Background: The people of California passed the country’s first medical cannabis law, encouraging federal and state governments “to implement a plan for the safe and affordable distribution of marijuana.” Despite a failure by the federal government to help California develop such a plan, ingenuity and compassion on the part of patients developed a community-based solution for distribution. Community based access refers to innovative and flexible medical cannabis distribution plans developed by patients and providers to meet patients’ needs. Community based access may include personal and collective cultivation, local access to affordable medicine, and other services designed to meet the needs of patients. The California legislature adopted a system for locally authorized distribution in the form of dispensaries, and subsequently paved the way for hundreds of such facilities to operate across the state. Taking California’s queue, similar community-based dispensaries took root in states like Colorado, Washington and Oregon. This development has prompted the implementation of statewide distribution programs in New Mexico, Rhode Island, Maine and New Jersey.

Findings: Cannabis is a plant with thousands of different strains, which affect patients differently. Not only is it difficult to cultivate cannabis with consistency and optimum quality, it is often too difficult or too impractical for patients that reside in public housing. The vast majority of the hundreds of thousands of patients in the U.S. cannot grow medical cannabis themselves and, therefore, rely on dispensaries to access it. A 2006 study by Amanda Reiman, Ph.D. of the School of Social Welfare at the University of California, Berkeley, examined the experience of 130 patients spread among seven different dispensaries in the San Francisco Bay Area. The study found that “patients have created a system of dispensing medical cannabis that also includes services such as counseling, entertainment and support groups, all important components of coping with chronic illness.” She also found that levels of satisfaction with the care received at dispensaries ranked significantly higher than those reported for other health care services nationally. Dr. Reiman noted that, “support groups may have the ability to address issues besides the illness itself that might contribute to long-term physical and emotional health outcomes, such as the prevalence of depression among the chronically ill.” For cannabis to be successfully used therapeutically, patients need more help using it. It’s not possible to believe that any patient who is going to need cannabis can grow and harvest the medicine by the time they’re going to need it.

Position: ASA supports community-based access models because they are proven to bring safe access to medical cannabis to hundreds of thousands of patients in need