Author’s update: the graphics in the post below have been updated to correct some minor mistakes, such as dated information that left out Rhode Island and Maine’s dispensaries and Oregon’s recent acceptance of Alzheimer’s agitation as a qualifying condition. Also, I have outlined Oregon’s attempt at legalization through the OCTA petition as it could be reasonably said to be as far along or farther along than Washington’s I-1068. I regret my errors.

With New Jersey recently becoming the 14th medical marijuana state, activists in marijuana law reform have been celebrating. After all, over 82 million Americans now live in states where medical use of marijuana is legal – that’s 27% of the US population! Last election, Massachusetts became the 13th decriminalization state, which means over 107 million Americans live in a state where possession of small personal amounts of marijuana no longer merit an arrest – that’s 35% of the US population.

However, after watching fourteen years of marijuana activism focused solely on those who use cannabis for medicine, I must warn activists that medical marijuana is not getting any better and the time for re-legalization of cannabis for all adults – even the healthy ones – is now.

Medical marijuana was a great 20th century strategy to get the sick and dying off the battlefield in the war on drugs. It was the perfect vehicle to enlighten the public, who for so long have been indoctrinated into the reefer madness that classifies cannabis like LSD and heroin. But in the 21st century the idea that marijuana is only a medicine is beginning to take hold and governments and voters are crafting ever-more-restrictive medical marijuana laws. For the vast majority of cannabis consumers this threatens to move us from the category of “illegal drug users” to “possessors of medicine without a prescription” – a step up, perhaps, but still left facing criminal prosecution.

California legalized medical marijuana in 1996. That initiative, Prop-215, established what is clearly the most liberal medical marijuana statute to date:

A doctor can recommend for any condition;

You needn’t have a “bona fide” doctor/patient relationship;

Dispensaries are allowed;

Self cultivation is allowed;

Patients are protected from arrest.

If we consider these five attributes of the law the baseline, then in the past fourteen years, all thirteen medical marijuana states that have followed have failed to achieve all five. Eight states only offer three or four of those liberties and the rest offer two or only one. Most disturbingly, the right of patients to grow their own medicine (or have a caregiver do it for them), which has been a bedrock principle in medical marijuana law, was taken away from patients in the most recent medical marijuana state, New Jersey. Bills that were considered but vetoed in 2009 in Minnesota and New Hampshire, and those moving forward in New York, Pennsylvania, as well as an initiative in Arizona, all sacrifice this core right.

A comparison of plant and possession limits also shows the decline from the original starting point in California, where 12 plants and 8 ounces are allowed. Oregon and Washington passed their laws next and have the highest statutory limits: 24 plants and 24 ounces in Oregon and 15 plants and 24 ounces in Washington. (To be fair, all the West Coast states started with lower limits or more vague limits that were modified by the legislature.) But since then, only one state has allowed more than 3 ounces (New Mexico with 6 ounces) and average number of plants allowed is a little less than ten.

Another decline in medical marijuana freedom appears when we look at the conditions for which medical marijuana protection is afforded in the various states. There are eight conditions which could be considered the “standard” ones: cancer; HIV/AIDS; seizure disorders, like epilepsy; spastic disorders, like multiple sclerosis; glaucoma; chronic nausea; cachexia; and chronic pain. Most medical marijuana states recognize all eight conditions; a couple (Vermont and Rhode Island) recognize seven of eight.

The latest law in New Jersey, however, eliminated chronic pain, chronic nausea, and cachexia, making it the most restrictive list in the nation. The bill proposed but vetoed in New Hampshire required one to try all other remedies for chronic pain before trying medical marijuana. The vetoed Minnesota bill wouldn’t even allow cancer and HIV/AIDS patients to use medical marijuana unless they could show they were terminal (about to die). The lists in the latest proposed bills continue to become more restricted.

Until we do have legalization for all, every medical marijuana law is going to fail to adequately serve all medical users and subject them to increasing restriction and scrutiny. Additionally, medical marijuana laws make patients an attractive target for criminals because prohibition maintains huge profits for stolen medical cannabis, as well as becoming targets for overzealous anti-marijuana cops and prosecutors.



The reason the recent medical marijuana laws are losing ground is not a failure of the medical marijuana strategy, but rather due to its success. Medical marijuana has portrayed the herb as “powerful and effective medicine”. Well, what do we do with powerful and effective medicines? We keep them under lock and key. We require people to visit doctors. We strictly monitor prescription pads. We bust people who have them without proper papers.

Rather than justifying the prohibitionists’ shibboleth of medical marijuana as “the camel’s nose under the tent” for legalization, I’m arguing it’s the opposite: that continuing the medical marijuana strategy further cements the “powerful and effective medicine” frame and takes us farther away from treating cannabis as a personal choice of relaxant. We’ll get to a point where the public accepts “powerful and effective cannabis medicine” and looks upon personal use like we look at someone getting fraudulent scrips for painkillers.

If one of the West Coast states doesn’t pull off legalization soon, the pendulum is going to swing back the other way on marijuana. The economic incentives may fade if the economy recovers and then the tax & regulate argument fizzles. And if we are going to continue working on medical marijuana, the bills and initiatives need to get better, not worse. The way it’s looking now is that the Northeast and upper Midwest are going to institute chronic conditions-only, 2 oz limit, strict registry, only personal doctor, no home grow, state-run dispensary medical marijuana for $15/gram in the next six years. How then do we approach those people and say, “Hey, you know that powerful and effective medical marijuana that you only let a few hundred really sick people use after jumping though a mile of hoops? We think everybody should have it and jump through no hoops!”

Medical marijuana would never have passed in any state if it were not for the votes of non-medical users of marijuana. I do believe it is time for medical marijuana patients in the states that have programs to “repay the favor” and fight as hard for legalization as social tokers fought for medical. Only patients can best make the argument that while prohibition exists, they will always face job discrimination, loss of child custody, high black market prices, housing discrimination, and the sneers of the Bill O’Reillys who think 99% of medical marijuana patients are faking. So long as the prohibition profit exists, there will always be these CBS Undercover investigations casting a pall on all legitimate medical marijuana because of the irresponsible acts of a few.

Maybe I’m just too much of a dreamer. I imagine acres and acres of hemp fields, huge indoor hydroponic cannabis warehouses, thriving cafes and coffeehouses, some folks growing their own in a garage or closet, regular outdoor festivals and special indoor events where cannabis smoking is permitted, buying and selling all varieties of cannabis from ounces at a farmer’s market to bulk bales at CostCo… and none of that is done with “powerful and effective medicines”.

I don’t think that it is reformer’s job to pass medical marijuana in all fifty states first and then worry about legalization in one. I think states that have medical should be moving forward on legalization, states without should focus on better medical laws by calling prohibitionists’ bluff on “marijuana outta control!” in the Western states with liberal medical laws.

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