Smoke and Mirrors 

Smoke and Mirrors 
Posted by CN Staff on January 05, 2005 at 17:42:45 PT
By Vrinda Normand 
Source: Metro
Justin Marik leans back in a chair at a coffee shop across the street from De Anza College, his legs spread wide and his blue eyes calm behind his wire-rimmed glasses. Just last year, the 22-year-old says he turned his life around with marijuana. At the age of 12, he depended on Ritalin for his attention-deficit disorder. He took Paxil and Prozac for depression during his teenage years, and he always kept Zanax on hand for his occasional panic attacks. He suffered migraines every week, fell behind in school and gradually crawled into a shell while his social life disappeared.
Despite all this, Marik seems relaxed and friendly, often relating the trauma of his formative years with a half-smile. What happened? "Well, I've smoked pot three times today," he explains. A few joints have now replaced his daily pharmaceutical cocktail. The graphic designer has loosened up so much that he confidently approaches a young woman at the end of his interview. Marik isn't afraid to come out about his choice of medicine. Unlike many underground patients in the South Bay, he is making his personal needs political. He recently joined the budding political action group Area 420, based in San Jose. "I don't like to hide my identity," he says. "That's how they demonize us so much. People think we're lowlifes or something because the government wants them to." Eight years after the passage of California's Proposition 215, which legalized the sale of marijuana to the critically ill, the medical marijuana scene lingers on the fringes of society. Ill repute shed on clinical practices for writing recommendations pales in comparison to the suspicion that clouds the drug's distribution channels. Especially for patients in the South Bay, getting in and out of the nearest dispensary is a much bigger ordeal than hopping in the car to the nearest Walgreen's. Void of any prominent medical marijuana supply lines, San Jose remains more conservative on the issue than its Bay Area neighbors. San Francisco, Oakland and Santa Cruz are all home to cannabis dispensaries or co-ops. Santa Cruz and San Francisco counties issue official ID cards for medical marijuana patients, and Oakland recently passed Measure Z, which will put private cannabis use at the bottom of the law enforcement priority list. Now three South Bay activists are heading a burgeoning movement to break down some of the bureaucratic walls limiting the legitimate cannabis community locally. And a small neighboring city on the north side of Santa Clara County may further eclipse the valley when it comes to supporting this controversial industry. Zoning In It's interesting to note that San Jose became the first U.S. city to monitor and permit medical marijuana distributors in 1997. Shortly after state Proposition 215 passed with 56 percent of the vote, the San Jose City Council voted on a zoning ordinance that would regulate where and how dispensaries could operate. In response to the section of the Health and Safety code that legalized marijuana for medical purposes in California, local legislators stepped in to provide specifics and added this section to the zoning code: "The intent of this proposition was to enable persons who are in medical need of marijuana to obtain and use it without fear of criminal prosecution. In order for this to occur, there must be places which dispense marijuana to those who qualify for its use in accordance with state law." The ordinance required dispensaries to be at least 500 feet from schools, day-care centers and churches, and at least 150 feet from residential areas. They could not operate outside the hours of 9am to 9pm, sell anything other than marijuana, allow smoking on the premises or admit anyone under 18. Opening a dispensary would require meeting these conditions as well as applying for a special-use permit so that the planning department could make sure the facility would not have an adverse effect on the surrounding area. At the time the zoning ordinance was passed, Robert Niswonger was running the San Jose Cannabis Club from his home, close to a school and a church. Niswonger challenged the city's right to regulate his operation (claiming freedom under Proposition 215), but the city found him guilty of violating the new zoning laws and shut him down. In a small office on Meridian Avenue, Peter Baez and Jesse Garcia were also operating a medical marijuana dispensary, the Santa Clara Medical Cannabis Center. Though the two men sided with law enforcement and even helped draft the zoning ordinance, they soon balked at the regulations. At one point they threatened to go on a hunger strike (one had AIDS, the other cancer) unless San Jose changed the law that required them to grow all their product on the premises. In March of 1998, the San Jose Police Department forced the Cannabis Center out of business by seizing its patient files, computers and bank account. Baez faced felony charges, all of which were eventually dropped, for allegedly selling pot to five people who didn't qualify under Proposition 215. The court case turned Baez into a living martyr for the medical cannabis community, but it may have had a chilling effect on dispensaries. Since then, no one has successfully opened one in San Jose or Santa Clara County. The county's cannabis history is almost as bleak. The Board of Supervisors scrambled to put together an ordinance after San Jose released its laws, and a local business owner, Suzie Andrews, started talking about opening a dispensary inside her head shop, Rainbow Smoke Shop, in the Burbank district (an unincorporated area of the county surrounded by west-central San Jose). But the county's ordinance mimicked that of San Jose, including the clause that dispensaries could not sell anything other than marijuana, effectively nixing Andrews' plan. According to Santa Clara County planner James Reilly, the stringent location restrictions of the ordinance make it extremely difficult for a dispensary to take root. In addition, the application requires a use permit and site approval, which adds up to more than $8,000 in fees. Reilly says the Planning Department has not received any applications or serious inquiries in eight years. Betting on Mainstream Around a table at a small cafe in San Jose, three local medical marijuana activists discuss the difficulties that they've run into with the Santa Clara County and San Jose governments. None of these men are going to go away without a fight. Meet Dennis Umphress, a gray-haired, round-bellied man whose clear, sober voice occasionally betrays an edge of biting humor. An active member of the Libertarian Party, freedom of choice trumps most issues for him, but as a representative for the state advocacy group Safe Access Now, he is fighting for more regulations in the medical marijuana field so patients can go about their business without feeling like criminals. Next to him is Jim Lohse, a high-strung man with ruddy cheeks who has memorized his entire Rolodex. He speaks at a rate of 500 words per minute and jokes with a twitch of his head, "You should see me when I'm not stoned." Lohse is a medical marijuana patient and caregiver, which means that he grows a crop of weed in his backyard during the summer and distributes the harvest to needy patients who have a hard time driving to dispensaries in the East Bay. Lohse wanted to expand his network of patients last September, so he posted an ad on Metro's Back Page. Hence Area 420 was born. Chuck (who declined to give his last name) now manages Area 420, although Lohse still runs the website: The edges of Chuck's heavy-lidded blue eyes wrinkle when he smiles, and his gentle demeanor seems to balance Lohse's intensity. As part of his information network, he directs callers to medical marijuana resources and is trying to bring the local community together with monthly meetings and barbecues. The hard part is getting medical marijuana patients to lend their public support. "Ninety-five percent of patients don't want to be politically active," Chuck says. "They just want to get their medicine from a local source." He aims to break this trend with his advocacy group. "Some people are still very fearful," Lohse explains. "What if this all gets overturned in a couple of years and it becomes illegal again? I have it in my health records that I used marijuana. I'm just making a bet that it's all going to go mainstream from here." Dispensing With Approval In Umphress' quest to liberate the medical cannabis scene in the South Bay, he has found that local politicians are avoiding the hot issue. He first contacted San Jose City Councilmember Pat Dando, and one of her staffers told him he should go to the county. Craig Mann, Terry Gregory's former chief of staff, told Umphress that medical marijuana wasn't on the councilman's agenda. Councilmember Chuck Reed confirms that there is "zero going on at the council about medical marijuana." He says it's not a city issue, so the council doesn't want to give attention to something over which it has "no authority or responsibility." In fact, San Jose seems to have grown colder toward medical marijuana in the past few years. Umphress recently discovered that the zoning ordinance for dispensaries passed in 1997 had disappeared from the books. Calls to the Planning Department and the city attorney's office yielded vague assertions that the legality of dispensaries had come into question. City Attorney Rick Doyle says the local government was waiting to see what the courts would do, although he couldn't cite any specific cases. A dig in the city clerk's office brought up a massive zoning code rewrite that took effect in January 2001. A few months prior to the rewrite, public notices were posted about the broad-sweeping change, but none mentioned the fact that the city was going to drop this particular ordinance. Now, opening a marijuana dispensary would require applying for a conditional-use permit, limited to heavy industrial areas. But Joan Hamilton, San Jose principal planner, says there is still some doubt as to whether or not the Planning Department would be able to approve one. "San Jose is not making a friendly atmosphere for legitimate medical marijuana patients to get their medicine locally," Umphress says. "Legal questionability hasn't stopped quite a few other counties." According to the California NORML website (, there are approximately 120 dispensaries, delivery services and co-ops throughout the state where patients can obtain medical marijuana. A few of these delivery services, based out of town, serve the San Jose area. "It comes down to: do you want to help ease the suffering of people or do you want to ignore the problem and pretend it's going to go away?" Umphress adds. It sounds like San Jose is doing the latter. "There is no need to have regulations in the zoning code because our feeling is that there aren't going to be any dispensaries requested," Doyle explains. Then might the lack of zoning and dubious permit approval discourage prospective dispensary owners? "That's certainly not the case," the city attorney responds firmly. But there's more to this official version. Daniel Halpern, a San Jose attorney, says he is working with a group of three people who want to open a dispensary in the South Bay. The process is still in the beginning stages so the individuals involved have declined to give their names, but Halpern says when they started looking for a location, they were "completely discouraged" by the city's position. "San Jose is extremely against dispensaries," the attorney says. "We were trying to stay away from a fight with the city ... because I know that they would probably win and bury my clients financially." The party recently found a spot in the Burbank district and has begun to seek the county's approval. About a year ago, Lohse considered opening a dispensary but decided there were too many hurdles in terms of overhead costs, time commitment and security. "It's not a very glamorous business," he explains. "People whine all day and try to show you fake ID cards, and then you take the risk of selling it illegally." Lohse prefers his small caregiver group, where he can verify everyone's doctor's notes personally. He says he is toying with the idea of opening a co-op so other people can help him grow the weed. The pot advocate is trying to stay on the good side of law enforcement; he says he invited the sheriff's office to check out his grow operation in Santa Clara, but they never took him up on the offer. The problem is, there aren't enough small groups like Lohse's to meet the needs of local patients. Considering the obstacles a private party would have to tackle in order to open and run a dispensary, Chuck of Area 420 suggests a possible solution: let the county do it. He has launched a petition to request that the Board of Supervisors establish a medical cannabis taskforce to look into the possibility of distributing marijuana through the county hospital system. So far, Chuck has collected about 500 signatures and plans to present his petition at a BOS meeting in early January or in February. Lohse thinks this request is a far stretch from what the county might agree to, but Chuck remains a bit more idealistic. "I'd like to have a big field out there growing it, but I don't think they'd ever go for that," he laughs. Racing the Run-AroundIn early 2004, Kevin Thibault ventured into Mountain View looking for a location to start up a medical cannabis dispensary. He currently runs a small co-op in Felton, where he provides for about 25 clients, and saw the need for another source in the South Bay. His exasperating journey shows how marijuana-related establishments fizzle without the backing of firm local guidelines. Thibault says he first approached the Mountain View Planning Department and said he wanted to open a dispensary. The woman he spoke to was a bit "taken aback," he recalls, and said she needed to speak with the district attorney. The next day he returned and she gave him the go-ahead to find a site. He came up with a 400-square-foot space in medical zoning on El Camino Real and returned to the Planning Department to get approval. Over the course of a month, he ran into the pitfalls of a system that wasn't prepared for him. He contacted the city repeatedly and got the run-around instead of a straight answer. Because of the delay, he lost the first location. By that summer, he found another site, also on El Camino Real. He gave a $3,000 down payment and managed to avoid signing a lease until he knew things would be stable. This time, he got a lot closer to his goal. After badgering the Planning Department again, he was finally told that his operation was good to go and all he needed to do was get a business license. The day before he opened up shop on Sept. 1, he notified the Mountain View Police Department of his intentions. He left copies of his business license and his medical marijuana ID card. He didn't hear anything until three days later. After two days of business, two plainclothes officers knocked on the door of his dispensary. He openly showed them his operation. They stayed for about 15 minutes and were very nice, he says. But the blow came when they told him he was too close to a school and requested that he shut down. "I said, 'Fine, I'm closed this afternoon.' I don't want to do this without having the police on my side," Thibault says. As cooperative as he was, the dispensary owner says he could have been spared a lot of trouble if the Planning Department had warned him about this factor ahead of time. But Thibault hasn't given up. He is still searching for a location that "makes everybody happy." Al Savay of Mountain View planning says his department is working very closely with Thibault to develop regulations for dispensaries. "This is really a new issue for us," he says. Savay says he is collaborating with the Police Department and the city attorney's office to discuss guidelines for the new land use and how to fit dispensaries into the local community. The planner commends Thibault's patience. Now Thibault is just crossing his fingers for the chance to realize the spirit of Proposition 215. He points out: "What's the point of voting in a law if there's no way to implement it?" Note: The South Bay's incoherent medical marijuana ordinances create confusion, driving some local activists to the brink of reefer madness.From the January 5 - 11, 2005 issue of Metro, Silicon Valley's Weekly Newspaper.Source: Metro (CA)Author: Vrinda Normand Published: January 5 - 11, 2005 Copyright: 2005 Metro Publishing Inc.Contact: letters metronews.comWebsite: Article & Web Site:Medicinal Cannabis Research Links Pot Racket: Suffering Suspicion Medical Marijuana Archives
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Comment #2 posted by FoM on January 05, 2005 at 19:02:36 PT
Study: Pot Boosts HIV Therapy Adherence
David Ryan Alexander, PlanetOut NetworkPublished Wednesday, January 5, 2005 According to a new study released Jan. 1, HIV patients suffering from nausea adhere more closely to their HIV antiretroviral treatment regimens when using medical marijuana.The study, titled "Marijuana Use and Its Association with Adherence to Antiretroviral Therapy Among HIV-Infected Persons With Moderate to Severe Nausea," was published in the Journal of Acquired Immune Deficiency Syndromes. Out of 168 HIV patients who participated in the study and provided information about their adherence to their antiretroviral therapy, 41 participants used marijuana.While the study did not reveal that marijuana use increased adherence to treatment overall, it did show that patients suffering from mild to severe nausea who use medical marijuana did adhere more greatly to their treatments.As part of the study's results, the report stated that while "examining subgroups of patients, among those with nausea, marijuana users were more likely to show an association with adherence than nonusers, while among those without nausea, marijuana use was lower associated with adherence." "It is the first real concrete indication that medical marijuana specifically helps HIV drug adherence," said Bruce Mirken, director of communications for the Marijuana Policy Project, a marijuana policy reform organization. "Essentially people experiencing nausea were staying on their anti-HIV cocktails more consistently ... which adds to the success of treatment."The study authors wrote, "Adherence to medications is a challenge to any chronically ill patient and is critically important to HIV-infected individuals, as sustained high levels of adherence are required for long-term viral suppression.""If people can't tolerate drugs, they tend not to take them," said Howard Grossman, executive director of the American Academy of HIV Medicine. "And if they can tolerate the medications, they're usually going to try and take the pills the right way."Grossman added that "many people don't find the same anti-nausea capabilities with Marinol (the synthetic form of a compound found in marijuana, THC), but when they smoke pot they do well."In contrast, the study also found that HIV patients not suffering from at least mild nausea who used medical marijuana were less likely to adhere to their treatment programs. Additional illicit drugs, which the study defined as heroin, cocaine and amphetamines, were shown to decrease adherence to treatment.It found no correlation "between adherence and gender, age, ethnicity, low quality of life, pain, or use of protease inhibitors or nonnucleoside reverse transcriptase inhibitors."
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Comment #1 posted by FoM on January 05, 2005 at 18:55:01 PT
News Article from Aidsmap
In HAART patients with nausea, marijuana use does not lead to poor adherence Michael CarterThursday, January 06, 2005 Smoking marijuana does not lead to poorer adherence to HAART in patients with mild to severe nausea caused by anti-HIV drugs, according to a study published in the January 1st edition of the Journal of Acquired Immune Deficiency Syndromes. However, the US investigators found that the use of other illicit drugs, and the smoking of marijuana by patients with no or mild nausea, was associated with non-adherence to HAART. Marijuana is used by some HIV-positive individuals to stimulate appetite and to counter nausea caused by HAART. Nevertheless, there are concerns about the safety of marijuana use, not least the potential for use of the drug to decrease adherence to HAART due to its psychoactive effects. It has been shown that the use of other illicit drugs, including heroin, cocaine and speed and decrease adherence to HAART, and two studies published in 2003 found that marijuana use had a similar affect. However, as marijuana is often used by HIV-positive patients to relieve symptoms or side-effects, investigators postulated that use of the drug might not be associated with poor adherence in patients taking HAART who are experiencing adverse events including nausea. Investigators recruited 252 HIV-positive patients from three HIV clinics in Northern California to their study in 2001. They were asked to report their adherence to HAART in the previous week. Patients who missed at least one dose were assessed as “non-adherent.” Individuals were also asked to say if they had ever used marijuana and to report the use of marijuana, and any other illicit substances, in the past four weeks. Of the 252 patients who completed the study questionnaire, 168 (67%) provided data about their adherence to HAART. In total 41 individuals (24%), said that they had used marijuana in the previous four weeks. A third of patients taking HAART (55 individuals) were assessed as non-adherent. In bivariate analysis, the investigators failed to find any positive or negative association between marijuana use and adherence (OR 0.92). Adherence was associated with a viral load below 50 copies/ml (p = 0.04) and having had mental distress about one’s health (p = 0.04). Adherence was negatively associated with use of illicit drugs other than marijuana in the last four weeks (p = 0.02) and with alcohol use in the last four weeks (p = 0.04). The investigators then looked at the subgroup of patients reporting moderate to severe nausea (43 individuals). Of the 20 patients who used marijuana, 75% were assessed as being adherent compared to 48% of the 23 patients who did not report use of the drug (p = 0.07). However, when the investigators looked at the 125 patients with no or mild nausea, they found that marijuana users were significantly less likely to be adherent than non-users (p = 0.02). “No crude association was found between marijuana use and adherence”, write the investigators, who add, “our data do suggest that use of smoked marijuana specifically to ameliorate nausea may be associated with adherence to antiretroviral therapy…in addition, our data confirm previously reported findings that the use of other illicit drugs is associated with lower rates of adherence”. The investigators note that the use of marijuana for medical purposes remains controversial and “do not here advocate its widespread use…however, in certain circumstances, specifically when patients are using marijuana to relieve nausea, marijuana is not associated with lower rates of adherence.” Reference de Jong BC et al. Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. J Acquir Immune Defic Syndr 38: 43 – 46, 2005.
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