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In the weeds of the state's medical marijuana law

Illinois's new cannabis program will help some ill patients, but its many rules, restrictions, and uncertainties are a real buzz kill.

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Despite what you may have heard, you're not going to be able to order a magic brownie with your morning coffee anytime soon. It's still not a great idea to fire up a joint at the bus stop during rush hour. And to stay supplied, most of your friends will have to continue to rely on their always available but slightly shady pot dealer.

In all likelihood, marijuana will be legal in Illinois next year—but only in the most limited way possible.

On April 17 the Illinois House voted 61-57 in favor of the Compassionate Use of Medical Cannabis Pilot Program, authorizing state officials to set up a system for the cultivation, sale, and use of marijuana for medical purposes. The state senate approved the legislation a month later and sent it to Governor Pat Quinn. As long as he doesn't veto the bill, it will become law in August and the program will get under way on January 1, 2014.

That will make Illinois the 20th state to put a medical marijuana law on the books.

But even advocates for the new law call it one of the most restrictive in the nation.

While the state's medical cannabis program could help thousands of ill patients across the state, it will be limited to those with serious ailments who are willing and able to jump through multiple hoops. And even then they might not have easy access to marijuana, because only a few carefully regulated businesses will be licensed to grow and sell it. And the law expires in just four years.

"The bill is not perfect, but it's the most perfect bill we could pass," says its chief sponsor, Democratic representative Lou Lang of Skokie. "I do think after the four-year pilot program we'll have a lot more information."

Perhaps it will even lead to a decline in the reefer madness that's dominated discussions of cannabis in Illinois for decades. "I'm hopeful that people will see this works OK and doesn't lead to the downfall of civilization," notes Eric Berlin, an attorney and patients' advocate.

As we await further signs, it might help to know what the law says, what it doesn't, and what that means for patients and potheads alike.

Democrats control pretty much everything in Illinois. Why has it taken so long for us to do what so many other places have already done—including very red states like Alaska, Arizona, and Nevada?

Despite being progressive in many ways, Illinois has been led for generations by politicians of both parties who've dismissed any talk of drug reform as being soft on crime.

Representative Lang started working to pass a new medical marijuana bill in 2009, but it wasn't until this spring that he could convince enough of his colleagues to sign on. Even then many legislators voiced concern that more kids would become drug abusers as a result of the law.

"There's an emotional reaction to cannabis—it's identified with so many things people are afraid of, and once those things get on the books it's hard to change them," says the Reverend Al Sharp, acting executive director of the Community Renewal Society, who lobbied on behalf of Lang's bill. "What's become abundantly clear—it can't be denied—is that cannabis helps a significant number of people who are really hurting. I saw that shift in the last three years."

Representative Lou Lang, a Democrat from Skokie, was the chief sponsor of Illinois’s medical marijuana law. - TAMARA BELL
  • Tamara Bell
  • Representative Lou Lang, a Democrat from Skokie, was the chief sponsor of Illinois’s medical marijuana law.

So who's going to be allowed to use marijuana now?

Only people who have a "debilitating medical condition"—but not just any debilitating medical condition. It has to be one of 40 maladies specified in the law, including cancer, glaucoma, HIV or AIDS, MS, Parkinson's, Crohn's, lupus, and traumatic brain injuries.

Wait—that list doesn't include athlete's foot. Don't tell me I'm going to have to suffer through with Tinactin alone.

I'm afraid you'll have to itch it out without medical cannabis. There is a way to add a new debilitating medical condition: you can petition the Illinois Department of Public Health, which then has six months to make a decision. But the law doesn't spell out how—state officials still have to map out many of the standards and regulations.

Significantly, chronic or severe pain is not included among the qualifying ailments, though it is in most other states with medical marijuana programs. And it often accounts for the biggest share of participating patients—93 percent of them in Colorado, according to a recent story in the Wall Street Journal. Of course, last fall Colorado voters did away with the headache of screening patients by voting to legalize recreational marijuana use.

California hasn't gone to full legalization yet, though you wouldn't know that from a trip to Venice Beach. Under state law, doctors there are allowed to write cannabis prescriptions for serious conditions and "any other illness for which marijuana provides relief"—which has come to include constipation, nightmares, and impotence.

Who exactly is not allowed to use medical marijuana in Illinois?

Well, for starters, everyone who doesn't have a "debilitating medical condition."

But that's not all. Cannabis remains prohibited for everyone younger than 18, regardless of his or her health—a concession made to pick up more political support.

The law also excludes anyone who's been convicted of a violent crime or felony drug offense—including, potentially, someone going through chemo who was caught with a supply before the new law was in place.

That's no good, but let's say I'm a qualifying candidate. How do I get access to marijuana?

Slow down—the state isn't ready to give you the OK yet. Not by a long shot.

First you'll need to document that your condition is real: Your doctor needs to provide "written certification" to the health department detailing your symptoms and arguing that cannabis is likely to help. The doctor will also need to confirm that he or she is actually your doctor and that you've undergone a physical examination. This exam cannot be conducted via telephone, telepathy, e-mail, Gchat, Skype, or any other "remote means." It can't happen at a location where cannabis is sold, or at the home of anyone who works in the cannabis business.

No problem—I see my dentist every six months.

You undoubtedly have a nice smile, but that's not going to help with the medical marijuana program. The physician has to be a doctor of medicine or osteopathy who has a license to prescribe drugs. Dentists are prohibited from prescribing cannabis. So are doctorates in astronomy and Russian lit.

I thought the Brothers Karamazov went a little long. Still, I'm willing to persevere. What's the next plot point?

You're demonstrating the patience of Dmitri Fyodorovich. Next, you have to submit to a background check by the state police. And don't forget your fingerprints—the state will need a set of those as well.

"There's definitely no privacy here at all," says Julie Falco, a medical cannabis activist who has MS. "This is pretty heavy stuff for patients who are just trying to find some relief."

I'm starting to get stressed out just thinking about it.

Unfortunately for you, stress alone is not a qualifying condition for the program. And that's not the end of the registration process.

Patients then need to submit an application to the health department that includes a signed statement asserting that they won't sell or give away medical cannabis.

If the department approves the application, it will forward the information to the secretary of state to include with your driving record, just in case you're pulled over and police want to check your story about that bag of marijuana.

The health department will maintain a registry of cannabis patients that's available to other state agencies and police "on a 24-hour basis" so they can keep track of "the date of sale, amount, and price of medical cannabis purchased by a registered qualifying patient."

So much for the push for smaller government. After all that, how many people are going to qualify?

No one is quite sure. Estimates are all based on other states, where the population and laws are different. On the high end, so to speak, is Colorado, where 2 percent of all state residents are medical cannabis patients, according to the Marijuana Policy Project, a research and advocacy organization. But in New Jersey, where rules are far more strict and implementation has been slow, the registration rate is just 0.01 percent. That could mean anywhere from 1,452 to 262,802 registered patients in Illinois. But MPP analysts believe Vermont is a better model, since it has a similar list of qualifying conditions. They predict 10,000 to 16,500 patients will register in Illinois.

Let's assume I survive the registration process. Can I just go to Walgreens for my marijuana, or do I have to visit the guy down the street growing plants in his basement?

There will be no green in Walgreens. And the guy down the street won't be able to sell it to you under the law either—unless he gets a license to turn his basement into a "dispensing organization." To acquire medical cannabis, registered patients have to pick one—and only one—dispensary, register their selection with the state, and then go to the site of the dispensary to make a purchase. The dispensary is then required to record the transaction with the state so that all cannabis is tracked.

I had no idea there were any pot shops in Illinois.

There aren't—not yet. But under the law, the state will be authorized to issue as many as 60 dispensary licenses to private operators. The Department of Financial and Professional Regulation hasn't set up all the rules yet, but the dispensaries will be required to be "geographically dispersed throughout the State to allow all registered qualifying patients reasonable proximity and access."

If a patient realizes her chosen dispensary is too far away, doesn't like the cannabis there, or wants to try another shop for any reason she needs to notify the state.

Are 60 dispensaries enough for 16,500 clients?

Advocates disagree.

"In rural areas, where a dispensary could be 30 or 40 miles away, that's going to make it difficult to get to," argues Dan Linn, the executive director of the Illinois chapter of the National Organization for the Reform of Marijuana Laws.

"People are driving hours now to buy the product illegally," counters Representative Lang. "I don't imagine there will be anyone in Illinois who wants this product who has to drive more than an hour for it."

Do I have to smoke or ingest my marijuana at the dispensary? I was hoping to catch Sharknado this weekend—am I allowed to take a little medicine with me?

Registered patients are allowed to carry legally purchased cannabis, as long as they have valid registration cards with them. But use is banned on school property, in cars, and in all other public places "where an individual could reasonably be expected to be observed by others."

And the dispensary is out too—patients aren't allowed to use cannabis there either.

What if I operate a lot of heavy machinery or Apple products for my job—am I still allowed to be a cannabis patient? Or what if my boss administers regular drug tests?

For starters, as the law reiterates, no one should use dangerous equipment or drive a vehicle while impaired.

That said, the law is somewhat muddled in its approach to workplace standards. On the one hand, it bans employers—along with schools and landlords—from discriminating against anyone simply for being a medical marijuana patient.

On the other, it allows employers to implement drug testing or "zero-tolerance" policies, and to crack down on anyone who violates them.

"Even if a patient only uses cannabis at home before they go to bed, they're still going to have it in their blood and would fail a zero-tolerance policy," notes Berlin, the attorney and advocate. "Patients will have to find employers who can tolerate this, and over time employers will have to adjust."

This is 2.5 ounces of marijuana—the amount registered patients will be allowed to acquire from a licensed dispensary every two weeks under Illinois law. That’s in line with many other states that have medical marijuana programs, though several allow larger quantities, and most let patients grow their own plants. In Illinois, only licensed cultivation centers will be allowed to grow. - BILLY P. MOUZÉE
  • Billy P. Mouzée
  • This is 2.5 ounces of marijuana—the amount registered patients will be allowed to acquire from a licensed dispensary every two weeks under Illinois law. That’s in line with many other states that have medical marijuana programs, though several allow larger quantities, and most let patients grow their own plants. In Illinois, only licensed cultivation centers will be allowed to grow.

How much marijuana can I get?

Patients will be allowed to purchase 2.5 ounces of "usable cannabis" every two weeks.

I have a friend—let's call him "Ganja Jones"—who likes to grow his own. If he's a qualifying patient, can he fill his own prescription under the law?

Not in Illinois. Fourteen states allow registered patients or their caregivers to grow on their property, with limits ranging from six plants in Alaska and Colorado to 24 in Oregon. But recently passed laws are more restrictive, and that includes the one in Illinois.

"When I first took this issue on, a bill had passed the Illinois Senate that had grow-your-own in it," says Lang. "I could not pass that in the House."

So only the dispensaries are permitted to grow medical marijuana?

No—the dispensaries aren't allowed to grow it either.

Huh. Something tells me that if they're going to dispense cannabis, they need to get it from somewhere.

It's true—the law allows for up to 22 cultivation centers, licensed by the Illinois Department of Agriculture.

Why 22? Why not a nice round number like 23, or 52?

Illinois has 22 state police districts.

What does that have to do with cultivating cannabis?

Some legislators worried about the marijuana supply growing out of control. To ease their concerns, the law was amended to make it easy for state police to monitor cultivation facilities—so one per police district.

Will 22 grow centers be able to produce enough cannabis for the entire state?

That too is a subject of debate, but based on what's happened in other states, most analysts believe they will. The important thing, they say, is to ensure that those in need of cannabis have plenty of options to choose from. For instance, some don't want marijuana with a high level of THC, the psychoactive chemical.

"I don't need to be recreationally zoned out on my couch eating Cheetos," says Falco, the MS patient. She wants to be able to "go into a dispensary and find different combinations—this is good for insomnia, this is good for spasticity."

What if my friend Ganja wants to go legit—how does somebody get into the dispensary or cultivation business?

Good question. I hope you've got a lot of time and money.

First of all, there are a ton of regulations for sellers and growers. Each "principal agent" and board member has to pass a background check and submit to fingerprinting, and no one can have a past drug offense. The names of all investors and owners in cultivation facilities also have to be provided to the state.

Plus, all marijuana facilities have to provide detailed security plans and set up systems for tracking every leaf and bud that's produced or sold; for cultivation centers, this includes "all cannabis byproduct, scrap, and harvested cannabis not intended for distribution." The facilities have to be open to random inspection from state officials, including the police.

Dispensaries can't be located within 1,000 feet of a school, and cultivation centers have to stay at least 2,500 feet away from schools or residential areas—all but ensuring none will open in the city of Chicago.

And then there are licensing fees.

How much are we talking?

The amounts haven't been determined yet, but the law states that the medical marijuana program has to pay for itself. That means the costs of regulation, oversight, and administration must be covered with fees.

That's not unusual—but it amounts to a high price for a license. In Massachusetts, for example, it costs $50,000 a year for a dispensary license.

So you'll need a lot of money and a clean record to grow and sell legally.

More money than you're thinking. "We get calls from people who say, 'I love cannabis plants and I want to get in.' So we say, 'Do you have a million dollars?'" says Adam Bierman, the president of MedMen, a California-based cannabis consulting firm. "A lot of people like to play golf, but that doesn't mean they should build golf courses."

Bierman estimates that serious entrepreneurs should have access to at least $250,000 in capital to start a dispensary and $1 million for a cultivation center. And it has to be money they have on hand or can raise through friends and investors. Because cannabis is still prohibited under federal law, banks won't lend to growers or sellers, and landlords are often leery of renting space. The security costs are far greater than for traditional retail or agricultural businesses.

And there's at least one other qualification: "You have to get somebody who's pretty ballsy," says an owner of a Michigan dispensary.

That's because the Illinois law expires in four years. Entrepreneurs could pour all kinds of time and money into a cannabis business, only to have the program disappear before they've made their money back.

Oh—and that federal law thing. There's always the chance you could be arrested for participating in a drug conspiracy and sentenced to federal prison.

Surely President Obama wouldn't let that happen in his home state.

It's not that clear—and please don't call me Shirley.

The Illinois law asserts that "states are not required to enforce federal law" and that "compliance with this Act does not put the State of Illinois in violation of federal law."

That's cool.

Yes, but it doesn't necessarily protect medical cannabis users, sellers, and growers.

In 2009 the U.S. Justice Department issued a memo that advised U.S. attorneys around the country not to focus resources on individuals "in clear and unambiguous compliance" with state medical marijuana laws.

Yet a follow-up memo two years later confirmed that the feds would continue to monitor "large-scale, privately-operated industrial marijuana cultivation centers." In the time since, federal authorities have prosecuted the proprietors of some operations in California, Montana, and Michigan.

And because the memos aren't written in stone, it's possible that the busts could get worse. "If Rubio defeats Clinton in 2016, we could have a different policy that says we're going to shut down every single cultivation center," says Gabriel Plotkin, an attorney at Miller Shakman & Beem and former federal public defender. "It creates a really risky thicket."

Yipes.

Stay calm. Analysts still believe the risk of federal prosecution in Illinois is minimal for users and for businesses following state law. "This law is targeted, narrow, and restricted—it keeps things pretty small," Plotkin says. "For those who want to take the risk, there's a real opportunity here."

The availability of edible cannabis products like hard candy will probably increase in the coming years—for both legal and black market sale. - BILLY P. MOUZÉE
  • Billy P. Mouzée
  • The availability of edible cannabis products like hard candy will probably increase in the coming years—for both legal and black market sale.

So there must be a way to make money in medical cannabis.

Yes, says the Michigan dispensary owner—"but not without pain."

He means that it's a difficult venture—but also that it would be a lot easier to bring in a profit if chronic pain were added to the list of qualifying conditions. Currently pain is the leading reason people visit his dispensary in eastern Michigan. All told, it draws 30 to 40 customers daily, and since it's a nonprofit, each one "donates" an average of $100. That adds up to $3,000 to $4,000 a day. Without the business from pain sufferers, the receipts would probably drop by as much as half.

It's not clear how much money is to be made in Illinois. But he's preparing to expand here anyway, since he thinks the opportunities will continue to flower. "We really don't see it going backwards, especially when two states have completely legalized and others are on the verge of doing it," he says.

When will I be able to visit a dispensary?

Though the program is supposed to start on January 1, it will take months, at a minimum, for the system to get up and running. Some interested businesses say they hope to open their doors a year from now, but in some other states the process has taken much longer—in Arizona, for example, it was two years.

I've lived in Illinois for awhile, so I have to ask: what's the government's cut of this?

The state could certainly use some more cash, but "I don't think we know if this'll be a significant source of revenue," says Representative Lang.

Patients will pay a 1 percent tax on the purchase of cannabis, as they would when buying other medications. On the business side, the state will impose a 7 percent tax on cultivation center sales. The proceeds will be used to underwrite the costs of running the medical cannabis program. If any money is left over, it's supposed to be used on crime prevention programs.

What about the politicians themselves? Are they going to make friends with financial benefits in the cannabis industry?

Actually, the law prohibits dispensaries and cultivation centers from giving to political campaigns in Illinois, and politicians are prohibited from accepting them.

Of course, the Illinois law isn't on the books yet, so no part of it has been challenged in court, but many legal analysts believe the contribution ban is unconstitutional.

What's going to stop a dispensary or patient from selling an extra dime bag to a friend?

It could happen, and probably will, but not as often as the stoners next door would like. Dispensaries and grow centers are required to track every speck of marijuana they handle, and anyone who breaks the law risks having his business shut down, his property seized, and his ass hauled to jail for felony drug trafficking. Doctors who sign off on bogus cannabis prescriptions could also face professional discipline and arrest.

More likely is the possibility of leakage from patients who don't use all 2.5 ounces they're allowed every two weeks. Rep Lang isn't sweating it. "There's also leakage of Vicodin and morphine and all kinds of other pharmaceuticals that can actually kill you. I think this worry about marijuana is ridiculous, especially since you and I could go to any high school in the state and buy some."

I can't help but fret a little bit about the pot dealer in my building. Is this going to put him out of business or drive up his prices?

Most experts don't believe the new law will have much of an impact on the black market, especially since the size of the program is expected to be so modest. But if there is some leakage, the marketplace may slowly include more professionally cultivated goods from Illinois and other states. The availability of not just cannabis buds but also products like hash oil, vaporizers, and edibles could increase.

My conservative Uncle Ron says medical marijuana laws just open the door to legalizing pot for everybody. So when can we expect this in Illinois?

Not real soon. It took years to pass this restrictive medical bill.

Then again, Dan Linn of NORML says some legislators are privately saying it's time for much bolder steps. "It would be surprising to have Illinois not start discussing legalization within four or five years."

UPDATE:This story has been amended to reflect the fact that New Hampshire's medical marijuana bill was signed into law on July 23, which would make Illinois the 20th state to create a medical cannabis program.

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