Background: Law enforcement, media, and some local officials have accused state cannabis laws of being too relaxed and subject to significant abuse. Criticism tends to be against both doctors and patients. Doctors are accused of providing recommendations without conducting a proper examination, for concocting diagnoses, and for specializing in medical cannabis. Patients, on the other hand, are accused of obtaining a recommendation to use medical cannabis recreationally. Most accusations against patients are made merely by visual observation of patients. Law enforcement often contends that most medical cannabis patients are abusing the law, describing such abusers with derogatory terms like, “Young Able-Bodied Males.”

Findings: While there may be some physicians that abuse the law by conducting inadequate examinations, the medical boards in each medical cannabis state are tasked with enforcing such practices. In California, a number of physicians have been investigated, but only a handful of them have been found in violation of the state board’s requirements. Becoming a patient is a process that includes being diagnosed by a licensed physician, providing medical history records to the physician and, often, the requirement to obtain a state identification card. This process can be time consuming and usually involves a considerable amount of money. If a patient then obtains medicine from a dispensary, the cannabis is typically more expensive than that obtained from the illicit market. For those patients accused of abusing the law, and who are arrested and prosecuted, the vast majority is found to be in compliance with medical cannabis laws and their cases are quickly dismissed. Compared to California’s approximately 37 million people, a patient population of 400,000 (1-2% of the general population) is marginal at best and seriously undermines the argument of widespread abuse.

Position: While some abuse of state laws probably exists, law enforcement and opponents of medical cannabis have greatly exaggerated those claims. Much like other pharmaceutical and over-the-counter medications, the existence of abuse does not lessen the efficacy of medical cannabis, and patients across the country should not be punished for the sins of others. Safe access to medical cannabis can and should include proper controls to reduce or eliminate abuse. The abuse potential of cannabis should be considered while developing a comprehensive plan for access to medical cannabis; the abuse potential of cannabis should NOT be considered an insurmountable obstacle and/or used as a way to impede or prohibit access.