Medical marijuana: issues confront policeDate: 9/3/2015 Editor’s note: This is the third in a three-part series in which Reminder Publications explores issues related to medical marijuana in Massachusetts – the current status of registered marijuana dispensaries, medical uses of marijuana, and law enforcement.
Springfield Police Commissioner John Barbieri is concerned.
In reviewing and educating himself on the recently established medical marijuana regulations, he has reached one unsettling conclusion – “Not much has been learned from the state’s current struggle with opioid addiction.”
Barbieri said his concerns are not related to whether or not marijuana has efficacious medical uses; that’s not his expertise. His worries focus on the rules and regulations and the potential of increased abuse, specifically by recreational users, and crime.
“I think the majority of police personnel in the state support the fact that there are people out there that need the relief and anything that will work for them is certainly something we want to see them obtain, but we also have some real concerns about how it’s going to be managed,” he said.
Flooding the market
With marijuana already being a highly sought after drug, Barbieri said the prospect of an influx of an extremely popular drug, even if originally legally obtained, creates serious public safety and public health concerns.
“The more marijuana that ends up in our city, the more potential for abuse,” he said.
“What this does for the market for marijuana is it certainly floods the market with more marijuana than is currently available,” he continued. “We already have a huge problem with prescription drugs and the opioid crisis and we haven’t been able to get a handle on that and now we’re going to flood the market with a new prescription drug that is in vast desire by people who would use it illicitly.”
Barbieri explained a large number of people addicted to opioids like heroin started out as legitimate prescription drug users who developed dependence and later turned to other means to satisfy their addiction. In addition to unlawful use and potential for addiction, Barbieri said he is a believer that marijuana is a “gateway drug.”
The concepts of addiction and marijuana use being linked to other illicit drug use have been challenged through the years, but Dr. Kevin Hill, director of the Substance Abuse Consultation Service in the Division of Alcohol and Drug Abuse at Boston’s McLean Hospital, assistant professor of psychiatry at Harvard Medical School and author of “Marijuana: The Unbiased Truth About the World’s Most Popular Weed,” said there is some validity to the claims.
He explained marijuana use “absolutely” could result in addiction, though a minority – approximately 9 percent of users – suffer from the affliction.
“People definitely get addicted to marijuana; they have problems,” he said. “By the time they get to me [for treatment], a lot of times it’s hard to distinguish who’s addicted to marijuana and who might be addicted to alcohol or addicted to opiates.”
Battling illegal drug trade
Along with personal issues for drug abusers, illegal drug sales also raise greater public safety concerns, Barbieri added.
“There is a large of amount of violence inherent in the drug trade, due to the sums of readily available cash on hand, which makes urban areas more unsafe,” he said. “Easing the availability of obtaining marijuana for resale will most likely place a burden on already strained police resources.”
Possession of medical marijuana, for which a patient and/or caregiver must be certified through a physician and the state to obtain, is only permitted for personal consumption for treatment of symptoms of a chronic condition. As with other legal drugs, if a patient were to sell it, they would be in violation of the law. That alone, however, has not proven to be a deterrent, Barbieri said.
“There are citizens who are willing to use drugs illegally and a tremendous amount of profits are available,” he said.
Community engagement, such as the Springfield Police’s C3 initiative, has been a strategy utilized more and more by local and state agencies to curb illegal drug sales, but there are limits to what the police are able to control, Barbieri added.
“We do a lot of work in regards to talking with neighborhood residents. They’re the first person to know if there’s signs of illegal drug sales or activity in their neighborhoods,” he said. “But we can’t be everywhere all the time and a lot of these transactions are made in a home or in the hallway outside a doctor’s office or at the pharmacy right after they receive the medication.”
Oversight of physicians
Under the law, patients wishing to use marijuana as a form of medical treatment must first receive a certification from a licensed physician and then register with the state to obtain an identification card. Because the Drug Enforcement Agency (DEA) still classifies marijuana as a Schedule 1 drug, it cannot be purchased in a pharmacy. Therefore, once certified and registered, a patient can obtain up to a 60-day supply at a registered marijuana dispensary.
Barbieri noted he believed the vast majority of physicians, including those who specialize in medical marijuana certifications, would conduct their business ethically, but “just like in law enforcement where 99 percent of the cops are phenomenal, I like to believe 99 percent of the physicians are phenomenal, but that small percentage can do a lot of damage.”
Oversight of physicians requires a delicate balance, something law enforcement has dealt with in battling prescription drug abuse, he explained.
“There’s always a difficult line to cross from public health to police in regards to confidentiality, but we do continuously work with the DEA and some of our other federal partners with regards to information that we get about physicians who are prescribing either for profit or are tremendously loose with the amount of prescriptions they write based on a minimal amount of evidence to create an influx of patients. There are doctors out there making a tremendous amount of money on visits and then obviously incentives from pharmaceutical companies with regard to their products,” he said.
Regarding marijuana specifically, he added, “I’m concerned with how often are you going to have to see your doctor, how much medical marijuana are you able to get in one shot and what are the regulations to ensure the medical marijuana is being utilized by the patient and that the patient is legitimately a patient. Do we have doctors out there who are going to liberally give prescriptions based on a minimal amount of evidence?”
Dr. David Getz of MariMed Consults, a Springfield-based physician’s office specializing in medical marijuana certifications, said his practice requires medical documentation that indicates the patient is currently being treated for a chronic condition. Records cannot be older than two years old. He said he also encourages patients to return for a follow-up appointment.
Possession questions
Those who are eligible to use, administer or sell marijuana legally are required to carry the state-issued identification card. Law enforcement can verify registration through the Medical Use of Marijuana Online System through the pre-existing Criminal Justice Information System.
Those in possession of marijuana without proof of certification would be subject to the penalties currently in place for non-medical users. In Massachusetts, quantities of less than an ounce are decriminalized, meaning anyone 18 or older found in possession would be required to surrender the drug and would be issued a $100 fine. Those under 18 would also have to participate in a drug awareness program.
Possession of more than an ounce of marijuana, labeled a Class D controlled substance by the state, could be jailed and face fines of $500 to $5,000 for first offenses and up to $10,000 for subsequent offenses.
However, if a person with valid identification is found in possession of marijuana, determining whether the marijuana found by police was legally obtained is essentially impossible.
“There will be no manner that I’m aware of to discern the difference,” Barbieri said.
The amount of marijuana that can be acquired through medical marijuana dispensaries adds to the potential of illicit sales, he added. Under the current statutes, a patient or caregiver can purchase a 60-day supply of up to 10 ounces of marijuana.
It’s a quantity that concerns even those who believe in the effectiveness of the drug.
Getz said it is “far in excess” of what anyone utilizing the drug for medical uses would need. Hill called it an “astronomical” amount that he could not see anyone ever using for medicinal purposes.
Targets for criminals?
With only one dispensary currently open, with a second in Northampton due to open later this month, the law allows patients and caregivers to grow their own supply. Once dispensaries are open, patients and caregivers can apply for hardships that would allow them to continue growing for personal use. In-home growing is something Barbieri identifies as presenting potential for problems.
“With the allowance for patients and caregivers to grow their own marijuana up to 60 days and the legislators are talking about now there’s a bill being introduced to allow a caregiver to be allowed to grow enough for up to 10 patients, that’s a tremendous amount of marijuana being grown in the home or another location,” he said.
He voiced concern for the safety of those patients and caregivers, explaining if the fact they are cultivating marijuana becomes known, they could be identified as targets for larceny and even violence by those seeking marijuana for their own use or illegal sale.
Barbieri also said he had questions regarding how the state intended to regulate home growing operations. The state does not specify the limit of the number of plants an individual can possess, stating only it should be “a sufficient amount for their 60 day supply” and “there should be no more than what is necessary to meet the patient’s individual needs” in its guidelines to law enforcement.
“If you’re going to grow a 60-day supply, who’s going to come into your house and regulate that it’s really just a 60-day supply?” he said. “I can understand the temptation even if you’re a legitimate caregiver. If you’re trying to grow a 60-day supply and you’re having a problem with your plants, aren’t you going to hedge your bets a little bit? You’re not going to want whoever you’re taking care of to not have enough marijuana when they really need it.”
Registered marijuana dispensaries raise other concerns, Barbieri added. In addition to the temptation to steal marijuana from patients or the establishment themselves, Barbieri explained many financial institutions are not accepting the money brought in by dispensaries because the practice is not federally approved. Resulting often in cash being stored on-site.
“First and foremost, it’s a security problem for people who would like to get the raw marijuana itself, but in its worst-case scenario, where are these large amounts of cash being stored [and] what provisions do they have to safeguard it?” he said.
Norton Arbelaez, spokesman for New England Treatment Access (NETA), which expects to become Western Massachusetts’ first operational registered medical marijuana dispensary in Northampton this month, said Massachusetts medical cannabis licensees “are among the most heavily regulated businesses in the country.”
He explained NETA’s safety and security protocols include, but are not limited to, full facility camera coverage, surveillance and recording systems, 24/7 monitoring of building electronic and security systems, RFID security access throughout all facilities, trained security staff on duty and “seed to sale” tracking of all products via a barcode-driven IT system.
“These type of measures are intended to increase public safety and assist law enforcement by allowing full transparency of all operations,” he said. “The real threat to public safety is continuing with the criminal prohibition of medical cannabis, which only serves to marginalize patients and strengthen violent black market organizations.”
Arbelaez added the industry in some areas has seen pushback from the banking industry, but his company had been able to establish a relationship with a local institution.
While previously illegal, the Obama Administration in February cleared the way for banks and credit unions to accept the funds. Since then, the Financial Crimes Enforcement Network (FinCEN) issued specific guidelines.
Under the guidance, financial institutions should “conduct customer due diligence,” an exhaustive process that includes license verification through the state, a review of the license application, the development of an understanding of the normal business practices, including the types of products to be sold to whom. The financial institution would also be expected to conduct “ongoing monitoring” of the business for suspicious activity.
John Fairbanks of the National Credit Union Administration’s (NCUA) Office of Public and Congressional Affairs, explained, “As far as NCUA’s guidance, the agency considers it a business decision on the part of an individual credit union whether to accept an account from a marijuana-related company. NCUA expects the credit union to identify and analyze the risk associated with such an account, as the credit [union] should do with any business account. The agency also expects the credit union be prepared to mitigate that risk.
“Credit unions should be aware of the FinCEN guidance and their responsibilities under the Bank Secrecy Act and anti-money-laundering laws. NCUA is responsible for ensuring compliance with [Bank Secrecy Act] and [Asset Liability Management] laws, and that is part of the annual examination the agency conducts at each credit union,” he added.
Representatives from the Federal Deposit Insurance Corporation were also contacted and referred Reminder Publications to the FinCEN guidelines for their official position.
In early July, legislators from Oregon and Colorado also introduced a bill that would “ensure that legal marijuana businesses can access banking services.”
Sen. Cory Gardner (R-CO) said in a press release announcing the bill, “This commonsense legislation solves a major public safety problem in my state by giving legitimate businesses acting in compliance with state laws access to the banking system.”
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