Medical Cannabis Confusion and Contamination in the Wild West of Weed

1. Medical Cannabis Confusion and Contamination in the Wild West of Weed By Nathan Donahoe Elected City Official and Chair of Medical Cannabis Committee for West Los Angeles Neighborhood Council (WLANC)

2. Table of Contents • What is Cannabis? • Medical, Legal • Cannabis Healthcare Industry at a Glance, Chain of Custody • Future of Cannabis Healthcare

3. What is Cannabis • Cannabis (Cán-na-bis; English pronunciation: /ˈkænəbɪs/) is a genus of flowering plants indigenous to Asia that includes two main varieties which are differentiated on their use: • Cannabis Sativa/Indica for medical use. First documented use 2700 years ago • Hemp for food and industrial use. First documented use 10,000 years ago.

4. Medical Uses as known by “Pop Pot Culture”. Cannabis Sativa Cannabis Indica Night Time Body High Relaxation Pain • Day Time • Head High • Energy • Mood Elevation

5. Historical Medical Uses Ancient China and India was considered a medicine Late 1800’s early 1900’s was sold as a tincture by pharmacies, Sears Catalogue and more.

6. Cannabis Tincture from 1900’s Sears Catalogue

7. Historical Food and Industrial Uses • Rope • Sails • Seeds for livestock • Declaration of Independence was drafted on hemp. George Washington Ben Franklin and Thomas Jefferson were all hemp farmers

8. How does Medical Cannabis Work? • THC, Tetrahydrocannabinol • CBD, Cannabidiol • Endocannabinoid system • Terpenes

9. THC and CBD • THC provides mood elevation, anti-depression and a “high”. • CBD anti-inflammatory, anti-anxiety, anti-psychotic

10. Endocannabinoid System • The endocannabinoid system refers to a group of neuromodulatory lipids and their receptors that are involved in a variety of physiological processes including appetite, pain-sensation, mood, and memory; it mediates the psychoactive effects of cannabis. • Receptors are found in the brain, CNS, lungs, liver, kidneys and certain cells. • Anandamide, Sanskrit for “bliss” is main chemical of that system.

11. Terpenoids • The terpenoids are a large and diverse class of naturally occurring organic chemicals found in plants used extensively for their aromatic qualities.

12. Plants Known for High Terpenoid Content • Lavender • Linalool • Citrus • Limomene • Cinnamon • Cinnamaldehyde  • Cannabis

13. Cannabis is a form of Aromatherpay? • Cannabis can reproduce terpenes found in other plants and is considered by “Pot Culture” to be the reason why different smelling strains have different medicinal effects.

14. Federal Law • Federally, marijuana and its derivatives are still considered illegal according to the Controlled Substances Act (CSA) (21 U.S.C. § 811). • (1) Schedule I.— • (A) The drug or other substance has a high potential for abuse. • (B) The drug or other substance has no currently accepted medical use in treatment in the United States. • (C) There is a lack of accepted safety for use of the drug or other substance under medical supervision."

15. California State Law • Proposition 215 • SB 420 • Attorney General Guidelines

16. 1996, Prop 215 Compassionate Use Act Health & Safety Code 11362.5 which states in part: … (A) To ensure that seriously ill Californians have the right to obtain and use marijuana for medical purposes where that medical use is deemed appropriate and has been recommended by a physician who has determined that the person's health would benefit from the use of marijuana in the treatment of cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or any other illness for which marijuana provides relief. (B) To ensure that patients and their primary caregivers who obtain and use marijuana for medical purposes upon the recommendation of a physician are not subject to criminal prosecution or sanction.

17. SB 420 • Establishing guidelines regarding how much marijuana patients may grow and possess, • -Instructing counties to implement a Voluntary State ID Card System, • -Recognizing the right of patients and caregivers to associate collectively or cooperatively to cultivate medical cannabis,

18. Attorney General Guidelines • Then August 2008, Attorney General Edmund Brown guidelines issued guidelines: • (1) ensure that marijuana grown for medical purposes remains secure and does not find its way to non-patients or illicit markets, • (2) help law enforcement agencies perform their duties effectively and in accordance with California law, • (3) help patients and primary caregivers understand how they may cultivate, transport, possess, and use medical marijuana under California law.

19. Conflicting State and Federal Law • Confusion and prosecution will continue until Cannabis gets reclassified under Federal law as having medical value. • States right issue for all 16 states that have laws permitting medical cannabis

20. Los Angeles City Law • August 2007 Then the City of Los Angeles Medical Marijuana Interim Control Ordinance states in part: … no new dispensaries are allowed to open in the City, and only previously existing dispensaries are allowed to operate. The ICO is intended to control the proliferation of dispensaries while the City develops permanent regulations for medical marijuana uses.

21. A Legal Loophole and Lawyers Allowed an Explosion of Collectives • “... you can initiate your nonprofit corporation and get your collective started in less than 5 minutes...and up and running within 2 weeks... The charge is $3777 and in about 14 days your collective will be signing up patients, growing, obtaining and possessing medicine for them, getting a tax payer's ID, a seller’s permit and such licenses and registrations as may be required/available in your town depending on your intended use: whether Growing, Delivering, and Distributing Cannabis among your patient members."

22. Current Los Angeles Legal Situation • Over 75 pending lawsuits against the city • $5 million dollars spent defending the city • With case laws constantly changing, and federal government not allowing regulation, it is difficult for city to make an ordinance

23. Industry Flow Chart • Genetics and Breeding -> Growing -> Harvest and Curing -> Trimming -> Processing -> Distribution/Vending -> Dispensing • Quality Control • Lab testing • Third Party Agriculture Inspecting

24. Genetics and breeding. • Cannabis plants are propagated by seeds and clones.

25. Differences Between Seeds and Clones Seeds Clones A branch/cutting is taken from a cannabis plant and regrown as an individual plant Has exact same characteristics as “mother plant” cutting was taken from. Only consistent way to get identical medicinal effect. • Pollinated seeds are taken from female cannabis plant. • Every seed will produce a cannabis plant with different characteristics of smell, medicinal effect, growth time, etc. • Every seed is like a cousin, although similar, will not be consistent.

26. Problems with Current Industry Standard for Genetics and Breeding • Genetic testing is not used to ensure that different cannabis providers have the strains they claim. • Mislabeling abounds. Patients do not get consistent medicinal effects, dosages or usages. • Example: What if every bottle labeled “Advil” at a pharmacy had different medicine in it?

27. Growing • Indoor • Greenhouse • Outdoor

28. Indoor growing • Plants are grown under artificial lights indoors in warehouses, residential neighborhoods, shipping containers, anywhere with water and power.

29. Problems with Current Industry Standard for Indoor Growing • Fire hazards from overloaded, or improperly wired electrical circuits. • Rooms not built to code or inspected for safety. • Worker safety issues with chemicals, pesticides, fertilizers, poor ventilation. • Grown in residential neighborhoods • Theft, burglary and crime of money and cannabis • Medicine contaminated with mold, chemicals and other contaminants

30. Greenhouse and Outdoor Growing • Plants are grown outdoors in the open air or under greenhouses.

31. Problems with Current Industry Standard for Outdoor and Greenhouse Growing • Watershed is depleted from water use and contaminated by fertilizer and chemical runoff, diesel spills • Theft, burglary and crime of money and cannabis • Medicine contaminated with mold, chemicals and other contaminants

32. Harvesting, Curing, Trimming • After female plants have matured they are harvested, hung to dry and have excess leaf and stems removed by trimming by hand or machine. Leaving the most medicine rich bud.

33. Problems with Current Industry Standard for Harvest, Curing and Trimming • Improperly cured medicine can grow mold, have chemical residue and other contaminants • Worker safety issues. Trimming can occur in sweat shop like conditions with long hours, little breaks. Repetitive stress injuries like carpal tunnel syndrome.

34. Processing • After curing cannabis can then be distributed as dried leaf or processed into concentrated versions such hash, oils, tinctures.

35. Edibles • Can then be processed into “edibles” cookies, sodas, lollipops, breath strips hot sauce, etc. • Topical lotions and balms

36. Problems with Current Industry Standard for Processing and Edibles • Chemicals such as butane, sulphuric acid are used creating danger for producers and patients. • Processed by amateurs in residential settings, fires, chemical spills • Medicinal effect not consistent, overdosing

37. Distribution/Vending • Growers then distribute to collectives, delivery services, black market. Or growers then give medicine to middle-men or vendors to vend.

38. Problems with Current Industry Standard for Vending and Distribution • Vendors are targets for robbery. • Medicine is mishandled and mislabeled • Youth get involved in the industry. • Sample business card of 18 year edible entrepreneur

39. Dispensing • Medicine is then dispensed, “sold” to patients by a storefront collective, delivery service or black market.

40. Sample Ads of Dispensers

41. Sample Ads of Collectives

42. Sample Ads of Collectives

43. How Patients obtain medicine • First, must get a “recommendation” from a physician.

44. California Medical Board’s Stance on Medical Cannabis • A physician should avoid the following: • a) Providing cannabis to a patient; • b) Describing to a patient how the patient may obtain cannabis, for example, by giving the name and address of a cannabis distributor; • c) Communicating with a cannabis distributor, such as a cannabis dispensary, to confirm a recommendation made to a patient in an office dialogue; • d) Offering a specific patient individualized advice concerning appropriate dosage, timing amount and route of administration. • Whether a particular recommendation or action is permissible will depend on the surrounding circumstances. Again, physicians cannot intentionally take an action for the purpose of enabling a patient to obtain cannabis or otherwise to violate the federal drug laws.

45. Cannabis Healthcare Quality Control Industries • Lab testing for medical potency, mold and chemical contaminants • Third party agricultural inspection

46. Lab Testing • Just like other plants, medicines or products, cannabis can be laboratory tested for medical potency, mold and chemical contaminants.

47. Problems with Current Industry Standard for Lab Testing • No universally accepted lab standards. No cannabis testing accreditation. Different labs get different results. • Labs have vested interest in providing false results. Lab customers will give their business to labs that produce high THC/CBD results or absence of contaminants.

48. Third party Agricultural Inspection • The same USDA standards applied to produce like tomatoes and apples are applied to cannabis and inspected by third party inspector companies.

49. Problems with Current Industry Standard for Third Party Agricultural Inspecting Companies • USDA does not currently recognize medical cannabis as an agriculture crop and does not recognize any companies.

50. Future of Cannabis Healthcare? • Sativex is a Cannabis based mouth spray for multiple sclerosis patients approved for use in Europe and is pending FDA trial approvals in the USA. • Also, being used in a study for cannabis addicts in Australia