Wayne State University Wayne State University Dissertations 1-1-2013 Qualitative Reports Of Michigan Medical Marijuana David Charles Peters Wayne State University, Follow this and additional works at: http://digitalcommons.wayne.edu/oa_dissertations Part of the Sociology Commons Recommended Citation Peters, David Charles, "Qualitative Reports Of Michigan Medical Marijuana" (2013). Wayne State University Dissertations. Paper 854. This Open Access Dissertation is brought to you for free and open access by DigitalCommons@WayneState. It has been accepted for inclusion in Wayne State University Dissertations by an authorized administrator of DigitalCommons@WayneState. QUALITATIVE REPORTS OF MICHIGAN MEDICAL MARIJUANA PATIENTS AND CAREGIVERS INCLUDING REDUCED OPIATE USE, DISPENSARY OPERATIONS, LEGAL CONCERNS, AND MARIJUANA STRAINS by DAVID C. PETERS II DISSERTATION Submitted to the Graduate School of Wayne State University, Detroit, Michigan in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY 2013 MAJOR: SOCIOLOGY (Medical) Approved by: ________________________________ Advisor Date ________________________________ ________________________________ ________________________________ @COPYRIGHT BY DAVID C. PETERS II 2013 All Rights Reserved DEDICATION All my work is dedicated to my wonderful children: Christopher, who grew up much too fast for this project; Andrew who was such a good little boy, playing quietly month after month, while I worked in my home office; but, especially to Katherine Joyce who left us after just five days in 2004. Katie had a very short life, but she made a difference, providing the inspiration for my return to school and showing everybody that she touched during her time on this Earth the real reason we are here: To do good works and contribute to the human condition by acquiring and disseminating knowledge, leaving a legacy of hope, and furthering the spirit of progress for our children and their children’s children. I will be joining you soon, baby, there are just a few things daddy needs to do first. The words of the teacher…Meaningless! Meaningless! Utterly meaningless! Everything is meaningless. What do people gain from all their labors at which they toil under the sun? Is there anything of which one can say, “Look! This is something new?” So I applied my mind to study and to explore by wisdom all that is done under the heavens. What a heavy burden God has laid on mankind! I have seen all the things that are done under the sun; all of them are meaningless, a chasing after the wind. What is crooked cannot be straightened; what is lacking cannot be counted. Then I applied myself to the understanding of wisdom, and also of madness and of folly, but I learned that this, too, is a chasing after the wind. For with much wisdom comes much sorrow; the more knowledge, the more grief.… So I saw that there is nothing better for a person than to be happy and to do good while they live…and to enjoy their work… The Book of Ecclesiastes ii ACKNOWLEDGEMENTS I express my eternal and undying love and thanks to my wife, Rochell Holmes Peters, JD, CPA for her love, support, patience, and her tireless financing during this long ordeal. I also express my profound appreciation and respect to all of the professors who touched my life over these many years, in particular my Master’s Thesis mentor and advisor, Nash Boutros, MD, and all my PhD Dissertation Committee members: The Chair, Mary Sengstock, PhD who gave me a chance to succeed and guided me the entire way and who, along with the other member of my “inside committee” Janet Ruth Hankin, PhD, introduced me to Medical Sociology, read my analyses for several years, and still kept me on the narrow path to graduation as a sociologist. They gave unflinching and honest support without fail and were always available, and always gave exceptional, often deeply profound, and even occasionally kind advice. I am in their debt in particular but owe much too every member of my committee and thank Professor Jesse Vivian, J.D., RPh who introduced me to interdisciplinary studies all the way back in 1991 and Professor Heather Dillaway, PhD who put up with my objections in class and patiently convinced me of the scientific value of depth interviews. Thanks for everything! I will not disappoint you. Finally, I thank all the people who helped with this study and gave so generously of their time and knowledge especially Timber, Kevin, Jamie, Ken, Bob, Matt, and Rich. May all of you continue to grow in love, peace, and good health. Sow your seed in the morning, and at evening let your hands not be idle, for you do not know which will succeed, whether this or that, or whether both will do equally well. The Book of Ecclesiastes iii TABLE OF CONTENTS Dedication…….……………………………………………………………………….……..….ii Acknowledgements…………………………………………………………………………..….iii List of Tables………….………….…………………………………………………………..…v CHAPTER 1: BACKGROUND………………………………………………………………1 CHAPTER 2: LITERATURE REVIEW………………………………………………………10 CHAPTER 3: METHODS…………………………………………………………………….68 CHAPTER 4: FINDINGS 1- USE OF MARIJUANA ELIMINATED OR REDUCED PRESCRIPTION OPIATES……………………………………………………88 CHAPTER 5: FINDINGS 2- VARIOUS LEGAL CONCERNS OF PATIENTS AND CAREGIVERS…………….…..…………………………………………110 CHAPTER 6: FINDINGS 3- DISPENSARY STRUCTURES AND MEDICAL MARIJUANA PROVIDER ORGANIZATIONS UNDER THE MICHIGAN MEDICAL MARIJUANA ACT BEFORE MCQUEEN………………………….………..133 CHAPTER 7: FINDINGS 4- STRAINS: THE PERCEIVED EFFECTS OF VARIETIES OF MARIJUANA……………………………………………………………...151 CHAPTER 8: LIMITATIONS AND CONCLUSION…………………………………..……162 Appendix 1: Interview Guide..……………………………………….………………………..175 Appendix 2: Advertising Flyer………………………………………………………………..183 References…………………………………………………………………………………...…184 Abstract………………………………………………………………………………………...199 Autobiographical Statement……………………………………………………………………201 iv LIST OF TABLES Table 1 Interview Recruitment Sources ........................................................................................ 71 Table 2: Internal Referrals of Interviewees by other Study Participants ................................. 72 Table 3: Interviewees by qualifying medical condition ............................................................... 74 Table 4: Initial Categories of Discussion in Interview guide ...................................................... 79 Table 5 : Final Codes and Interview Themes by Volume of Data Collection ........................ 81 Table 6: Collapsed Content for Findings from Original Study Questions ................................ 83 Table 7 :Interview Types ................................................................................................................. 84 Table 8: Caregiver Interviewees by medical marijuana experience ....................................... 84 Table 9: Interviewees by Education ............................................................................................. 85 v 1 QUALITATIVE REPORTS OF MICHIGAN MEDICAL MARIJUANA PATIENTS AND CAREGIVERS INCLUDING REDUCED OPIATE USE, DISPENSARY OPERATIONS, LEGAL CONCERNS, AND MARIJUANA STRAINS Chapter 1: BACKGROUND Introduction: The use of marijuana has been a particularly contentious issue in the United States for many decades. This is unexpected since, until the 1937 Marijuana Stamp Act (P.A. 238, 75 th Congress, 50 Stat. 551, Aug. 2, 1937) marijuana was common and grown throughout the country as a commodity that provided oil, fiber, food, and medicine. Marijuana use in world history is also extensive, predating the written historical record by many thousands of years. This substance, once commonly used by physicians for a variety of medical treatments, has gone from a commodity used across the globe for a number of purposes, including for medicinal purposes as a medicine, to totally banned in almost every country. A resurgence in the use of marijuana in the 1960’s was met by the counter-force of U.S. federal law and a variety of international treaties instigated by the United States government which legislated in 1970 that marijuana was a “schedule I drug” with “no legitimate medical use and a high propensity for abuse” (P.A. 91513, 91 st Congress, 84 Stat. 1242, Oct. 27, 1970). Despite marijuana prohibition, recently there has been an increase in claims about potential medical uses for marijuana. By 2013, the perceived efficacy of medical marijuana as a palliative for a number of diseases and conditions and even as an actual treatment prompted 17 States and the District of Columbia to legalize the medical use of marijuana in opposition to federal law while two States, Washington and Colorado, have legalized marijuana for all purposes. These diverse views on marijuana have caused 2 numerous conflicts on the political scene, as well as confrontations between extremists on both sides. Although much has been written about marijuana use in contemporary popular media, these have tended to focus, until very recently, on validating the governments unambiguous anti-marijuana position. A calmer, more reasoned and balanced analysis of the different perspectives of individuals who have specific concerns regarding the use of marijuana is needed. The major problem is that until very recently the perspective of marijuana users has not been the focus of the media, academia, medicine, and scientific research. Meanwhile, the courts, law enforcement, and other government agencies have used harsh tactics to subject marijuana users to penalties and thereby marginalize them and made research on the population