tag sales would go into the state general fund (21-28.6.19(c), p, 227). At the same time, the net revenue tax paid by buyers at compassion centers will be reduced from 4% to 3%.

The distinction between mature plants and seedlings (which current law distinguishes as “usable” and “unusable” marijuana) would be eliminated, so seedlings would weigh against the plant count limits. The proposal would also reduce by half, from 12 to 6, plants allowed to a patient who grows for himself or herself. Caregivers would still be allowed to have up to 24 plants and grow for up to five patients (including themselves if they are also a patient), but there would be a new limit of 24 plants in any single location “except for licensed compassion centers, licensed cooperative cultivators, and licensed cultivators.” Each grower would be limited to a single location that would be required to be registered with the Department of Business Regulation. If two or more growers have a cooperative cultivation facility, a new provision requires that it must be separately licensed.

Raia defended the tag plan as an effort to provide “a level of accountability” and “bring some oversight and order to a marketplace that hasn’t had that” due to “ill-defined rules.” In particular, he said that a major goal was to “cut down on the overflow into the illegal recreational market” from the legal medical market. Of the anticipated $8 to $8 1/2 million in revenue, he said, $1 to $1 1/2 million would be used to improve the administration of the medical marijuana project. Another major goal, he said, was to enable the Department of Health to develop regulations for testing of safety and quality, although he was unable to say at this time how the costs of the required testing would be funded. “We’re focused on the legislative process, and promulgation of the regulations would come after the legislation is in place,” he said.

The current statutory provision that allows a patient to appoint up to two primary caregivers (21-28.6-6(d), p, 202) would be removed, which would have the apparent effect of reducing the number to only one. Patients would no longer designate a compassion center as a caregiver and could purchase from any licensed compassion center, but all compassion centers would be required (21-26.8-12(g)(3), p. 216) to record every dispensing transaction into a statewide database that they would also check before dispensing – to prevent a patient from exceeding a 15-day limit. Patients would be identified in this new database by their card number but not by name. A new class of “licensed cultivators” would be created who grow for compassion centers rather than for particular patients.

There is a wide variety of other proposed changes. Possession of marijuana products made by extraction using flammable chemicals, such as butane hash oil (BHO), would be totally banned for both patients and caregivers. Medical professionals from states other than Rhode Island, even Massachusetts and Connecticut, would no longer be allowed to certify a patient’s need. Current law mandates the Department of Health decide an application or renewal within 15 days, and this would be changed to allow the department to set its own time limit by regulation.

The patient and caregiver community has reacted extremely negatively to the proposals, especially to paid tagging and reductions in plant count. The Rhode Island Patient Advocacy Coalition in a statement on their web site said the lower plant counts, in combination with reclassifying seedlings as plants, effectively constitute a 75% reduction in production for patients who grow for themselves and for caregivers who grow for a single patient. Whether patients, many on disability, are in a position to pay this up-front per-plant fee has also been questioned.

The proposed changes, taken together, appear to be an effort by the state to discourage growing by patients and caregivers and instead to provide economic incentives for patients to obtain medical marijuana from compassion centers. The proposed changes also appear to remove the extensive statutory regime (21-26.8-12(b), pp. 207-208) that mandates the licensing of exactly three compassion centers, no more and no less, and instead leave the total up to the discretion of the Department of Health by regulation: under the new proposal, the department would appear to be free to license dozens of compassion centers or none at all. Sex and Marijuana: Carnal Cravings and Cannabis Connect

Since as early as the 7th century, cannabis has been used to enhance sex in many cultures. It isn’t limited to simply being an aphrodisiac either; cannabis has a long history of being used in sex rituals, easing pain during sex from childbirth or other medical conditions and treating STDs. While there currently is no concrete evidence of its effectiveness, as the topics of sex and cannabis become less taboo there will hopefully be some more research in the area.

Whether we examine the tantric sex rituals of ancient India or practices of Persian prostitutes in the late 1800s, we humans have quickly caught on to the beneficial physiological reactions that we have when consuming cannabis. These reactions are similar to sexual arousal itself: bliss, heightened sensitivity, relaxation, an increased mind-body connection and a sense of time slowing down. Strain selection and method of delivery will dictate how you feel; smoking a strong sativa may exacerbate anxiety lingering on the conscience, whereas choosing an indica-dominant hybrid may ease both stress and body pain and guide you into a relaxed and euphoric state. Smoking and vaporizing aren’t the only options for bud and the bedroom these days either. Marijuana infused edibles may take longer to set in, but their effects produce a deep body relaxation and can last for many hours. During the sex rituals in ancient India, participants would consume a drink called bhang, which is essentially a marijuana milkshake (recipe below) for an enlightened experience and powerful orgasms. Topical applications are also becoming more popular, with the advent of infused massage oil and companies like Foria making infused lubricant. Foria’s product has received overwhelmingly enthusiastic reviews from women; not only does is increase the quality (and quantity) of orgasms, is also makes sex possible for women with complications from childbirth, menopause or medical conditions like endometriosis, for whom it was previously too painful to manage. Currently sold only in Colorado, it’s easy to whip up a batch of your own and will probably be cheaper too — a bottle of Foria’s product goes for $44 a pop.

Bhang Cannabis Drink:

Ingredients: 2 cups water 4 cups warm milk 1/2 to 1 teaspoon rosewater 1oz bud 3/4 to 1 cup sugar 2 tablespoons blanched, chopped almonds 1/8 teaspoon garam masala (blend of black pepper, cardamom, caraway seed, clove, cinnamon, bay leaf, nutmeg, mace, cumin seed, corainder, and saffron – varies between brands) 1/4 teaspoon ginger powder

Instructions: Bring the water to a boil in a clean teapot. Remove any stems or seeds from the cannabis, add to the teapot, and cover. Let simmer for approximately 7 minutes. Strain the water and cannabis through cheesecloth and squeeze the wet cannabis to extract as much water as possible. Save this water. Place the cannabis in a mortar and add 2 tablespoons warm milk. Slowly but firmly grind the milk and cannabis together. Put the cannabis through cheesecloth and squeeze out as much milk as you can. Save this milk. Repeat this process until you have used 1/2 cup (8 tablespoons) of milk. (Save this milk. The cannabis should look pulpy at this point.) Put the cannabis back into the mortar. Add the chopped almonds and enough warm milk to completely cover the chopped almonds and cannabis. Grind the mixture in a mortar until a fine paste is formed. Put this through cheesecloth and squeeze out as much milk as you can. Save this milk also. (Repeat until dry.) Throw out the dry mass. Combine all the liquids that have been saved (the water and the milk). Add garam masala, ginger powder, sugar, rosewater, and remaining milk. Stir. Chill, serve and enjoy.

Note: This drink is VERY potent!! Consume small amounts at a time and wait 45 minutes to an hour for the onset of effects.

Homemade Cannabis Lubricant

Ingredients: 1 cup liquid coconut oil (MCT oil) or raw coconut oil* 1 cup trim or bud, or 1 gram hash 1 tablespoon liquid sunflower lecithin

Instructions: Combine ingredients in crockpot on low/warm setting or in a Magical Butter Machine, set on the “oil” setting. If using crockpot, cook 3-4 hours stirring frequently. Strain and cool.

*lubricant made with raw coconut oil will solidify at room temperature, however the heat from your hand will re-liquefy the product; note that oil-based lubricants can weaken latex condoms