Column: Medical Marijuana – Drawing a Line

The Michigan Medical Marihuana Act (old-tyme spelling courtesy of the Michigan legislature) has been in effect since December 2008, but it wasn’t until last summer that seemingly every stationary object and alternative newspaper in Michigan was plastered with pot-leaf emblazoned ads for dispensaries, compassion centers, and doctors willing to recommend medical marijuana.

As the business columnist for the Current, I dropped in on one such business, hoping to sit down with the good doctor and get a sense of just how all this worked. To ensure accuracy, I always record my interviews, something the subjects of those interviews usually appreciate: No one wants to be misquoted.

I was shocked when this doctor declined to be recorded. In four years of writing that column no one had ever asked that I not record: burlesque dancers, roadkill-eating geeks, foreign-born restaurateurs with unpopular social stances, even those involved in actual criminal enterprises had all been fine with a recorded interview.

But this medical doctor didn’t want me to record her talking about her medical practice, nor would she tell me her first name – although LinkedIn outed her the next day when it showed me her picture and suggested we connect as business contacts.

Reporter John McKenna Rosevear (author of the 1960s classic “Pot: A Handbook of Marijuana”) has extensively researched Michigan’s medical cannabis scene – he wrote an exhaustive piece on cannabis-recommending doctors, dispensaries, and growers for the Ann Arbor Observer in November 2010 – and told me he had similar experiences. “These people are reticent about disclosing information for reasons that are never clearly explained; for instance, I went into a dispensary and I was introduced to the secretary and the two men who were running it. Later I called and said I didn’t get the secretary’s last name, so they gave it to me – and then they called right back and said ‘Don’t Use It!!!’ [laughs] … I can appreciate their caution; what the hell, be cautious, but this business about not using my first name, that’s insane, that’s irrational.”

When the anonymous doctor – who had been emphatic that “we’re not the one-night chop-shop physician going into being a dispensary” – saw that I still had one of her old pot-leaf emblazoned business cards (it had a 10-percent-off coupon on the back), she rolled her eyes dismissively: “Those were made by a partner who is no longer with the practice.” Half a year later, every one of this clinic’s print ad campaigns has prominently featured a huge pot leaf.

I’m going to draw a line in the sand: When you refuse to tell people your first name – or hand out business cards that give your name is “James Chainsaw” (looking at you, Liberty 420 Clinic) – or refuse to talk to media (Hint: most small businesses in their first year are thrilled to get a call from a writer; it’s free advertising) – or neglect to file the $10 record of assumed business name with the county – or dispense medical treatments with names like “AK-47,” “God Bud,” or “Grape Ape Fuck You” (I’m not making these up) – or generally embrace the iconography of an innocuous and annoying subculture best known for buoying sales of Nutter Butters – when you do those things, you run the risk of seeming like a shyster.

Despite this sketchy sheen, Rosevear – himself a card-carrying cannabis patient – points out that “there is a humanitarian or merciful aspect to it; we are getting [cannabis] to people in chronic pain. … But the question that presents itself is: What percent? Is it half-and-half merciful and just-getting-a-buzz? I don’t know, and I don’t know how to find out. But I do know that it’s wonderful that we can introduce a medicine into the culture that’s been forbidden for irrational reason for 60-plus years, and then it can actually give people some comfort … We’ve gone past the prejudice throughout the state.”

And let’s be clear: Those looking to get legitimate access to medical marijuana must go through a fairly regimented process with reasonable safeguards – in contrast to the process used by that half of all American adults who’ve used pot illicitly (calling your neighbor’s cousin who’s in that band you saw that one time). The afflicted must first be evaluated by a licensed medical doctor or osteopath, who may choose to recommend medical cannabis to ease debilitating pain or nausea, glaucoma, seizures, or severe and persistent muscle spasms – such as those associated with multiple sclerosis.

If the patient and doctor agree that cannabis is a reasonable treatment, they complete some forms (about as complicated as a school field-trip slip), and submit these to the state with a filing fee. Usually the fee is $100, although the state reduces the fee to $25 for those on disability, Social Security, or Medicaid/MI Health. According to the wording of the law, these applications are implicitly approved 20 days after the state receives the paperwork. Cannabis-recommending doctors suggest patients create a compliance paper trail by posting these registered mail and paying with a personal check.

The medical marijuana registration process is obviously better regulated than the calling-Mike’s-cousin system. But it’s also more competently controlled than the dispensing of many prescription psycho-actives. I’ve suffered panic attacks since 2008, but well before I was evaluated by a single medical doctor – let alone actually diagnosed with a “panic disorder with agoraphobia” – I was repeatedly and emphatically offered Xanax by every nurse, physician’s assistant, and receptionist I spoke to. Pro-tip: If you need to score Xanax, try being a grown man sobbing as he attempts to explain that he is now inexplicably terrified of the bus and grocery store; you will get pills, no questions asked.

Xanax’s subjective effects are similar to those of marijuana, but Xanax is classified as a Schedule IV controlled substance (low abuse-potential and limited risk of psychological or physical dependence), while marijuana is a Schedule I drug (high abuse potential and no recognized medical value). No legitimate studies have established that marijuana is any more sinister than Xanax; the latter is known to often result in physical dependence. A 2006 study by the U.S. Substance Abuse and Mental Health Services Administration numbered benzodiazepines – the class of drugs that includes Xanax – among the most frequently abused recreational drugs.

I cannot speak to the safety and efficacy of marijuana, but the Michigan Medical Marihuana Act undeniably protects limited possession for the legitimately afflicted. And it loosely describes an avenue for the ill to receive that medicine – either growing it themselves or getting it from a licensed “caregiver” grower. Pharmacies can only dispense controlled substances prescribed by a physician, and a Schedule I drug like marijuana can’t be “prescribed,” only “recommended.” This is where Ann Arbor’s well-advertised dispensaries find their niche.

Ann Arbor city attorney Stephen Postema is quick to point out over email, “As the MMMA [Michigan Medical Marihuana Act] does not identify, regulate, or necessarily contemplate dispensaries, such clarification could come from legislative amendments, but none have been passed thus far.” As it stands, the Michigan Medical Marihuana Act doesn’t mention dispensaries, let alone protect them from prosecution. Likewise, the law does not explicitly legalize buying or selling or any meaningful distribution of marijuana. Subsequently, dispensaries dwell in a universe of euphemism: Growers do not “sell” or “supply” marijuana, they “donate overage.” Likewise, dispensaries don’t tend to have “customers,” but rather “members” who make “donations.” The word “compassion” comes into play with a regularity only matched by the Dalai Lama’s Tweets and stumping Republicans.

But on the street – where Xanax pills are “z-bars” – it doesn’t seem that all dispensaries are about compassion; they seem to be about plain old money. According to a reliable source in Ann Arbor, “dispensary prices are certainly higher than street prices. For one, it’s my belief that dispensaries don’t do the bulk discount that street vendors typically do when you are getting a quarter [of an ounce] or more. … One can obtain a $600 ounce from a dispensary, and street rates for comparable product is still floating in the $300 to $400 range. I’ve witnessed growers of medical product who are willing to part with what would easily be a $400 street ounce or $520 dispensary ounce for only $300 if you happen to be in the right place right before they go to the dispensary, because the dispensary only pays them $250 each. So there is somewhat of an impact on street rates, if only because there are now very many more people growing legally who can make profit with much less risk than was the case a few years ago.”

This sheds a whole new light on the dispensary moratorium debate, both here in Ann Arbor and in communities throughout the state, where the Michigan Association of Municipal Attorneys – headed by our own city attorney, Stephen Postema – has offered a variety of ways that city councils can make it illegal, or simply functionally impossible, to operate a dispensary. In terms of compassion and medical treatment, of course I believe that the anxious and afflicted should have access to medicine that helps them. But, as a business writer, when I look at a 60-100 percent mark-up, that doesn’t necessarily smack of compassion to me. That looks an awful lot like plain old retail – something that we should and do regulate in the form of zoning laws and licensing. After all, a strong argument can be made that a bar or strip club furnishes succor and compassion to its members; we still don’t want nine of them on every block.

Rosevear also spoke to Postema in the course of his research: “He made a very conservative statement, and he’s right, really: We don’t have any guidelines from the state; the state’s at a loss as to what to do … Estimates are that there’s $32 million per year in the pot business, and none of it’s being taxed. What’s 6 percent of $32 million?”

About the author: In addition to occasional columns for The Chronicle, David Erik Nelson writes the monthly business column for Current, which is a free printed publication available at various locations countywide, as well as online. He’s also the author of various books, including most recently, “Snip, Burn, Solder, Shred“.