Fourteen states and the District of Columbia allow people to use marijuana to treat a wide variety of ailments. Each law is different — but if you look at them in chronological order, a pattern emerges: The laws are becoming stricter. The states passing laws today include more regulation than the early adopters did.
California voters approved the first law in 1996. The language in Proposition 215 was simple — essentially it said "allow sick people to use pot."
The broadly worded language successfully avoided conflict with federal law, under which marijuana possession remains illegal. But with almost no restrictions, dispensaries flourished. In Los Angeles County alone there are more than 100 places to legally buy pot. And more than 40,000 medical marijuana cards have been issued in California.
In November, California voters will decide whether to go ahead and make this de facto legalization official. A proposition on the ballot will ask voters if they want to make pot legal for adults.
After California passed the law, 13 more states and D.C. also passed medical marijuana laws. Some, like Washington and Oregon, don't allow dispensaries at all. But so far, none have gone to the lengths New Mexico has to regulate medical pot.
The Most Restrictive: New Mexico
New Mexico does allow dispensaries, but only nonprofit ones. And to date, only five have been approved. One of them, NewMexiCann Natural Medicine, is based in an office behind a restaurant in Santa Fe, N.M. Getting a license to grow and distribute marijuana was a seven-month process, according to Executive Director Len Goodman.
With New Mexico’s tight regulation of the state's medical marijuana program, it took Len Goodman of NewMexiCann Natural Medicine seven months and a 100-plus page application to get approval to grow and distribute pot.
With New Mexico’s tight regulation of the state's medical marijuana program, it took Len Goodman of NewMexiCann Natural Medicine seven months and a 100-plus page application to get approval to grow and distribute pot. Jeff Brady/NPR
"What there is is a long checklist: a two-page, single-spaced checklist," he says.
The state wants to know things like: Who will grow the plants? What is their experience? What will the distribution model look like? And then there are more mundane matters, like what the labeling and invoices will look like, Goodman says.
New Mexico limits Goodman to 95 plants. That means demand is always outpacing supply — and that's just how the state wants it. If supply increases too much, there's a risk legal medical marijuana could be diverted to the illegal recreational market.
But that means patients like Dennis Garcia have to go without. He's a broad-shouldered Iraq war veteran who uses marijuana to treat symptoms of post-traumatic stress disorder.
"Cannabis was the only thing that was really helping me," Garcia says.
Just getting approved to use marijuana was difficult for Garcia. Both a doctor and a psychiatrist had to sign a state form saying traditional treatments failed. They also had to conclude that marijuana would do Garcia more good than harm.
When he couldn't find marijuana through dispensaries, Garcia started growing his own in his garage. To get a license, Garcia had to prove that he could keep his crop secure and promise to follow other regulations.
"It can't be within a certain amount of distance from a school. It can't be seen or visible from the street or any public property," Garcia says.
Getting Marijuana Only To The Sick
All these restrictions are designed to ensure New Mexico's program is for medical use — not a back-door way to legalize pot.
"It's the result of the practical experiences of trying to get away from the California model," says New Mexico State Sen. Cisco McSorley.
Dennis Garcia, a military veteran, grows his own marijuana to treat post-traumatic stress disorder. Garcia first tried to buy pot from a state-licensed grower, but none had any to sell.
Dennis Garcia, a military veteran, grows his own marijuana to treat post-traumatic stress disorder. Garcia first tried to buy pot from a state-licensed grower, but none had any to sell. Jeff Brady/NPR
McSorley says New Mexico has shown that through strict regulation, medical marijuana can be made available only to the sick. But there is a risk in such active regulation. It's possible a federal prosecutor could charge New Mexico regulators with helping people get access to marijuana.
"My very first goal was that I didn't go to jail and none of my doctors went to jail and nobody in the Department of Health went to jail," says Dr. Alfredo Vigil, secretary of the New Mexico Department of Health.
To date, there's been no interest from federal prosecutors, and New Mexico's law has avoided the California model of dispensaries popping up all over.
"So far there's really not the kind of money to be made that would underwrite proliferation of those kinds of businesses and I'm hoping we can keep it that way," says Vigil.
The Power Of The States
Now New Jersey appears ready to go beyond even New Mexico. Under that state's program, virtually every marijuana bud that's harvested will have been closely monitored by a bureaucrat.
In all of this, there's an interesting civics lesson, says Vanderbilt University law professor Rob Mikos. Federal law — in this case the ban on marijuana possession — always is supreme, but there are times states can choose to go their own way.
"What they're doing is perfectly legitimate," Mikos says. "It's just a passive form of resistance to federal authority."
Mikos says states have traditionally prosecuted nearly all of the marijuana possession cases. Now, in response to their citizens they're actually embracing medical marijuana and the feds aren't doing much about it.
Mikos says when it comes to using marijuana for medical purposes, our culture is changing and the states are leading the way.