A Proposal on Legalization of Medicinal Marijuana in Hillsborough County November 30th, 2012

Forward: Under federal (Pub.L. 91-513. 84 Stat. 1242) and Florida state law (Criminal Code 893.13), the cultivation, sale and distribution of Cannabis across international borders, state boundaries and within the State of Florida is punishable by imprisonment and citation. The proceeding proposal is posed under the assumption of medicinal legalization within the state of Florida and the benefits of such implementations. Further analysis on the impact of such laws and their procurement are provided for Hillsborough County.

History of Cannabis in the United States

The history of Cannabis as a medicinal remedy and cash crop predates the establishment of the United States of America, yet the controversial stigma associated with the plant has arisen as recently as the 20th century. Despite its morally reprehensible reputation, Cannabis has the potential to serve as a medically remedial crop while generating sizable revenues for local and state governments.

Presently, the plant is listed as a Schedule I drug under the US Controlled Substances Act of 1970 (1). The act defines a schedule I drug as having:

A high potential for abuse No accepted medical application No accepted safety standards associated with medical consumption of the plant.

In early colonial settlements, hemp (a form of low THC cannabis) was an obligatory cash crop as commissioned by king James of England for export to the European continent (2). The pharmaceutical uses of the crop came to light in the 19th century when cannabis infused elixirs were readily available on stock shelves nationwide as remedial measures for sleeplessness, irritability, depression, fever, lack of appetite, and chronic pain.

The exponential growth of technology and industry following the industrial revolution saw an influx of trade between immerging markets across the globe. The boom in commerce was not without its vices; a growing convergence of opiates from eastern markets flooded western boutiques and social scenes, causing a rapid rise in habituation, vagrancy and crime.

In response to the large increase in opium trade, cannabis had become closely associated with abuse, mismanagement and crime due to its potency as an anxiolytic and pain inhibitor. By 1905, over 20 states had already implemented laws detailing proper cultivation, importation and distribution of cannabis within the United States (3). State adulteration followed suit; many states adopted measures that would prohibit the sale of cannabis in tandem with alcohol or tobacco (4).

The first nationwide measure concocted to address cannabis and other poisons was the Pure Food and Drug Act of 1906, which required all sales of nonprescription cannabis to be labeled with warnings of potentially deleterious effects that result from consumption (5).

In 1914, the Harrison act taxed the production, importation and distribution of opiates. The act attempted to control the supply of opiates, along with cannabis containing substances, by levying strict fines on possessors without permits and

demagoguing the consumption of such substances as hazards of health and society. Drafters of the bill appealed to unscientific, anecdotal evidence, making use of racial divisions to emphasize their point. One such testimony described drug-crazed, sex-mad negroesmurdering whites, degenerate Mexicans smoking marijuana, and Chinamen seducing white women with drugs
(6)

In 1925, the International Opium Convention attempted to mediate the global trade of global narcotics. The Convention concluded that the shipment of cannabis to member countries only require trade permits to conduct such activities for medical and scientific purposes (7).

The US Narcotics Act of 1925 bestowed more authority to the United States government to tax cannabis importation, however it did not empower state and local jurisdictions to imprison, fine or enforce the distribution of cannabis
(8)

Anslingers war against cannabis was an often exaggerated, unsubstantiated propaganda campaign against cannabis users that invoked racial hatred and social myopia via mass media. In one radio broadcast diatribe, Anslinger was found saying:

"There are 100,000 total marijuana smokers in the US, and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing, result

from marijuana usage. This marijuana causes white women to seek sexual relations with Negroes, entertainers and any others."

The campaign was intended to dissuade audiences from consuming marijuana, as Anslinger popularized, he went on to become the chief of the Bureau of Narcotics, formed in 1930 (9).

The strive to attain public sentiment for cannabis prohibition was once again at the center of global attention during the 1936 Geneva Convention on Narcotic trafficking. The United States, led by Anslinger, advocated harsh punitive measures be taken against individuals that cultivate, distribute and consume cannabis globally, emphasizing severe deprivation of civil liberties as remedial solutions to violators. Despite tumultuous lobbying efforts, the United States failed to procure a preferred policy across the global spectrum, failing to ratify the final convention treaty, labeling it as weak (10).

The Marijuana Tax Act was the staple-hold of present day cannabis policy in the United States. It sought to prohibit and criminalize all non-medical, non-industrial uses of cannabis. Importation of the plant levied a tax of $337 (inflation adjusted dollars) against the importer, while medical and industrial uses were annually taxed approximately $14 and $32, respectively (inflation adjusted dollars). A fine of approximately $1,400 was levied against individuals
(11)

Signs of protest against Cannabis regulation began with the Laguardia Commission in 1944, which sought to discredit exaggerated claims of violence, delinquency and rebellion associated with marijuana and establish medical and societal standards for its administration. The commission concluded:

1. Marijuana is used extensively in the Borough of Manhattan but the problem is not as acute as it is reported to be in other sections of the United States. 2. The introduction of marijuana into this area is recent as compared to other localities. 3. The cost of marijuana is low and therefore within the purchasing power of most persons. 4. The distribution and use of marijuana is centered in Harlem. 5. The majority of marijuana smokers are Blacks and Latin-Americans. 6. The consensus among marijuana smokers is that the use of the drug creates a definite feeling of adequacy. 7. The practice of smoking marijuana does not lead to addiction in the medical sense of the word. 8. The sale and distribution of marijuana is not under the control of any single organized group. 9. The use of marijuana does not lead to morphine or heroin or cocaine addiction and no effort is made to create a market for these narcotics by stimulating the practice of marijuana smoking. 10. Marijuana is not the determining factor in the commission of major crimes. 11. Marijuana smoking is not widespread among school children. 12. Juvenile delinquency is not associated with the practice of smoking marijuana. 13. The publicity concerning the catastrophic effects of marijuana smoking in New York City (12) is unfounded.

Finally, in 1969, the Supreme Court case Leary vs. the United States found the Marijuana Tax Act unconstitutional on the basis of violating the 5 th amendment and exposing carriers to the risk of self-incrimination (13).

Immediately following the court decision, the United States legislature adopted the Controlled Substances Act of 1970, fully prohibiting the possession of Cannabis under any circumstances. Under the Reagan administration, sweeping

measures were implemented to fortify the severity of criminal possession, including between 2-3 years in prison and up to a $20,000 fine.

In the decades following the enactment of the Controlled Substance Act, many rearrangements of policy have been considered and implemented, and states and some states have slowly detracted from federal mandates prohibiting medicinal marijuana. A rise in public interest and social activism spurred many state legislatures to recognize the scientific evidence of Marijuanas medicinal effects as well as potential sources of state revenue.

Current Status of Marijuana in In Florida

Florida law pertaining to the possession of marijuana adheres directly to federal mandates following the Controlled Substance Act. Possession of 20 grams or less carries a possible misdemeanor incarceration sentence of 1 year and a maximum fine of $1,000. Anything above 20 grams is considered a felony and carriers a sentence of up to 5 years and a maximum fine of $5,000 (14).

Status Quo of Scientific Inquiry into Marijuana Consumption

In 1999, in response to Californias passage of the medical Marijuana law, the white house commissioned the Institute of Medicine to review data on the potential benefits of the drug. The IOM promptly concluded that nausea,

appetite loss, pain or anxiety are all symptoms that can be safely and effectively mitigated by Marijuana use. The federal government refused to acknowledge the report (15).

The National Institute for Drug Abuse funded research that compared illegal nonmedical marijuana use in San Francisco to Amsterdam, where adults had the capability to purchase marijuana for recreational purposes. The studies concluded that the frequency of use of hard drugs was significantly lower in Amsterdam. For instance, the use of crack cocaine was nearly 4.5 times higher in San Francisco (16).

The National Research Council concluded that the nation possesses little information about the effectiveness of current drug policy, especially of drug law enforcement. And that data that existed showed little apparent relationship between severity of sanctions prescribed for drug use and prevalence or frequency of use (17).

Most importantly, a federally funded study by the National Institute on Drug Abuse found that marijuana use caused no significant increase in mortality as compared to tobaccos associated increased risk of death (18).

Marijuanas main ingredient is delta-9-tetrahydrocannabinol (THC) which, due to its similar chemical structure, attaches to cannabinoid receptors in the brain and

simulate an effect normally produced by the bodys natural neurotransmitters, eliciting influence on pleasure, memory, thinking, concentration, movement, coordination, sensory and time perception.

The FDA has recognized the therapeutic role THC plays in relieving nausea associated with chemo-therapy, but refused to recognize Marijuana as the main approach to THC administration (19).

Costs of Marijuana Prohibition in the United States

In an open letter issued by over 530 distinguished economists to the Bush administration, experts called for an open and honest debate about marijuana prohibition concluding we believe such a debate will favor a regime in which marijuana is legal but taxed and regulated like other goods.

According to this report, the economic implication of marijuana prohibition are starkly outweighed by the implications of its legalization: legal regulation of Cannabis would save the federal government approximately $7.7 billion in expenditures ($2.4 billion at the federal level and $5.3 billion at a state level). Assuming a consumption tax, similar in nature to alcohol or tobacco taxes, were implemented, the tax would generate an estimated $6.2 billion. In the study, the author(s) cite that the residual revenue derived from marijuana legalization can

help cover the full cost of anti-terrorism port security measures required by the Maritime Transport Security Act of 2002.

A study conducted by Jeffrey A. Miron, a professor of economics at Harvard University concluded that the financial benefits of marijuana legalization far outweigh the burdens of prohibitions. The report estimated that state costs for executive, judicial and corrective prohibition of marijuana accounted for $103.19, $152.16 and $32.72 million per year, respectively, an aggregate of $288 million per state. The same report cited a study (Baicker & Jacobson, 2004) that adjusted state revenues from marijuana seizures and court fees was approximately $89 million and $3.5 million, respectively, resulting in a net loss of about $196 million dollars (21).

Benefits of Implementing the California Model in Hillsborough County

California has been a pioneer in the medical marijuana industry across the United States. Despite initial blowback from the federal government following medical marijuana legalization, United States Attorney General Eric Holder stated earlier during the 2012 year that the Obama administration has interest only in pursuing marijuana distributors that are violating federal and state law. By not pursuing distributors on a state level, the federal governments ease on intrastate marijuana regulation has allowed Californias distribution market to flourish; approximately 750 dispensaries exist across the state, generating

between $870-$2 billion per year, or close to $1.6 million per dispensary annually
(21)

States generated revenue through the issuance of dispensary licenses, which come with a hefty price tag, ranging from $1000 to $3000, in excess of $2000 application fees (e.g Denver, CO), have been shown to be considerably effective in obtaining government revenue.

In San Francisco, approximately 20 dispensaries are currently operational, serving a population that has a consumption rate of approximately 13.2% (of the state population). Relative to San Franciscos 7.5 million people, each dispensary serves a market of roughly 375,000 per dispensary (21).

Implementing the San Francisco model in Hillsborough county would require adjusting market indicators for marijuana commerce. In Florida, the consumption rate of marijuana is less than half of California (~6.00%) and the population of Hillsborough County is approximately 1.3 million. If the San Francisco model were adjusted for Hillsborough, the regional market would reach the entire population with approximately 4 dispensaries across the county. At this rate, competition would be optimal and the state marijuana usage rate -adjusted revenue per dispensary would equal about $727,000, or $2.9 million.

Hillsborough countys per capita share of cost savings as a result of state-wide marijuana legalization would account for approximately $13.5 million in savings

towards Hillsborough law enforcement, judicial courts and correctional facilities. Above all, small yet sizable portions of public revenue derived from property taxation of dispensaries, along with city licensing.

Establishment of Preliminary Research Fund Hillsborough countys estimated share of savings and revenues sum to approximately $20 million in additional funds. Though this pales in comparison to the recommended $3.06 billion budget recommendation, it represents a 3.2% portion of the Hillsborough County General Citizens Fund of $613.2 million, 6.0% of which ($36.6 million) is allocated for the health department
(22)

Initial savings and revenue should not be spent hastily in an attempt to fill budget gaps. Rather, it is recommended that initial revenue streams be directed towards the formation of a research committee for the following purposes:

Assessing the effect of marijuana legalization on crime. Determining what health related issues, in Hillsborough county marijuana, is most likely to treat. Ascertain the necessity of rehab clinics in the event of blowback from legalization. Determine what aspect of the public health budget will have the most return on investment.

Issues with Implementation

Smuggling

Following the Obama administrations ease on marijuana friendly legislation, the risk of federal persecution has, in many ways subsided. However, Tampas reputation as a key international port for both Florida and the United States poses risks of smuggling, which remains ardently illicit under federal law.

Patient Risk

Despite the existence of vehement support and feverish resistance to medical marijuana legalization, scientific findings from non-government entities are scarce and many times contradictory. In some instances, marijuana is found to exacerbate symptoms of depression and psychosis in previously diagnosed patients with bipolar disorder. Other studies have shown that marijuana has proven to be a strong analgesic, anxiolytic, anti-emetic and appetite inducer in patients with chronic pain syndromes, cancer and depression.

Based on conflicting factors, marijuanas impact on the human body is dependent on the individuals predisposition. Generally, patient prescriptions under-go a probationary period of monitoring, which usually takes place between two weeks and month subsequent to initial administration. The prescriptions affect on the patient is observed and action is taken accordingly; this probationary method can serve as a strong hedge against potential abuse and/or worsening of symptoms. Public Health Provisions: 1. Monitor health status to identify / solve community problems. a. Under the plan, the residual savings from the legalization of medicinal marijuana will be placed in a preliminary research fund to observe socioeconomic and financial impacts. 2. Diagnose and investigate community health problems / hazards a. Probationary periods on prescription marijuana will allow doctors to discern the benefits/hazards associated with consumption on a per case basis. 3. Inform, educate, and empower people about health issues. a. Research fund will be largest and first of its kind to take place on a county-wide basis and will contribute to unbiased, government based scientific findings for future implementation in other jurisdictions. 4. Mobilize community partnerships / actions to identify and solve health problems.

a. Research protocol will produce physician based surveys of medicinal marijuana impacts on prescribed patients. 5. Develop policies and plans that support individual and community health efforts. a. Policies will be developed following preliminary research period. 6. Enforce laws / regulations that protect health, ensure safety. a. Funds usually allocated towards the enforcement of marijuana laws may be redirected towards other services associated with law enforcement (e.g homicide, assault, prostitution). 7. Link people to needed personal health services and assure the provision of health when otherwise unavailable. a. Contingent on research findings, medicinal marijuana has been found to have the capability of alleviating symptoms of diseases without the prospect of habituation. As a result, it may serve as a natural substitute to synthetically produced prescription drugs that have been linked to addiction. 8. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. a. Physician based feedback. 9. Research for insights / innovative solutions to health problems a. Insight on marijuana effectiveness on county-wide level.

Citations: 1) Office of Diversion Control: Drug Enforcement Administration. a. http://www.deadiversion.usdoj.gov/schedules/index.html 2) Deitch, Robert (2003). Hemp - American History Revisited. New York City: Algora Publishing. pp. 16. ISBN 0-87586-213-6. 3) United States. Bureau of Chemistry (1905). Bulletin, Issues 96-99. Washington, DC: G.P.O.. 4) Chemist & druggist (London, New York City, Melbourne: Benn Brothers) 28: 68,330. 1886. http://books.google.com/books?id=qiPOAAAAMAAJ. 5) Ayers, Edward A. (August 1907). "What The Food Law Saves Us From: Adulterations, Substitutions, Chemical Dyes, and Other Evils". The World's Work: A History of Our Time XIV: 93169322. Retrieved 2009-07-10. 6) "Opium Throughout History". PBS Frontline. Retrieved 2010-04-14. 7) "W.W. WILLOUGHBY: OPIUM AS AN INTERNATIONAL PROBLEM, BALTIMORE, THE JOHNS HOPKINS PRESS, 1925". Druglibrary.org. Retrieved 2011-03-09. 8) Keel, Robert. "Drug Law Timeline, Significant Events in the History of our Drug Laws". Schaffer Library of Drug Policy. Retrieved 2007-04-24. 9) Inciardi, James A. (1986). The War on Drugs: Heroin, cocaine, crime, and public policy. Palo Alto: Mayfield Publishing Company. p. 231. ISBN 0-87484-743-5. 10) The 1936 Geneva Convention for the Suppression of the Illicit Traffic in Dangerous Drugs". Druglibrary.org. Retrieved 2011-05-26. 11) Full Text of Marihuana Act of 1937: http://www.druglibrary.org/Schaffer/hemp/taxact/mjtaxact.htm 12) The Laguardia Report. http://www.druglibrary.net/schaffer/Library/studies/lag/conc1.htm. 13) Pub. L. No. 91-513, 84 Stat. 1236, 1292 (October 27, 1970). See also Lynn v. West, 134 F.3d 582 (4th Cir. 1998). 14) http://norml.org/laws/penalties/item/florida-penalties 15) Joy, JE, Watson, SJ, and Benson, JA. Marijuana and Medicine: Assessing the Science Base. National Academy Press. 1999. p. 159. See also, Harris, G. FDA Dismisses Medical Benefit From Marijuana. New York Times. Apr. 21, 2006) 16) Reinarman, C, Cohen, PDA, and Kaal, HL. The Limited Relevance of Drug Policy: Cannabis in Amsterdam and San Francisco. American Journal of Public Health. Vol. 94, No. 5. May 2004. p. 836-842. 17) National Research Council. Informing Americas Policy on Illegal Drugs: What We Dont Know Keeps Hurting Us. National Academy Press, 2001. p. 193. 18) Sidney, S et al. Marijuana Use and Mortality. American Journal of Public Health. Vol. 87 No. 4, April 1997. p. 585-590. Sept. 2002. 19) http://www.forbes.com/sites/henrymiller/2012/03/28/the-real-dope-on-medicalmarijuana/ 20) Miron, J. The Budgetary Implications of Marijuana Prohibition.

21) San Francisco Chronicle, "Marijuana 101", April 21, 2008 22) http://www.hillsboroughcounty.org/DocumentCenter/Home/View/4034