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Americans For Safe Access

AN ORGANIZATION OF MEDICAL PROFESSIONALS, SCIENTISTS, AND PATIENTS HELPING PATIENTS

MEDICAL CANNABIS DISPENSING
COLLECTIVES AND LOCAL REGULATION

Headquarters
1322 Webster Street, Suite 402, Oakland, California, 94612 PHONE: 510.251.1856 FAX: 510.251.2036

National Office
1906 Sunderland Place, NW, Washington DC 20036 PHONE: 202.857.4272 FAX: 202.857.4273

WEB: www.AmericansForSafeAccess.org TOLL FREE: 1.888.929.4367
MEDICAL CANNABIS DISPENSING COLLECTIVES
AND LOCAL REGULATION 2006
EXECUTIVE SUMMARY
Introduction ....................................................................................................................1

OVERVIEW
About this Report...........................................................................................................3
About Americans for Safe Access..................................................................................3
The National Political Landscape...................................................................................3
History of Medical Cannabis in California ....................................................................4
What is a Medical Cannabis Dispensing Collective ......................................................4
Rationale for Medical Cannabis Dispensing Collectives ..............................................5
Medical Cannabis Dispensing Collectives are Legal Under State Law........................5
Why Patients Need Convenient Dispensaries ...............................................................6
What Communities are Doing to Help Patients...........................................................6

IMPACT OF DISPENSARIES AND REGULATIONS ON COMMUNITIES
Dispensaries Reduce Crime and Improve Public Safety ...............................................7
Why Diversion of Medical Cannabis is Typically Not a Problem .................................8
Dispensaries Can Be Good Neighbors ...........................................................................8

BENEFITS OF DISPENSARIES TO THE PATIENT COMMUNITY
Dispensaries Provide Many Benefits to the Sick and Suffering ................................10
Research Supports the Dispensary Model...................................................................11
Many Dispensaries Provide Key Social Services ..........................................................11
Conclusion.....................................................................................................................13

APPENDIX A
Recommendations on Dispensary Regulations...........................................................14

APPENDIX B
Ordinance Evaluation Survey Questions .....................................................................18

APPENDIX C
Survey Answer and Data Analyses ..............................................................................19

APPENDIX D
Maps of Ordinances .....................................................................................................20

For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.
Americans For Safe Access
AN ORGANIZATION OF MEDICAL PROFESSIONALS, SCIENTISTS AND PATIENTS HELPING PATIENTS

EXECUTIVE SUMMARY
California's original medical cannabis law, • offering a safer environment for patients
the Compassionate Use Act (Prop. 215), than having to buy on the illicit market
directs local officials to implement ways for • improving the health of patients through
qualified patients to access their medicine. social support
With the passage of state legislation (SB 420) • helping patients with other social
in 2003, and the 2005 court ruling in People services, such as food and housing
v. Urziceanu, medical cannabis dispensing • having a greater than average customer
collectives (or dispensaries) are now satisfaction rating for health care
recognized as legal entities. Since most of
the more than 150,000 cannabis patients in Creating dispensary regulations combats
California (NORML 2005 estimate) rely on crime because:
dispensaries for their medicine, communities • dispensary security reduces crime in the
across the state are facing requests for vicinity
business licenses or zoning decisions related • street sales tend to decrease
to the operation of dispensaries. • patients and operators are vigilant
• any criminal activity gets reported to
Americans for Safe Access, the leading police
national organization representing the
interests of medical cannabis patients and Regulated dispensaries are:
their doctors, has undertaken a study of the • legal under California state law
experience of those communities that have • helping revitalize neighborhoods
dispensary ordinances. The report that • bringing new customers to neighboring
follows details those experiences, as related businesses
by local officials; it also covers some of the • not a source of community complaints
political background and current legal status
of dispensaries, outlines important issues to This report concludes with a section
consider in drafting dispensary regulations, outlining the important elements for local
and summarizes a recent study by a officials to consider as they move forward
University of California, Berkeley researcher with regulations for dispensaries. ASA has
on the community benefits of dispensaries. worked successfully with officials in Kern
In short, this report describes why: County, Los Angeles, San Francisco and
elsewhere to craft ordinances that meet the
Regulated dispensaries benefit the state's legal requirements, as well as the
community by: needs of patients and the larger community.
• providing access for the most seriously ill Please contact ASA if you have questions:
and injured 888-929-4367.

For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.

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2
OVERVIEW OF MEDICAL CANNABIS DISPENSARIES

"As the number of patients in the state of California who rely upon medical cannabis for their treatment
continues to grow, it is increasingly imperative that cities and counties address the issue of dispensaries in
our respective communities. In the city of Oakland we recognized this need and adopted an ordinance
which balances patients' need for safe access to treatment while reassuring the community that these
dispensaries are run right. A tangential benefit of the dispensaries has been that they have helped to
stimulate economic development in the areas where they are located."
- Desley Brooks, Oakland City Councilmember

ABOUT THIS REPORT city and county officials are also considering
Land-use decisions are now part of the imple- how to arrive at the most effective regulations
mentation of California's medical marijuana, for their community, ones that respect the
or cannabis, laws. As a result, medical cannabis rights of patients for safe and legal access
dispensing collectives (dispensaries) are the within the context of the larger community.
subject of considerable debate by planning
and other local officials. Dispensaries have ABOUT AMERICANS FOR SAFE ACCESS
been operating openly in many communities Americans for Safe Access (ASA) is the largest
since the passage of Proposition 215 in 1996. national member-based organization of
As a compassionate, community-based patients, medical professionals, scientists and
response to the problems patients face in try- concerned citizens promoting safe and legal
ing to access cannabis, dispensaries are cur- access to cannabis for therapeutic uses and
rently used by more than half of all patients in research. ASA works in partnership with state,
the state and are essential to those most seri- local and national legislators to overcome bar-
ously ill or injured. Since 2003, when the legis- riers and create policies that improve access to
lature further implemented state law by cannabis for patients and researchers. We
expressly addressing the issue of patient col- have more than 30,000 active members with
lectives and compensation for cannabis, more chapters and affiliates in more than 40 states.
dispensaries have opened and more communi-
ties have been faced with questions about
business permits and land use options. THE NATIONAL POLITICAL LANDSCAPE
A substantial majority of Americans support
In an attempt to clarify the issues involved,
safe and legal access to medical cannabis.
Americans for Safe Access has conducted a
Public opinion polls in every part of the coun-
survey of local officials in addition to continu-
try show majority support cutting across politi-
ously tracking regulatory activity throughout
cal and demographic lines. Among them, a
the state. (safeaccessnow.org/regulations.) The
Time/CNN poll in 2002 showed 80% national
report that follows outlines some of the
support; a survey of AARP members in 2004
underlying questions and provides an
showed 72% of older Americans support legal
overview of the experiences of cities and
access, with those in the western states polling
counties around the state. In many parts of
82% in favor.
California, dispensaries have operated respon-
sibly and provided essential services to the This broad popular consensus, combined with
most needy without local intervention, but an intransigent federal government which

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refuses to acknowledge medical uses for supported Proposition P, a ballot initiative
cannabis, has meant that Americans have which recommended a non-enforcement poli-
turned to state-based solutions. The laws vot- cy for the medical use, cultivation and distri-
ers and legislators have passed are intended bution of marijuana. In 1992, citing both the
to mitigate the effects of the federal govern- interests of their constituency and the
ment's prohibition on medical cannabis by endorsement of therapeutic use by the
allowing qualified patients to use it without California Medical Association, the San
state or local interference. Beginning with Francisco Board of Supervisors adopted a res-
California in 1996, voters passed initiatives in olution urging the mayor and district attorney
eight states plus the District of Columbia -- to accept letters from recommending physi-
Alaska, Colorado, Maine, Montana, Nevada, cians (Resolution No. 141-98). In 1993, the
Oregon, and Washington. State legislatures Sonoma Board of Supervisors approved a res-
followed suit, with elected officials in Hawaii, olution mirroring a Senate Joint Resolution
Maryland, Rhode Island, and Vermont taking passed earlier that year, noting that a UN
action to protect patients from criminal penal- committee had called for cannabis to be
ty, and the California legislature amending its made available by prescription and calling on
voter initiative in 2003. "Federal and State representatives to support
returning [cannabis] preparations to the list of
Momentum for these state-level provisions for
available medicines which can be prescribed
compassionate use and safe access has contin-
by licensed physicians" (Resolution No. 93-1547).
ued to build as more research on the thera-
peutic uses of cannabis is published. And the Since 1996 when 56% of California voters
public advocacy of well-known cannabis approved the Compassionate Use Act (CUA),
patients such as the Emmy-winning talkshow public support for safe and legal access to
host Montel Williams has also increased public medical cannabis has only increased. A
awareness and created political pressure for statewide Field poll in 2004 found that "three
compassionate state and local solutions. in four voters (74%) favors implementation of
the law. Voter support for the implementa-
Twice in the past decade the U.S. Supreme
tion of Prop. 215 cuts across all partisan, ideo-
Court has taken up the question. In the most
logical and age subgroups of the state."
recent case, Gonzales v. Raich, a split court
(field.com/fieldpollonline/subscribers/Rls2105.pdf)
upheld the ability of federal officials to prose-
cute patients if they so choose, but did not Even before the release of that Field poll,
overturn state laws. In the wake of that deci- state legislators recognized that there is both
sion, the attorneys general of California, strong support among voters for implement-
Hawaii, Oregon, and Colorado all issued legal ing the safe and legal access promised by the
opinions or statements reaffirming their Compassionate Use Act (CUA) and little direc-
state's medical cannabis laws. The duty of tion as to how local officials should proceed.
state and local law enforcement is to the This led to the drafting and passage of Senate
enforcement and implementation of state, Bill 420 in 2003, which amended the CUA to
not federal, law. spell out more clearly the obligations of local
officials for implementation.
HISTORY OF MEDICAL CANNABIS IN
CALIFORNIA WHAT IS A CANNABIS DISPENSARY?
Local officials and voters in California have The majority of medical marijuana (cannabis)
recognized the needs of medical cannabis patients cannot cultivate their medicine for
patients in their communities and have taken themselves or find a caregiver to grow it for
action, even before voters made it legal in them. Most of California's estimated 200,000
1996. In 1991, 80% of San Francisco voters patients obtain their medicine from a Medical

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Cannabis Dispensing Collective (MCDC), often state, the California legislature enacted
referred to as a "dispensary." Dispensaries are Senate Bill 420 in 2004, which expressly states
typically storefront facilities that provide med- that qualified patients and primary caregivers
ical cannabis and other services to patients in may collectively or cooperatively cultivate
need. There are more than 200 dispensaries cannabis for medical purposes (Cal. Health &
operating in California as of August 2006. Safety Code section 11362.775). This provision
Dispensaries operate with a closed member- has been interpreted by the courts to mean
ship that allow only patients and caregivers to that dispensing collectives, where patients
obtain cannabis and only after membership is may buy their medicine, are legal entities
approved (upon verification of patient docu- under state law. California's Third District
mentation). Many dispensaries offer on-site Court of Appeal affirmed the legality of col-
consumption, providing a safe and comfort- lectives and cooperatives in 2005 in the case
able place where patients can medicate. An of People v. Urziceanu, which held that SB
increasing number of dispensaries offer addi- 420, which the court called the Medical
tional services for their patient membership, Marijuana Program Act (MMPA), provides col-
including such services as: massage, acupunc- lectives and cooperatives a defense to mari-
ture, legal trainings, free meals, or counseling. juana distribution charges. Drawing from the
Research on the social benefits for patients is Compassionate Use Act's directive to imple-
discussed in the last section of this report. ment a plan for the safe and affordable distri-
bution of medical marijuana, the court found
RATIONALE FOR CANNABIS DISPENSARIES that the MMPA and its legalization of collec-
tives and cooperatives represented the state
While the Compassionate Use Act does not government's initial response to this mandate.
explicitly discuss medical cannabis dispen- By expressly providing for reimbursement for
saries, it calls for the federal and state govern- marijuana and services in connection with col-
ments to "implement a plan to provide for lectives and cooperatives, the Legislature has
the safe and affordable distribution of mari- abrogated earlier cases, such as Trippett,
juana to all patients in medical need of mari- Peron, and Young, and established a new
juana." (Health & Safety Code § 11362.5) This defense for those who form and operate col-
portion of the law has been the basis for the lectives and cooperatives to dispense marijua-
development of compassionate, community- na. (See People v. Urziceanu (2005) 132
based systems of access for patients in various Cal.App.4th 747, 33 Cal.Rptr.2d 859, 881.)
parts of California. In some cases, that has
meant the creation of patient-run growing This new case law parallels the interpretation
collectives that allow those with cultivation of SB 420 provided to the League of Cities last
expertise to help other patients obtain medi- year by Berkeley Assistant City Attorney
cine. In most cases, particularly in urban set- Matthew J. Orebic, in his presentation
tings, that has meant the establishment of "Medical Marijuana: The conflict between
medical cannabis dispensing collectives, or dis- California and federal law and its effect on
pensaries. These dispensaries are typically local law enforcement and ordinances." As he
organized and run by groups of patients and states in that report:
their caregivers in a collective model of patient- In the 2004 legislation, Section 11362.775
directed health care that is becoming a model … expressly allow[s] medical marijuana to
for the delivery of other health services. be cultivated collectively by qualified
patients and primary caregivers, and by
MEDICAL CANNABIS DISPENSARIES ARE necessary implication, distributed among
LEGAL UNDER STATE LAW the collective's members… Under the col-
In an effort to clarify the voter initiative of lective model, qualified patients who are
1996 and aid in its implementation across the unwilling or unable to cultivate marijuana

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on their own can still have access to mari- Officials recognize their duty to implement
juana by joining together with other quali- state laws, even in instances when they may
fied patients to form a collective. not have previously supported medical
cannabis legislation. Duke Martin, mayor pro
Orebic also notes that the law allows for
tem of Ridgecrest said during a city council
those involved to "receive reimbursement for
hearing on their local dispensary ordinance,
services rendered in supplying the patient
"it's something that's the law, and I will
with medical marijuana."
uphold the law."

WHY PATIENTS NEED CONVENIENT
DISPENSARIES "Because they are under strict city regulation,
While some patients with long-term illnesses there is less likelihood of theft or violence and
or injuries have the time, space, and skill to less opposition from angry neighbors. It is no
cultivate their own cannabis, the majority in
the state, particularly those in urban settings, longer a controversial issue in our city."
do not have the ability to provide for them- -Mike Rotkin, Santa Cruz
selves. For those patients, dispensaries are the
only option for safe and legal access. This is all
the more true for those individuals who are This understanding of civic obligation was
suffering from a sudden, acute injury or illness. echoed at the Ridgecrest hearing by
Councilmember Ron Carter, who said, "I want
Many of the most serious and debilitating to make sure everything is legitimate and
injuries and illnesses require immediate relief. above board. It's legal. It's not something we
A cancer patient, for instance, who has just can stop, but we can have an ordinance of
begun chemotherapy will typically need regulations."
immediate access for help with nausea, which
is why a Harvard study found that 45% of Similarly, Whittier Planning Commissioner R.D.
oncologists were already recommending McDonnell spoke publicly of the benefits of
cannabis to their patients, even before it had dispensary regulations at a city government
been made legal in any state. It is unreason- hearing. "It provides us with reasonable pro-
able to exclude those patients most in need tections," he said. "But at the same time pro-
simply because they are incapable of garden- vides the opportunity for the legitimate
ing or cannot wait months for relief. operations."
Whittier officials discussed the possibility of an
WHAT COMMUNITIES ARE DOING TO outright ban on dispensary operations, but
HELP PATIENTS Greg Nordback said, "It was the opinion of
our city attorney that you can't ban them; it's
Many communities in California have recog-
against the law. You have to come up with an
nized the essential service that dispensaries
area they can be in." Whittier passed its dis-
provide and have either tacitly allowed their
pensary ordinance in December 2005.
creation or, more recently, created ordinances
or regulations for their operation. Dispensary Placerville Police Chief George Nielson com-
regulation is one way in which the city can mented that, "The issue of medical marijuana
exert local control over the policy issue and continues to be somewhat controversial in
ensure the needs of patients and the commu- our community, as I suspect and hear it
nity at large are being met. As of August remains in other California communities. The
2006, twenty-six cities and seven counties issue of 'safe access' is important to some and
have enacted regulations, and many more are not to others. There was some objection to
considering doing so soon. See appendix D.) the dispensary ordinance, but I would say it
was a vocal minority on the issue."

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IMPACT OF DISPENSARIES AND REGULATORY ORDINANCES
ON COMMUNITIES IN CALIFORNIA

DISPENSARIES REDUCE CRIME AND for their members and staff more seriously
IMPROVE PUBLIC SAFETY than many businesses. Security cameras are
Some reports have suggested that dispen- often used both inside and outside the prem-
saries are magnets for criminal activity or ises, and security guards are often employed
other behavior that is a problem for the com- to ensure safety. Both cameras and security
munity, but the experience of those cities with guards serve as a general deterrent to crimi-
dispensary regulations says otherwise. Crime nal activity and other problems on the street.
statistics and the accounts of local officials sur- Those likely to engage in such activities will
veyed by ASA indicate that crime is actually tend to move to a less-monitored area, there-
reduced by the presence of a dispensary. And by ensuring a safe environment not only for
complaints from citizens and surrounding dispensary members and staff but also for
businesses are either negligible or are signifi- neighbors and businesses in the surrounding
cantly reduced with the implementation of area.
local regulations. Residents in areas surrounding dispensaries
This trend has led multiple cities and counties have reported improvements to the neighbor-
to consider regulation as a solution. Kern hood. Kirk C., a long time San Francisco resi-
County, which passed a dispensary ordinance dent, commented at a city hearing, "I have
in July 2006, is a case in point. The sheriff lived in the same apartment along the
there noted in his staff report that "regulato- Divisadero corridor in San Francisco for the
ry oversight at the local levels helps prevent past five years. Each store that has opened in
crime directly and indirectly related to illegal my neighborhood has been nicer, with many
operations occurring under the pretense and new restaurants quickly becoming some of
protection of state laws authorizing Medical the city's hottest spots. My neighborhood's
Marijuana Dispensaries." Although dispensary- crime and vandalism seems to be going down
related crime has not been a problem for the year after year. It strikes me that the dispen-
county, the regulations will help law enforce- saries have been a vital part of the improve-
ment determine the legitimacy of dispensaries ment that is going on in my neighborhood."
and their patients. Oakland's city administrator for the ordinance
The sheriff specifically pointed out that, regulating dispensaries, Barbara Killey, notes
"existing dispensaries have not caused notice- that "The areas around the dispensaries may
able law enforcement of secondary effects be some of the most safest areas of Oakland
and problems for at least one year. As a now because of the level of security, surveil-
result, the focus of the proposed Ordinance lance, etc…since the ordinance passed."
is narrowed to insure Dispensary compliance Likewise, Santa Rosa Mayor Jane Bender
with the law" (Kern County Staff Report, noted that since the city passed its ordinance,
Proposed Ordinance Regulating Medical there appears to be "a decrease in criminal
Cannabis Dispensaries, July 11, 2006). activity. There certainly has been a decrease in
The presence of a dispensary in the neighbor- complaints. The city attorney says there have
hood can actually improve public safety and been no complaints either from citizens nor
reduce crime. Most dispensaries take security from neighboring businesses."

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7
Those dispensaries that go through the per- members are to behave in and around the
mitting process or otherwise comply with dispensary. Many have "good neighbor"
local ordinances tend, by their very nature, to trainings for their members that emphasize
be those most interested in meeting commu- sensitivity to the concerns of neighbors, and
nity standards and being good neighbors. all absolutely prohibit the resale of cannabis
Cities enacting ordinances for the operation to anyone. Anyone violating that prohibition
of dispensaries may even require security is typically banned from any further contact
measures, but it is a matter of good business with the dispensary.
practice for dispensary operators since it is in
their own best interest. Many local officials
surveyed by ASA said dispensaries operating "The areas around the dispensaries may be
in their communities have presented no prob-
lems, or what problems there may have been some of the most safest areas of Oakland now
significantly diminished once an ordinance or because of the level of security , surveillance,
other regulation was instituted.
etc. since the ordinance passed."
Mike Rotkin, fifth-term councilmember and -Barbara Killey, Oakland
former four-term mayor in the City of Santa
Cruz, says about his city's dispensary, "It pro-
vides a legal (under State law) service for peo- As Oakland's city administrator for the regula-
ple in medical need. Because it is well run and tory ordinance explains, "dispensaries them-
well regulated and located in an area accept- selves have been very good at self policing
able to the City, it gets cooperation from the against resale because they understand they
local police. Because they are under strict city can lose their permit if their patients resell."
regulation, there is less likelihood of theft or In the event of street or other resale, local law
violence and less opposition from angry enforcement has at its disposal all the many
neighbors. It is no longer a controversial issue legal penalties the state provides. This all adds
in our city." up to a safer street environment with fewer
Regarding the decrease in complaints about drug-related problems than before dispensary
existing dispensaries, several officials said that operations were permitted in the area. The
ordinances significantly improved relations experience of the City of Oakland is a good
with other businesses and the community at example of this phenomenon. The city's leg-
large. An Oakland city council staff member islative analyst, Lupe Schoenberger, stated
noted that they, "had gotten reports of break that, "…[P]eople feel safer when they're
ins. That kind of activity has stopped . That walking down the street. The level of marijua-
danger has been eliminated." na street sales has significantly reduced."
Dispensaries operating with the permission of
WHY DIVERSION OF MEDICAL CANNABIS the city are also more likely to appropriately
IS TYPICALLY NOT A PROBLEM utilize law enforcement resources themselves,
One of the concerns of public officials is that reporting any crimes directly to the appropri-
dispensaries make possible or even encourage ate agencies. And, again, dispensary operators
the resale of cannabis on the street. But the and their patient members tend to be more
experience of those cities which have institut- safety conscious than the general public,
ed ordinances is that such problems, which resulting in great vigilance and better pre-
are rare in the first place, quickly disappear. In emptive measures. The reduction in crime in
addition to the ease for law enforcement of areas with dispensaries has been reported
monitoring openly operating facilities, dispen- anecdotally by law enforcement in several
saries universally have strict rules about how communities.

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8
DISPENSARIES CAN BE GOOD NEIGHBORS about establishing it or running it."
Medical cannabis dispensing collectives are Mark Keilty, Planning and Building director of
typically positive additions to the neighbor- Tulare, when asked if the existence of dispen-
hoods in which they locate, bringing addition- saries affected local business, said they had
al customers to neighboring businesses and "no effect or at least no one has complained."
reducing crime in the immediate area.
And Dave Turner, mayor of Fort Bragg, noted
Like any new business that serves a different that before the passage of regulations there
customer base than the existing businesses in were "plenty of complaints from both neigh-
the area, dispensaries increase the revenue of boring businesses and concerned citizens,"
other businesses in the surrounding area sim- but since then, it is no longer a problem.
ply because new people are coming to access Public officials understand that, when it
services, increasing foot traffic past other comes to dispensaries, they must balance both
establishments. In many communities, the the humanitarian needs of patients and the
opening of a dispensary has helped revitalize concerns of the public, especially those of
an area. While patients tend to opt for dis- neighboring residents and business owners.
pensaries that are close and convenient, par-
ticularly since travel can be difficult, many
patients will travel to dispensary locations in
parts of town they would not otherwise visit.
"Dispensaries themselves have been very good
Even if patients are not immediately utilizing at self policing against resale because they
the services or purchasing the goods offered understand they can lose their permit if their
by neighboring businesses, they are more like-
ly to eventually patronize those businesses patients resell." -Barbara Killey, Oakland
because of convenience.
ASA's survey of officials whose cities have Oakland City Councilmember Nancy J. Nadel
passed dispensary regulations found that the wrote in an open letter to her fellow col-
vast majority of businesses adjoining or near leagues across the state, "Local government
dispensaries had reported no problems associ- has a responsibility to the medical needs of its
ated with a dispensary opening after the people, even when it's not a politically easy
implementation of regulation. choice to make. We have found it possible to
build regulations that address the concerns of
Kriss Worthington, longtime councilmember neighbors, local businesses law enforcement
in Berkeley, said in support of a dispensary and the general public, while not compromis-
there, "They have been a responsible neigh- ing the needs of the patients themselves.
bor and vital organization to our diverse com- We've found that by working with all inter-
munity. Since their opening, they have done ested parities in advance of adopting an ordi-
an outstanding job keeping the building clean, nance while keeping the patients' needs
neat, organized and safe. In fact, we have had foremost, problems that may seem inevitable
no calls from neighbors complaining about never arise."
them, which is a sign of respect from the com-
munity. In Berkeley, even average restaurants Mike Rotkin of Santa Cruz stated that since
and stores have complaints from neighbors.” Santa Cruz enacted an ordinance for dispen-
sary operations, "Things have calmed down.
Mike Rotkin, fifth term councilmember and The police are happy with the ordinance, and
former four term mayor in the City of Santa that has made things a lot easier. I think the
Cruz said about the dispensary that opened fact that we took the time to give people
there last year, "The immediately neighboring who wrote us respectful and detailed expla-
businesses have been uniformly supportive or nations of what we were doing and why
neutral. There have been no complaints either made a real difference."

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9
BENEFITS OF DISPENSARIES TO THE PATIENT COMMUNITY
DISPENSARIES PROVIDE MANY BENEFITS obtaining their medicine."
TO THE SICK AND SUFFERING Oakland's city administrator for ordinances,
Safe and legal access to cannabis is the reason said safe access to cannabis is "very impor-
dispensaries have been created by patients tant" for the community. "In the finding the
and caregivers around the state. For many council made to justify the ordinance, they
people, dispensaries remove significant barri- say 'have safe and affordable access'."
ers to their ability to obtain cannabis. Patients
in urban areas with no space to cultivate And Mike Rotkin, the longtime Santa Cruz
cannabis, those without the requisite garden- elected official, said that this is also an impor-
ing skills to grow their own, and, most critical- tant matter for his city's citizens: "The council
ly, those who face the sudden onset of a considers it a high priority and has taken con-
serious illness or who have suffered a cata- siderable heat to speak out and act on the
strophic illness - all tend to rely on dispen- issue."
saries as a compassionate, community-based It was a similar decision of social conscience
solution that is an alternative to potentially that lead to Placerville's city council putting a
dangerous illicit market transactions. regulatory ordinance in place. Councilmember
Many elected officials around the state recog- Marian Washburn told her colleagues that "as
nize the importance of dispensaries for their you get older, you know people with diseases
constituents. As Nathan Miley, former who suffer terribly, so that is probably what I
Oakland City councilmember and now get down to after considering all the other
Alameda County supervisor said in a letter to components."
his colleagues, "When designing regulations, While dispensaries provide a unique way for
it is crucial to remember that at its core this is patients to obtain the cannabis their doctors
a healthcare issue, requiring the involvement have recommended, they typically offer far
and leadership of local departments of public more that is of benefit to the health and wel-
health. A pro-active healthcare-based fare of those suffering both chronic and acute
approach can effectively address problems medical problems.
before they arise, and communities can
design methods for safe, legal access to med- Dispensaries are often called "clubs" in part
ical marijuana while keeping the patients' because many of them offer far more than a
needs foremost." clinical setting for obtaining cannabis.
Recognizing the isolation that many seriously
Likewise, Abbe Land, mayor of West ill and injured people experience, many dis-
Hollywood says safe access is "very impor- pensary operators chose to offer a wider array
tant" and long-time councilmember John of social services, including everything from a
Duran agreed, adding, "We have a very high place to congregate and socialize to help with
number of HIV-positive residents in our area. finding housing and meals. The social support
Some of them require medical marijuana to patients receive in these settings has far-
offset the medications they take for HIV." reaching benefits that is also influencing the
Jane Bender, mayor of Santa Rosa, says, development of other patient-based care
"There are legitimate patients in our commu- models.
nity, and I'm glad they have a safe means of

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10
RESEARCH SUPPORTS THE DISPENSARY and very friendly. I enjoy coming."
MODEL "This is the friendliest dispensary that I have
A 2006 study by Amanda Reiman, Ph.D. of the ever been to and the staff is always warm and
School of Social Welfare at the University of open. That's why I keep coming to this place.
California, Berkeley examined the experience The selection is always wide."
of 130 patients spread among seven different
dispensaries in the San Francisco Bay Area. Dr.
MANY DISPENSARIES PROVIDE KEY
Reiman's study cataloged the patients' demo-
graphic information, health status, consumer SOCIAL SERVICES
satisfaction, and use of services, while also Dispensaries offer many cannabis-related serv-
considering the dispensaries' environment, ices that patients cannot otherwise obtain.
staff, and services offered. The study found Among them is an array of cannabis varieties,
that "medical cannabis patients have created some of which are more useful for certain
a system of dispensing medical cannabis that afflictions than others, and staff awareness of
also includes services such as counseling, what types of cannabis other patients report
entertainment and support groups, all impor- to be helpful. In other words, one variety of
tant components of coping with chronic ill- cannabis may be effective for pain control
ness." She also found that levels of while another may be better for combating
satisfaction with the care received at dispen- nausea. Dispensaries allow for the pooling of
saries ranked significantly higher than those information about these differences and the
reported for health care nationally. opportunity to access the type of cannabis
likely to be most beneficial.
Patients who use the dispensaries studied uni-
formly reported being well satisfied with the
services they received, giving an 80% satisfac-
tion rating. The most important factors for "There are legitimate patients in our
patients in choosing a medical cannabis dis- community, and I'm glad they have a safe
pensary were: feeling comfortable and secure, means of obtaining their medicine."
familiarity with the dispensary, and having a
rapport with the staff. In their comments, -Jane Bender, Santa Rosa
patients tended to note the helpfulness and
kindness of staff and the support found in the Other cannabis-related services include the
presence of other patients. availability of cannabis products in other
Patients in Dr. Reiman's study frequently cited forms than the smokeable ones. While most
their relationships with staff as a positive fac- patients prefer to have the ability to modu-
tor. Comments from six different dispensaries late dosing that smoking easily allows, for
include: others, the effects of edible cannabis products
are preferable. Dispensaries typically offer edi-
"I love this spot because of the love they give, ble products such as brownies or cookies for
always! They treat everyone like a family those purposes. Many dispensaries also offer
loved one!" classes on how to grow your own cannabis,
"This particular establishment is very friendly classes on legal matters, trainings for health-
for the most part and very convenient for care advocacy, and other seminars.
me." Beyond providing safe and legal access to
"The staff and patients are like family to me!" cannabis, the dispensaries studied also offer
important social services to patients, including
"The staff are warm and respectful." counseling, help with housing and meals, hos-
"The staff at this facility are always cordial pice and other care referrals, and, in one case,

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11
even doggie daycare for members who have social model are only part of the culture of
doctor appointments or work commitments. social club facility. Another component of
Among the broader services the study found this model … is the possible benefit that
in dispensaries are support groups, including social support has for one diagnosed with
groups for women, veterans, and men; cre- a chronic and/or terminal physical or psy-
ativity and art groups, including groups for chological illness. Beyond the support that
writers, quilters, crochet, and crafts; and medical cannabis patients receive from
entertainment options, including bingo, open services is the support received from fellow
mike nights, poetry readings, internet access, patients, some of whom are experiencing
libraries, and puzzles. Clothing drives and the same or similar physical/psychological
neighborhood parties are among the activi- symptoms…. It is possible that the mental
ties that patients can also participate in health benefits from the social support of
through their dispensary. fellow patients is an important part of the
healing process, separate from the medici-
Social services such as counseling and support
nal value of the cannabis itself.
groups were reported to be the most com-
monly and regularly used service, with two- Several researchers and physicians who have
thirds of patients reporting that they use studied the issue of the patient experience
social services at dispensaries 1-2 times per with dispensaries have concluded that there
week. Also, life services, such as free food are other important positive effects stemming
and housing help, were used at least once or from a dispensary model that includes a com-
twice a week by 22% of those surveyed. ponent of social support groups.
Dr. Reiman notes that, "support groups may
have the ability to address issues besides the
"Local government has a responsibility to the illness itself that might contribute to long-
medical needs of its people, even when it's not term physical and emotional health outcomes,
such as the prevalence of depression among
a politically easy choice to make. We have found the chronically ill."
it possible to build regulations that address the
For those who suffer the most serious illness,
concerns of neighbors, local businesses law such as HIV/AIDS and terminal cancer, these
enforcement and the general public, while not groups of like-minded people with similar
conditions can also help patients through the
compromising the needs of the patients grieving process. Other research into the
themselves. We've found that by working with patient experience has found that many
all interested parities in advance of adopting an patients have lost or are losing friends and
partners to terminal illness. These patients
ordinance while keeping the patients' needs report finding solace with other patients who
foremost, problems that may seem inevitable are also grieving or facing end-of-life deci-
never arise." -Nancy Nadel, Oakland sions. A medical study published in 1998 con-
cluded that the patient-to-patient contact
associated with the social club model was the
Dispensaries offer chronically ill patients even best therapeutic setting for ill people.
more than safe and legal access to cannabis
and an array of social services. The study
found that dispensaries also provided other
social benefits for the chronically ill, an impor-
tant part of the bigger picture:
[T]he multiple services provided by the

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12
CONCLUSION

Dispensaries are proving to be an asset to the medicine their doctors recommend: the most
communities they serve, as well as the larger seriously ill and injured. Many dispensaries
community within which they operate. also offer essential services to patients, such as
help with food and housing.
ASA's survey of local officials and monitoring
of regulatory activity throughout the State of Medical and public health studies have also
California has shown that, once working reg- shown that the social-club model of most dis-
ulatory ordinances are in place, dispensaries pensaries is of significant benefit to the over-
are typically viewed favorably by public offi- all health of patients. The result is that
cials, neighbors, businesses, and the communi- cannabis patients rate their satisfaction with
ty at large, and that regulatory ordinances dispensaries as far greater than the customer-
can and do improve an area, both socially and satisfaction ratings given to health care agen-
economically. cies in general.
Dispensaries - now expressly legal under Public officials across the state, in both urban
California state law - are helping revitalize and rural communities where dispensary reg-
neighborhoods by reducing crime and bring- ulatory ordinances have been adopted, have
ing new customers to surrounding businesses. been outspoken in praise of what. Their com-
They improve public safety by increasing the ments are consistent on and favorable to the
security presence in neighborhoods, reducing regulatory schemes they enacted and the
illicit market marijuana sales, and ensuring benefits to the patients and others living in
that any criminal activity gets reported to the their communities.
appropriate law enforcement authorities.
As a compassionate, community-based
More importantly, dispensaries benefit the response to the medical needs of more than
community by providing safe access for those 150,000 sick and suffering Californians, dis-
who have the greatest difficulty getting the pensaries are working.

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13
APPENDIX A

RECOMMENDATIONS ON DISPENSARY the nomination is transmitted to the Clerk of
REGULATIONS the City Council, the nominee shall be
Cannabis dispensaries have been operating deemed approved. Appointments to the com-
successfully around California for a decade mission shall become effective on the date
with very few problems. But since the legisla- the City Council adopts a motion approving
ture and courts have acted to make their the nomination or on the 41st day following
legality a matter of state law more than local the date the mayoral nomination was trans-
tolerance, the question of how to implement mitted to the Clerk of the City Council if the
appropriate zoning and business licensing is City Council fails to act upon the nomination
coming before local officials all across the prior to such date.
state. What follows are recommendations on Of the three members nominated by the
matters to consider, based on adopted code Mayor, the Mayor shall nominate one mem-
as well as ASA's extensive experience working ber to represent the interests of City neigh-
with community leaders and elected officials. borhood associations or groups, one member
to represent the interests of medical marijua-
COMMUNITY OVERSIGHT na patients, and one member to represent
the interests of the law enforcement commu-
In order to appropriately resolve conflict in
nity.
the community and establish a process by
which complaints and concerns can be Of the four members of the commission
reviewed, it can often be helpful to create a appointed by the City Council, two members
community oversight committee. Such com- shall represent the interests of City neighbor-
mittees, if fair and balanced, can provide a hood associations or groups, one member
means for the voices of all affected parties to shall represent the interests of the medical
be heard, and to quickly resolve problems. marijuana community, and one member shall
represent the interests of the public health
The Ukiah City Council created such a task
community.
force in 2005; what follows is how they
defined the group:
DISPENSARIES REGULATIONS ARE BEST
The Ukiah Medical Marijuana Review and
HANDLED THROUGH THE HEALTH OR
Oversight Commission shall consist of seven
members nominated and appointed pursuant PLANNING DEPARTMENTS, NOT LAW
to this section. The Mayor shall nominate ENFORCEMENT AGENCIES
three members to the commission, and the Reason: To ensure that qualified patients,
City Council shall appoint, by motion, four caregivers, and dispensaries are protected,
other members to the commission. Each nom- general regulatory oversight duties - including
ination of the Mayor shall be subject to permitting, record maintenance and related
approval by the City Council, and shall be the protocols - should be the responsibility of the
subject of a public hearing and vote within 40 local department of public health (DPH) or
days. If the City Council fails to act on a may- planning department. Given the statutory
oral nomination within 40 days of the date mission and responsibilities of DPH, it is the

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14
natural choice and best-suited agency to • Placerville
address the regulation of medical cannabis • Ripon
dispensing collectives. Law enforcement agen- • Selma
cies are ill-suited for handling such matters, • Tulare
having little or no expertise in health and • Calaveras County
medical affairs. • Kern County
• Los Angeles County
Examples of responsible agencies and
• City and County of San Francisco.
officials:
• Angels Camp - City Administrator RESTRICTIONS ON WHERE DISPENSARIES
• Atascadero - Planning Commission CAN LOCATE ARE OFTEN UNNECESSARY
• Citrus Heights - City Manager
AND CAN CREATE BARRIERS TO ACCESS
• Los Angeles - Planning Department
• Plymouth - City Administrator Reason: As described in this report, regulated
• San Francisco - Department of Public dispensaries do not generally increase crime
Health or bring other harm to their neighborhoods,
• Selma - City Manager regardless of where they are located. And
• Visalia - City Planner since for many patients travel is difficult, cities
and counties should take care to avoid unnec-
ARBITRARY CAPS ON THE NUMBER OF essary restrictions on where dispensaries can
locate. Patients benefit from dispensaries
DISPENSARIES CAN BE COUNTER-
being convenient and accessible, especially if
PRODUCTIVE the patients are disabled or have conditions
Reason: Policymakers do not need to set arbi- that limit their mobility.
trary limitations on the number of dispensing
collectives allowed to operate because, as It is unnecessary and burdensome for patients
with other services, competitive market forces and dispensaries, to restrict dispensaries to
and consumer choice will be decisive. industrial corners, far away from public transit
Dispensaries which provide quality care and and other services. Depending on a city's pop-
patient services to their memberships will ulation density, it can also be extremely detri-
flourish, while those that do not will fail. mental to set excessive proximity restrictions
(to schools or other facilities) that can make it
Capping the number of dispensaries limits impossible for dispensaries to locate any-
consumer choice, which can result in both where within the city limits. It is important to
decreased quality of care and less affordable balance patient needs with neighborhood
medicine. Limiting the number of dispensing concerns in this process.
collectives allowed to operate may also force
patients with limited mobility to travel farther
for access than they would otherwise need to. PATIENTS BENEFIT FROM ON-SITE
CONSUMPTION AND PROPER
Artificially limiting the supply for patients can VENTILATION SYSTEMS
result in an inability to meet demand, which
Reason: Dispensaries that allow members to
in turn may lead to such undesirable effects as
consume medicine on-site have positive psy-
lines outside of dispensaries, increased prices,
chosocial health benefits for chronically ill
and lower quality medicine.
people who are otherwise isolated. On-site
Examples of cities and counties without consumption encourages dispensary members
numerical caps on dispensaries: to take advantage of the support services that
• Dixon improve patients' quality of life and, in some
• Elk Grove cases, even prolong it. Researchers have
• Fort Bragg shown that support groups like those offered

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15
by dispensaries are effective for patients with referral, or network services, and facilitation
a variety of serious illnesses. Participants active or assistance in the lawful, "retail" distribu-
in support services are less anxious and tion of medical cannabis. "Dispensary" means
depressed, make better use of their time and any facility or location where the primary pur-
are more likely to return to work than pose is to dispense medical cannabis (i.e., mar-
patients who receive only standardized care, ijuana) as a medication that has been
regardless of whether they have serious psy- recommended by a physician and where med-
chiatric symptoms. On-site consumption is also ical cannabis is made available to and/or dis-
important for patients who face restrictions to tributed by or to two or more of the
off-site consumption, such as those in subsi- following: a primary caregiver and/or a quali-
dized or other housing arrangements that fied patient, in strict accordance with
prohibit smoking. In addition, on-site con- California Health and Safety Code Section
sumption provides an opportunity for 11362.5 et seq. A "dispensary" shall not
patients to share information about effective include dispensing by primary caregivers to
use of cannabis and to use specialized delivery qualified patients in the following locations
methods, such as vaporizers, which do not and uses, as long as the location of such uses
require smoking. are otherwise regulated by this Code or appli-
cable law: a clinic licensed pursuant to
Examples of localities that permit on-site
Chapter 1 of Division 2 of the Health and
consumption (many stipulate ventilation
Safety Code, a health care facility licensed
requirements):
pursuant to Chapter 2 of Division 2 of the
• Berkeley Health and Safety Code, a residential care
• San Francisco facility for persons with chronic life-threaten-
• Alameda County ing illness licensed pursuant to Chapter 3.01
• Kern County of Division 2 of the Health and Safety Code,
• Los Angeles County residential care facility for the elderly licensed
pursuant to Chapter 3.2 of Division 2 of the
DIFFERENTIATING DISPENSARIES FROM Health and Safety Code, a residential hospice,
PRIVATE PATIENT COLLECTIVES IS or a home health agency licensed pursuant to
IMPORTANT Chapter 8 of Division 2 of the Health and
Reason: Private patient collectives, in which Safety Code, as long as any such use complies
several patients grow their medicine collec- strictly with applicable law including, but not
tively at a private location, should not be limited to, Health and Safety Code Section
required to follow the same restrictions that 11362.5 et seq., or a qualified patient's or
are placed on retail dispensaries, since they caregiver's place of residence.
are a different type of operation. A too-
broadly written ordinance may inadvertently PATIENTS BENEFIT FROM ACCESS TO
put untenable restrictions on individual EDIBLES AND MEDICAL CANNABIS
patients and caregivers who are providing CONSUMPTION DEVICES
either for themselves or a few others.
Reason: Not all patients smoke cannabis.
Example: Santa Rosa's adopted ordinance, Many find tinctures (cannabis extracts) or edi-
provision 10-40.030 (F) bles (such as baked goods containing
cannabis) to be more effective for their condi-
"Medical cannabis dispensing collective,"
tions. Allowing dispensaries to carry these
hereinafter "dispensary," shall be construed
items is important to patients getting the best
to include any association, cooperative, affilia-
level of care possible. For patients who have
tion, or collective of persons where multiple
existing respiration problems or who other-
"qualified patients" and/or "primary care
wise have an aversion to smoking, edibles are
givers," are organized to provide education,

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16
essential. Conversely, for patients who do
choose to smoke or vaporize, they need to
procure the tools to do so. Prohibiting dispen-
saries from carrying medical cannabis con-
sumption devices, often referred to as
paraphernalia, forces patients to go else-
where to procure these items. Additionally,
when dispensaries do carry these devices,
informed dispensary staff can explain their
usage to new patients.
Examples of localities allowing dispen-
saries to carry edibles and delivery
devices:
• Angels Camp
• Berkeley
• Citrus Heights
• Santa Cruz
• Sutter Creek
• West Hollywood
• Alameda County
• Kern County
• Los Angeles County.

For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.

17
APPENDIX B

MEDICAL CANNABIS DISPENSARY
ORDINANCE EVALUATION SURVEY
QUESTIONS

1. What is your name and position? 9. How many medical cannabis dispensaries
are there now? What is the estimated popula-
tion of the area that may utilize them? Do
2. How important is safe access to medical you think the current number of dispensaries
marijuana in your community? is enough to address the needs of the com-
munity?

3. On what date did your city/county pass its
ordinance? 10. Has there been an increase or decrease in
criminal activity related to dispensaries since
the regulations were implemented?
4. Were there medical cannabis dispensaries
in your district before the ordinance? How
many? 11. How has the ordinance improved the
public safety in your community? Has it wors-
ened the public safety? How?
5. If any, were there any complaints against
them before the ordinance was passed? If yes,
who made the complaints? What were the 12. Has the existence of dispensaries affect-
specific complaints that were made? How fre- ed local business? How do neighboring busi-
quently were complaints made? nesses view dispensaries?

6. Were there any objections to passing an 13. What would you advocate be changed
ordinance to regulate medical cannabis dis- in the current regulations?
pensaries?

14. Do you have anything else you would
7. If so, what were the primary objections? like to say in evaluation of the medical
Who were the main objectors? cannabis ordinance?

8. Has the ordinance implementation
allayed or amplified those concerns?

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18
APPENDIX C

SURVEY ANSWER AND DATA ANALYSIS • Objections to the ordinance were allayed
Summary after implementation.
• Regulation improved public safety.
• The majority of responses were positive.
• Crime decreases or shows no effect affect
• Safe access is important to every
after regulations
community.
• Most businesses are either supportive of
• Complaints of dispensaries generally
or neutral about neighboring dispensaries.
decrease after regulation.

19
For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.

20
For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.

21
For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.

22
For more information, see www.AmericansForSafeAccess.org or contact the ASA office at 1-888-929-4367 or 510-251-1856.

23
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