Here is what I anticipate in 2012:

1. More uncertainty:   More cities will try and create ordinances to limit where dispensaries can operate.    It also looks like Katherine Harris is going to release a new set of guidelines to qualify how the system needs to work.   Word on the street is that California wants to get away from ALL storefront dispensaries. The question is going to be how do patients get safe access to medicine.

2. Patients will still be able to get recommendations from their doctors and grow 12 plants at home at will.   There WILL be dispensary locations to get their medicine but they may have to drive a little bit further than last year.

3. Delivery services will start thriving.    We are already starting to see many delivery services taking over in areas where dispensaries closed.   This is a good thing as it limits the visibility of medical marijuana and hopefully the cities will forget about it and leave them/us alone.

4. Ballot initiative: it looks like proponents of total legalization for recreational use are going to put another ballot measure for vote in November.  I expect this to NOT pass by about 3-4% points just like proposition 19 failed.    However I expect a second ballot initiative to be placed on the books to tax and regulate MEDICAL marijuana.   This I think WILL pass but ONLY IF they do a great job at promoting it as MEDICAL and not recreational.   So how they campaign will be huge.

5. Doctors: expect a handful of doctors to lose their licenses this year for failing to follow the medical board guidelines.   I expect that we will see a lot of these fly-by-night clinics closing and falling like dominos once the medical board takes action.  This is a good thing.

6. Expect President Obama to LOSE CALIFORNIA in the general election.  This will mean the end to his presidency.   The one vote that he had was the left that thought he was a proponent of medical marijuana.  He HAS LOST that vote 100%   Across the board people are fed up with his lip service on respecting states rights.  Expect the next Republican President to be neutral on this issue.   I believe a republican president will be more inclined to respect states rights.

I expect Governor Brown to create a sensible plan for medical marijuana in California.  He is a thinker and a realist.    He will understand the futility of pushing medical marijuana back to the black market.

Stay tuned!

1. Are you 18 years of age? Most doctors will not recommend medical marijuana to minors even with parental consent and a qualifying diagnosis out of fear of losing their medical license.    Therefore, with some exceptions, you need to be at least 18 years of age to obtain a medical marijuana card.   Also, most dispensaries only help patients 21 years and older.    Legally however you can obtain a medical marijuana card at any age with parental consent.

2. Are you a California resident? You must have a valid California drivers license or state issued ID to qualify in California.   This means out of state residents who are visiting do not qualify.

3. Are you on probation or parole? The law states that patients on parole or probation can not receive a medical marijuana card unless they have official approval in writing from their parole officer.   Convicted felons can not qualify.

4. Do you have a qualifying diagnosis? In California there is a list of diagnosis that qualify automatically.  HOWEVER, in addition doctors can recommend medical marijuana for anything that it provides relief for and that evidence can be backed by patient reports.   Therefore if you have chronic insomnia (for example) and can not tolerate ambien or lunesta and have used marijuana with good results, you would qualify.   Any of these conditions have to interfere with your normal activies or bodily functions as per the American Disability Act of 1990.  This would mean it would be a serious medical conditions.

Before you read the list below, patients with any diagnosis where pain has persisted for more than 3 months (definition of chronic pain) DO qualify.   The other more common things you can get a medical marijuana card are for insomnia, anxiety, back pain, nausea, muscle spasms, headaches, PMS, menopause, arthritis, lack of appetite etc.

“Serious medical condition” means all of the following medical conditions:

1. Acquired immune deficiency syndrome (AIDS);
2. Anorexia;
3. Arthritis;
4. Cachexia;
5. Cancer;
6. Chronic pain;
7. Glaucoma;
8. Migraine;
9. Persistent muscle spasms, including, but not limited to, spasms associated with multiple sclerosis;
10. Seizures, including, but not limited to, seizures associated with epilepsy;
11. Severe nausea;
12. Any other chronic or persistent medical symptom that either:
    1. Substantially limits the ability of the person to conduct one or more major life activities as defined in the Americans with Disabilities Act of 1990 (Public Law 101-336); and
    2. If not alleviated, may cause serious harm to the patient’s safety or physical or mental health

5. Do you have medical documentation verifying your diagnosis? It is not enough to walk into the doctors office and tell them you have headaches for example.   You need to have some medical documentation that another physician evaluated you for the condition that you are complaining of.    So if you have back pain, you would probably have an x-ray or MRI report.   Or you may have physical therapy notes etc.    As long as you can document that you have been formally diagnosed you can qualify.

6.  Once you have a documented diagnosis you can then talk to a doctor that is willing to recommend medical marijuana.  In California there a many clinics that specialize in this because patients primary care doctors or specialist are NOT WILLING to recommend it.

7.  Once you make an appointment and bring your medical records you will then see the doctor.   This doctors appointment SHOULD be like any other doctors visit.  For example, in my office, you will fill out a patient medical history form, have your vital signs taken (blood pressure, temperature, pulse) and I will review everything with you.  I will perform a physical exam and then go over all the benefits and risks of using medical marijuana (called informed consent).  I then show you how to use a vaporizer so you don’t have to smoke it and lastly my staff will go over how to find a reputable dispensary.

That is it!  It is not as difficult as you may thing and certainly should not be intimidating.

If you are located in Orange County or Long Beach feel free to call our office at 766-721-0047 or pre-qualify for FREE on our website at www.MCSoCal.com

In this blog I will summarize the most pertinent changes:

1) Patients will be allowed to join ONLY ONE collective (dispensary):

- Currently patients go from dispensary to dispensary to find the highest quality medicine and the most professional staff.   At each one, they are forced to become a member.    Most patients  join 3-4 collectives over a 12 month period to find one they feel the most comfortable at.

I think the new guidelines are a bad idea.   For one, there is no guarantee of the quality of medicine that a patient receives prior to joining a collective.   So a patient may join a collective only to realize their medicine is not effective.   In addition, a patient may realize over a few months that the level of professionalism is not what they expected.   Many collectives have much more professional staff than others.

The current system works in my opinion because it forces collectives to maintain very high standards as far as quality and variety of medicine and also their level of professionalism.   Take the pizza analogy in NYC.   If you are a pizza joint in NYC and have terrible pizza and an unfriendly staff, their customers can easily walk next door and get excellent service and great pizza.   This forces someone entering the pizza business to make the very best pizza and treat their customers right.

I can not tell you how many patients visit a collective and tell me that they would never go back because of the poor quality and lack of professionalism.   However they are forced to join right when they walk in the door.

Secondly, if a patient need medicine and happens to be in San Francisco when they normally get medicine in Long Beach they should be able to find a local collective and get medicine.   In my mind this should be treated as any other medicine.  If a patient has allergies and needs some allegra it shouldn’t matter if they buy it at CVS in San Diego or Savon in Oakland.  Treat it the same.

2. Collectives can only charge for medicine what the cost is to grow it.

A collective is a business no matter what the AG guidelines say.  It takes people who dedicate all of their time to run the business and that requires money.   I can not see how a collective can not charge more than the cost to grow it to cover all of its operating expenses.

In addition, collective are required to pay state sales tax, yet are not allowed to sell it. If it costs a collective $1500 to cultivate a pound of medicine, how can they sell it for $1500 and still pay state sales tax can cover all of its operating expenses?  The answer is that they can’t.

They should allow these collectives to operate for profit and let the market determine the prices for quality medicine.   This is how drug companies and pharmacies operate and thus collectives should follow the same business model.

3. Cultivators must be a member of ONE collective and can only provide medicine to one collective.  Actually it states that collectives must grow ALL of its medicine for its members.

Currently what is happening is most collectives do not have the means or capabilities to grow all its medicine for its members.    One, it takes large areas to grow that quantity of medicine.  How can a dispensary (collective) that is not allowed to profit run and operate warehouses?  They can’t.     Collectives would prefer to grow their own medicine because it is much cheaper than buying it wholesale from another source (which is what is currently being done).   Two, most patients (collective members) do not have the skill, time or financial resources to grow their own medicine.   I think the state has the impression that you plant a seed and give it some water every day and its like the chia-pet.  It takes  lot of skill to produce medicine free from molds and insects.

4. Cities can still make their own ordinances.

This NEEDS to happen.  In the current state of affairs, cities ban and collectives sue.  It is both a waste of city taxpayers dollars, manpower and time.  They need to do what Long Beach is doing which is setting an ordinance that makes sense.

Regardless, if you are considering opening a collective you need the advice of a solid attorney.  Do not go at this alone or you will pay dearly.

I recommend Anthony Curiale in Brea, CA.   He is handling the lawsuit against the cities of Anaheim and Costa Mesa and is super knowledgable.

This is not unusual and I would imagine that MasterCard, Visa and Discover will follow suit.    For the past 2 years the banking industry has given the medical marijuana community a heck of a time trying to conduct ordinary business.  READ ON…

Speak to anyone who runs a dispensary/collective or medical marijuana clinic and they will tell you their struggles with the banking industry.     What banks have done is, without notice, frozen accounts and turned off merchant services.   I personally had this happen to me on three occasions.

The first incident was with BANK OF AMERICA.    I had been banking with them for 10 years, both personal and business.   I had a merchant account with them in addition to a business and personal checking account.   All of my credit cards, payroll and ordinary business expenses were handled by these accounts.  One saturday in Jan 2010 I happened to open my mail and received a notice from BofA that as of Tuesday my accounts were going to be frozen and that they could hold my funds for 3-6 MONTHS!      That left me with one working day (Monday) to cash out all of my money and find a new bank to bank with.   I had upcoming payroll and had all of my business expenses auto-debited from those accounts.    On top of that THEY FROZE MY CREDIT CARD ACCOUNT THE WEEK BEFORE WITHOUT NOTICE and were now holding onto thousands of dollars of my money indefinitely!   (it took me 9 months to recover those funds)

When I went to my branch manager to see what happened their response was “I’m sorry we can not help you.  This was a decision by risk management in our New York office.  Your best bet is to call them.”  When you call risk management they essentially leave a recording that says “This was a business decision and it is not reversible.   Leave a message and we will get back to you.” To make a long story short, this is a businesses worst nightmare.    I was without credit card services and had to reestablish all new account overnight.

The issue is that banks are federally insured and because cannabis is illegal they do not want to risk having the government not insure their funds.    One day you are banking with them and the next day you are done.  No questions asked.

The bottom line is that people in this industry are going to struggle until the federal government legalizes marijuana.  And when marijuana is finally legalized federally, major corporations will jump in and put us all out of business anyway.   So cheers!

IF YOU ARE IN THIS INDUSTRY AND NEED A GOOD CREDIT CARD MERCHANT COMPANY FEEL FREE TO CONTACT ME.  I HAVE FINALLY LOCATED A BANK ON THE EAST COAST THAT IS COMPLETELY MEDICAL MARIJUANA FRIENDLY!

I want to reiterate one more time that a Cultivation Certificate from a doctors office is NOT VALID NOR RECOGNIZED BY LAW ENFORCEMENT.

If you plan on growing more than the 12 plant limit established by Senate Bill 420 I highly recommend you contact a knowledgable attorney.  Spending $325 for one hour of his professional recommendation will save you tens of thousands in legal fees and stress that you can not imagine.

I RECOMMEND THAT YOU FIRST SPEAK WITH ATTORNEY:

ANTHONY CURIALE

418 South Brea Boulevard
Brea, CA 92821-5301
(714) 529-9376

He is super knowledgable and very reasonable in his pricing.

I hope that helps.

Dr. Breen

Although I am not an attorney, I want to give you some practical advice on growing your own medicine.  In addition I want to give you information based on my EXPERT testimony in court regarding patients charged with growing with intent to sell.  READ ON…

Prior to Senate Bill 42o, patients in California who had a doctors recommendation could grow as much medicine as they needed.  There was not a limit on the number of plants.   Senate Bill 420, passed in 2003-2004, changed that limit to 12 immature or 6 mature plants and limited total possession to 8 ounces.   There are some counties that have changed that number but for the majority of counties that limit remains.

There was a case referred to as “The Kelly Case” where the California supreme court ruled that it is unconstitutional to limit the number of plants patients could grow.  All of a sudden patients were thrilled at the ability to grow as much medicine as they wanted.   What the court also said was that patients could grow what would be reasonable for their current use.   Or put more plainly, “be able to prove you need 99 plants for personal use.”

This left a very vague law in place.   I recently testified in court for one of my patients who was arrested and charged with intent to sell.  He had approximately 90 plants.

The prosecution did not challenge that my patient was legitimate.  I had his medical records, had a qualifying diagnosis and had a up to date recommendation.

However when I took the stand the prosecution began to ask me a series of questions regarding any formal training I had for medical marijuana.  The answer is that there is no formal training.

He then asked me what the recommended dose is for patients to use medical marijuana?  The answer to that question is that there is NO recommended dosing schedule like there is for prescription medication.   I simply stated that I tell patients to use a little medicine as possible to provide relief for their symptoms.

He then argued that because there is no formal training and because there is no recommended dosing that I, by law, can not recommend an amount of medication for patients to use.    The judge agreed.

Therefore, it was up to the patient to prove that he needed 90 plants worth of medication for his condition.   Various experts testified for the defense but at the end of the day… the judge made his decision on the amount of marijuana my patient was growing.   It did not end well.   He had to take a plea agreement.

The conclusion that I made from testifying in cases like these is this:    REGARDLESS OF HOW MANY PLANTS I WRITE  A PATIENT CAN GROW… IT IS IRRELEVANT.   THE PATIENT IS GOING TO HAVE TO PROVE IN COURT THAT HE NEEDS THAT MANY PLANTS.

So how many plants should you grow?   My recommendation is to stay within the initial limits of 12/6 set by senate bill 420.   There has not been a case that I am aware of where a patient was convicted of intent to sell for having less than 13 plants.

Lastly, if your doctor is charging to write a “plant number exemption” on your recommendation you are wasting your money.   You are also getting a false sense of security.

I hope that helps.

Out of that law came the “growers certificate” which doctors offices provided patients with who wish to grow their own medicine.

The intent of this blog is to clarify this document and answer any questions you may have.  READ ON….

Patients who receive a written recommendation by a physician to use medical marijuana have the right to grow their own medicine.   A growers certificate is NOT NEEDED to grow.  All you need is a written recommendation.    Some doctors offices are charging for a “Grower’s Certificate” which they tell patients they need in order to grow medicine.  THIS IS FALSE AND IS A SCAM. NEVER PAY FOR A GROWERS CERTIFICATE!

What we now recommend to patients is that they post a copy of their written recommendation in the vicinity of the garden.  This will suffice.

Our office always provided patients with a growers certificate FREE of charge as an additional document to place in their garden.  We recently discontinued that policy do to the following point of confusion.

Patient were interpreting having a growers certificate with the right to produce large gardens with as many plants as they needed to supply marijuana to dispensaries. That is NOT THE CASE.

If you are producing marijuana to sell to dispensaries you have to be part of a collective and have an attorney set you up with all the proper legal documentation.

So to be clear: a “growers certificate” is not a recognized legal document in the state of California.  All patients need to grow medical marijuana is a written recommendation from a licensed physician.

For any questions feel free to contact us through our website.   www.MCSoCal.com

This is the latest effort of cities to get a handle on an industry they have neglected to regulate. READ ON…

Lake Forrest has had an ongoing battle with dispensaries.  They have received injunctions to close them only to be sued and have them reopened.  Currently there is litigation trying to sort this whole mess out.  In the meantime it looks like a judge is going to order them closed within the month.

Although this may seem like a bad thing for the medical marijuana business in Orange County my opinion is that it will force the city to create an ordinance that makes sense even sooner had these shops continue to operate unregulated.

The bottom line is that permanently closing or banning marijuana dispensaries will only push patients back to the black market to get their medicine.    Or just as likely, dispensaries will go to delivery only which will make it that much harder for the city to tax and regulate them.   Both of those are not a good thing and will prolong the inevitable… which is a sensible ordinance to let them survive and thrive.

I encourage every reader to go to the city of Costa Mesa’s website and click on “video archive” and then watch the medical marijuana study session from April 12th.    It was the most clear and professional presentation on why the city needs to regulate medical marijuana dispensaries.   Each city council should get this presentation.

It is amazing to think that we are 15 years since the passage of proposition 215 and yet there is no clear policy on how to regulate dispensaries.     The quickest way to remove criminals from selling marijuana illegally is to create an ordinance where the cities can do background checks on owners and make sure only professionals qualify to operate them.   Without an ordinance you have cities with collectives run by gangs to business professionals and they have no idea who is who.    For example, Costa Mesa believes there are only 16 dispensaries operating in their city.  The real number is closer to 65.   The reason they have a problem is because anyone who can fog a mirror and has access to marijuana can open one up and fly under the radar.

IF YOU ARE LOOKING TO START A COLLECTIVE LEGALLY I SUGGEST YOU CONTACT ATTORNEY ANTHONY CURIALE IN BREA, CA.   HE IS SUPER SMART AND SPECIALIZES IN THIS INDUSTRY.

You get the point.   It is not rocket science.

More and more I read about how states, local and federal governments are pushing back at medical marijuana laws in an attempt to curtail them.    There is good reason and I think the medical marijuana community is partly to blame.

At the end of of our presentation one of the counsel members, a middle aged caucasian women (who happens to be a high school teacher) made this comment:  ”At the high school I teach I hear students talking about how easy it is to get a medical marijuana card and it seems like they all have one.   What are you doing to curtail all the use among teenagers?”  THIS IS A GREAT QUESTION AND A MAJOR PROBLEM RIGHT NOW.  AND I THINK THIS IS THE REASON WE ARE SEEING THE PUCH BACK FROM LOCAL AND STATE GOVERNMENTS. READ ON….

It was a great comment/question and needed to be addressed.   What the community does not want is anybody who can fog a mirror to be able to walk into a doctors office and get a recommendation to use medical marijuana and then take that recommendation to one of 50 unregulated dispensaries that willing sell them 8 ounces of medicine twice per week.   Then that “patient” goes to school/college/work and sells it off for profit.

Unfortunately this is happening all the time across the state and is the reason community leaders are saying “Stop.  Lets take another look at the existing laws and not do anything until we can address this issue.”

I recently visited a collective in Santa Ana and was speaking to the general manager.  He readily admitted to me that 60% of his sales are to people using marijuana recreationally.   They are not patients yet they have recommendations from doctors to use marijuana.

I also recently had surveillance video shown to me of a Costa Mesa collective selling marijuana to the same guy outside their shop every day for a week when clearly he was dealing it to other non-patients.

Just this morning I had a patient who has been using marijuana for insomnia for 4 years (he is now 21) and did not ever have a physical exam and had no medical documentation… yet he had two years of recommendations from Medicann (medical marijuana clinic).

I live this industry daily and can say that it needs to be regulated.   I realize that many people think that marijuana should be legal but that is not what this discussion is about.  Proposition 215 was and is for patients.    We need to focus on keeping it for patients until the federal government legalizes it.  Only then will state and local governments give us any credibility.

Here is how you research a doctor medical record:

For MD’s (medical doctors) you will need their full name or License number for the State you are in (the clinic, if legitimate, should provide you with this information)  In california you can simply copy and paste this link into your web browser:  ** Note that if your doctor is a DO (doctor of osteopathic medicine) it will have a separate tab that says “click here” to verify their license record.

http://www2.mbc.ca.gov/LicenseLookupSystem/PhysicianSurgeon/Search.aspx

Once you search your physician it will tell you if they have been disciplined by the medical board or have any pending issues.

YOU DO NOT WANT TO GET A RECOMMENDATION FROM A DOCTOR THAT HAS BEEN DISCIPLINED BY THE MEDICAL BOARD.   Why?   Because if they end up losing their medical license your recommendation is no longer valid and you have to see another doctor in good standing all over again.   You would be surprised how many clinics are being run by doctors who have suspended licenses to practice their specific field.

The second thing you want to do after checking their medical license is to make sure that the doctor is going to physically be in the office to go over your medical records and examine you.   The state medical board clearly stated that this is the standard of acre and that SKYPE consultations FAIL to meet the standard of care.   Although these clinics are operating it is only because the medical board does not have the manpower to investigate and shut every one of these doctors down.  EVENTUALLY IT WILL HAPPEN.

Two clinic were just shut down in Orange county for being affiliated with dispensaries and doing SKYPE recommendations.  All of their patients now have invalid recommendations and have to spend the additional money to go to a legitimate clinic.

If you do both of these things you increase your chances of finding a legitimate doctor and clinic.

Be blessed,