Hawaii was one of the first states to legalize medical marijuana, and the first to pass the law through the Legislature rather than ballot initiative (which Hawaii does not allow at the state level).

That was in 2000, following the lead of citizens in California in 1996, five other Western states and Maine. Today, 23 states allow marijuana to be used for medicinal purposes.

But Hawaii is one of only five states — Alaska, Michigan, Montana and Washington are the others (see table below) — that do not provide qualifying patients with a method of obtaining their medicine.

medical marijuana vile

A strain of medical marijuana called White Widow.

Flickr: Mark

Washington, however, legalized marijuana for recreational use in 2012 and a similar measure is before Alaska voters this fall. In Montana, dispensaries were allowed for a time but have been subject to legal restrictions since 2011.

The national trend is to incorporate some form of distribution system. After all, why have a medical marijuana law if it’s very difficult to get marijuana?

That could be changing.

On Tuesday at the Hawaii State Capitol, the state’s Medical Marijuana Dispensary System Task Force will convene to develop recommendations for the establishment of a regulated statewide dispensary system. The proposals are likely to be the basis of legislation when the Hawaii Legislature convenes in January.

Public hearings in Hilo on Wednesday and Oahu on Sept. 24 are intended to obtain public testimony “on issues and concerns” regarding dispensaries in Hawaii.

As Civil Beat reported Sunday, a new report from the Legislative Reference Bureau highlights “glaring uncertainties” within the state’s medical marijuana program, in particular concerns about access to and transportation of medical marijuana.

Hawaii is one of only five states out of 23 where medicinal marijuana is allowed that do not provide patients with dispensaries.

The LRB report’s very title hints at its conclusion: “Is the Grass Always Greener? An Updated Look at Other State Medical Marijuana Programs.”

The answer to that question, as illustrated by the difference in state laws, is that other states make it easier to get medical pot.

Hawaii does allow patients to cultivate their crop. But that’s not so easy.

“Yes, you can grow it, but only if you’ve got the time, space, expertise and security,” said Pamela Lichty, president and co-founder of the Drug Policy Forum of Hawaii, a nonprofit created in 1993 to promote public education about current and alternative drug policies.

When legislators crafted the 2000 bill, said Lichty, they made the assumption that it would not be difficult to get marijuana.

“But that did not take into account the 70-year-old woman diagnosed with cancer who is starting chemotherapy next week,” she said, suggesting that it would be very difficult for such a patient to obtain marijuana illegally.

From Public Safety to Health

Two bills related to setting up medical marijuana dispensaries went nowhere in the legislative session last spring.

One measure called for creating a system of registered medical marijuana dispensaries and dispensary agents. The other would have allowed counties to establish “compassion centers” for the dispensing of medical marijuana and make them subject to the general excise tax.

Lawmakers did agree, however, to pass a concurrent resolution creating the task force and calling for it to report back to the Legislature next year.

Della Au Belatti, the chairwoman of the House Health Committee who authored the resolution and sits on the task force, said the Legislative Reference Bureau report has provided important information for task force members.

“There are huge gaps in the way that our law is now administered, and we have to address that,” she said. “I think it would be unconscionable that we don’t address that gap.”

When it comes to Hawaii’s medical marijuana program, Belatti said she wants to adopt the best practices from other states.

“That is what is valuable about the LRB report,” she said. “We have an opportunity to see what other states are doing. We don’t want to commit the same mistakes others did. We want a regulatory system that takes into consideration all the concerns out there.”

“There are huge gaps in the way that our law is now administered.” — Della Au Belatti

Bellati did not say whether there was sufficient legislative support to approve dispensaries.

“We’ll cross that bridge when we come to it,” she said.

But the Legislature has shown a new willingness to revisit its 14-year-old law.

Last session, for example, it agreed to transfer the medical pot program from the Department of Public Safety to the Department of Health by Jan. 1. The idea had been proposed before but always opposed by key law enforcement agencies. (Public Safety administers the state’s prison system.)

There was opposition this time around too.

“We find it ironic the Department of Health would be expected to oversee the Medical Marijuana Program, when according to the State of Hawaii Department of Health’s website, their mission is ‘to protect and improve the health and environment for all people in Hawaii,'” testified Paul Ferreira, the acting chief of police for Hawaii County.

Ferreira continued: “Having the Department of Health oversee the Medical Marijuana Program goes against their own mission statement, especially when it is acknowledged there are known health risks associated with marijuana use.”

Honolulu’s prosecuting attorney’s office had this to say about the idea: “While there has been ongoing debate about the physical effects of marijuana, the Federal schedule of controlled substances was recently updated in September 2012, and continues to list marijuana as a Schedule I controlled substance. In light of this, strict regulations should be maintained to facilitate effective enforcement and control of this highly controlled substance.”

“It is important for law enforcement officers to readily identify the proper location of a patient‘s medical marijuana supply.” — Honolulu Prosecuting Attorney’s Office

The department added, “In particular, it is important for law enforcement officers to readily identify the proper location of a patient‘s medical marijuana supply, and for the Department of Public Safety to require that certifications for medical marijuana be issued by a patient’s primary care physician, for a specified medical condition. To do otherwise would permit or even encourage widespread abuse of the medical marijuana laws and marijuana usage.”

But Kat Brady, coordinator of the Community Alliance on Prisons, which advocates for smart policing policies, said that was ridiculous.

Noting that the medical pot program resides in Public Safety’s Narcotics Enforcement Division, Brady said it has presented “a plethora of problems including (but certainly not limited to) the division’s administrator releasing the confidential information about patients to the press, the continuing disregard of patients, the excessive overtime at (the division), the extreme intimidation of doctors who recommend medical cannabis to patients, and the extreme delay that patients experience obtaining their registration cards.”

Brady pointed out that the medical cannabis law was passed “as compassionate legislation to address the needs and relieve the suffering of Hawaii’s residents.”

The Narcotics Enforcement Division, by contrast, she said “has proven to be without compassion and, in fact, has proven their disdain for medical cannabis patients. This is a very sad statement for the Aloha State.”

Transportation, Security, Other Concerns

The bill to transfer the program to the Health Department passed, as did a second measure that amends legal definitions of “adequate supply,” “medical use,” “primary caregiver,” “usable marijuana” and “written certification.”

After more than a decade, legislators wrote in the bill, “the experience of the program indicates that improvements to the law will help to fulfill its original intent by clarifying provisions and removing serious obstacles to patient access and physician participation.”

Still, resistance to improving Hawaii’s medical marijuana system remains. Some law enforcement officials didn’t even want to see a task force on the subject.

A study by the University of California, Los Angeles, found that the more medical marijuana dispensaries and delivery services a city has, the more its residents use marijuana regardless of whether or not they have a medical reason,” testified Jason Kawabata, an acting major of the Narc0tics and Vice Division of the Honolulu Police Department. “Opening marijuana dispensaries will widen availability and misuse regardless of the controls that are in place.”

“Sending sick people to the black market to relieve their pain and suffering is mean-spirited and controverts the compassion out of which this law was born.” — Kat Brady

Kawabata added, “Although medical marijuana is currently legal in Hawaii for use by the seriously ill, research by the Food and Drug Administration indicates that marijuana has no current acceptable or proven medical use. The FDA does not approve the use of marijuana as a form of medical treatment.”

Brady also testified 0n the task force resolution — in support.

“Sending sick people to the black market to relieve their pain and suffering is mean-spirited and controverts the compassion out of which this law was born,” she argued.

Dispensaries are not the only focus of the medical marijuana task force. Another issue raised by the LRB report is transportation — for example, if a patient wants to travel between islands. The report says state law “remains unsettled” concerning the transportation of medical marijuana outside the home.

Should Hawaii move forward on dispensaries, other new requirements may also be necessary such as fees and taxes, training and education, labeling, quality control, security and limits on channels of supply and distribution, says LRB.

Supporters of medical marijuana say such concerns are to be expected as programs evolve and become more commonplace.

As Lichty, who helped push for the 2000 law, pointed out, no one at the time gave any thought to the need for dispensaries.

“Nobody had a dispensary system,” she recalled. “It wasn’t out there as a topic of the time.”

Source: Legislative Reference Bureau

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