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Monthly meetings of the Rossmoor Medical Marijuana Club typically draw audiences of 100 or more men and women seeking to expand their knowledge of how cannabis might be helpful in coping with some of the health challenges that often accompany aging. The Club’s reputation and audiences have grown steadily over the last five years, and success stories abound; but only recently have we gathered quantitative data to give a more comprehensive picture of medical marijuana use among those who attend our meetings.

This article presents the highlights of a survey of 204 club meeting attendees conducted during the last three months of 2017. Seventy-three percent of respondents to the survey were female, as were 69 percent of those who reported that they are currently using some form of cannabis. This is a little higher proportion of females than even the Rossmoor population. It may suggest that women are a bit more adventurous; however women have long been recognized to be family leaders in healthcare.

Exactly 50 percent of current users are 75 and over and 37 percent are 65-74. Many have wondered whether these seniors who are embracing the use of medical marijuana do so as a result of life-long familiarity with the plant. This survey revealed that only four percent of current users used marijuana often as teenagers and only six percent used it often as adults.

Study results confirmed that the main uses for cannabis are to improve sleep (61%) and to reduce pain (60%). Participants also reported that they use cannabis to reduce stress (37%), for relaxation and pleasure (28%). Twenty-five percent of users are taking some form of medical marijuana to treat a medical condition.

Respondents were asked which method of use they preferred. Only eight percent of users prefer the traditional method of smoking the plant while 15 percent prefer using a vape pen. The most popular cannabis products are tinctures, which are used by 33 percent. Next most popular are edibles. Thirteen percent of users prefer topicals such as balms, creams or ointments.

It is widely recognized that many older cannabis users do not necessarily enjoy the psychoactive effects that are associated with the plant. Among survey respondents a preference for non-psychoactive products was indicated by 62 percent of users. Only 11 percent preferred psychoactive forms of cannabis, but 27 percent of respondents lik

Just how helpful are older users finding marijuana? Given the complexities of finding the right form of administration and the right dosage, we were surprised to find that 94% of users reported that they find medical marijuana helpful, with 53% finding it “very helpful.” Only 6 percent found that it was “not at all” helpful.

Those who use marijuana to assist with sleep were significantly more likely to prefer edibles and tinctures than those who use marijuana for other purposes. Those who use marijuana to relax and for pleasure are much more likely to say that they prefer to vape or smoke rather than using marijuana in other forms. The widest range of methods of administration are reported by those who use medical marijuana for pain, with tinctures, edibles and topicals being particularly popular. Uses for this purpose take all, and often multiple forms, often apparently depending on the type and location of the pain.

The six percent of respondents who indicated that marijuana has been “not at all helpful,” and some of those who have found it only “somewhat helpful” offered a variety of reasons why they have not had more success. These include difficulties finding the right delivery method, finding the right product, difficulties finding the right dose, or some combination of all of these. In addition, some respondents reported cost to be a barrier. These responses cannot be meaningfully quantified because of their small numbers and often overlapping reasons. It is likely that these respondents are still in the process of figuring out the best form and dosage since they are continuing to attend club meetings.

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Most local cities—in fact, all cities in Contra Costa save for Richmond—have imposed bans, extended moratoriums, and have expressed concerns about the permitting of local cannabis businesses, despite that California voters overwhelmingly supported legal access to medicinal cannabis in 2015 and legal access to adult-use cannabis last November.
Because of these bans, cannabis patients in Contra Costa County (starting 1 January 2018) will likely be forced to drive to or order delivery from companies in Oakland, Berkeley, Vallejo, or Richmond. Many companies in these cities do not deliver to Contra Costa County. Those that do deliver charge a premium for the service ($10-$15 delivery fees) and require minimum order amounts. Add on the 15% excise tax that will be imposed on all retail sales (you can avoid the 15% tax if you pay $100 annually for a State ID card), and you can expect a delivery of a $16 tin of 5mg chocolate blueberries to cost about $34.

How did we get here?

In 2015, the California State Legislature passed a series of bills collectively called the Medical Cannabis Regulations and Safety Act (MCRSA). And last November, California voters passed Prop 64, the Adult Use of Marijuana Act (AUMA). In June, the California State Legislature approved a bill to merge these initiatives into a single set of regulations called the Medicinal and Adult Use Cannabis Regulations and Safety Act (MAUCRSA).

After 20 years of an unregulated system, California will finally implement a state-governed regulatory system that oversees all aspects of the industry, including: cultivation, extraction, manufacturing, testing, distribution and delivery, and taxation. These new laws address important regulatory and safety issues that the industry has needed for a long time.

However, this first iteration of these regulations is seriously flawed and presents barriers of access for the very people the regulations should protect. Some of these regulations cause undue burdens on the companies who are currently compliant with state law. For example, there exists a requirement that, effective January 1, all cannabis companies must have express permission from their city of origin to legally operate a cannabis business.

At first blush, this seems a reasonable requirement—all businesses require a local business permit. In the cannabis industry, however, it is a death knell to most cannabis businesses east of the Caldecott tunnel.

Here’s why:

Before the end of the 2017 calendar year, cities currently have three options for regulating cannabis:

Option 1: Allow local cannabis companies to exist by issuing city-designed business
licenses and by establishing local regulations.
Option 2: Establish no local regulations and allow the State regulations to govern local
cannabis laws.
Option 3: Enact a city-wide ban and prohibit cannabis companies from operating in
the city.

Option 1 represents a considerable amount of work for a municipality. To enact local cannabis regulations, a city must create a local regulatory system to determine:
• The types of businesses allowed (for example, store front dispensaries, lab testing, or commercial cultivation)
• The number of licenses to issue for each type of business
• The locations available to these businesses
• The requirements, fees, and qualifications necessary for obtaining a license

Most city councils argue that they simply do not have enough time to implement this type of regulatory structure, especially when the State has not issued its final draft of regulations yet.

Option 2 is undesirable because cities and counties do not want to abdicate power to the State, lose the ability to enforce more restrictive regulations, and lose the opportunity to collect taxes.

That leaves Option 3, which is the least threatening and easiest way to respond to the state-imposed deadline and is why cities across California are enacting bans and moratoriums.

Unfortunately, many city councils have very little first hand knowledge about using cannabis to treat age-related and chronic illness. This lack of education fuels a reluctance and enforces misperceptions despite data that demonstrates the positive impact of a local cannabis industry, including lower incidents of DUIs, violent crimes, suicides in young men, and opioid-related overdoses and deaths1, 2.

We know that cannabis prohibition doesn’t work. It fuels the black market and prevents access to the responsible people who need these products. It’s critical that Contra Costa County residents continue to have access to locally-based cannabis services.

There is still time to affect change. Call and write to your civic representatives and tell them you want to receive products and services from companies that are licensed locally. If they tell you that you’re allowed to have your products delivered to your home, let them know that is not good enough. We voted for access to legal cannabis. Driving to Oakland or paying exorbitant prices to delivery companies located in different counties effectively limits our access.

Consider this: cannabis is far safer to ingest than NSAIDs (conservative estimates have reported 3,200 deaths annually as a result of NSAID-induced GI bleeding; 0 deaths annually are attributed to cannabis) 3. What if similar restrictions and requirements were placed on ibuprofen? What if you had to drive to Richmond every time you needed to buy Advil? Or spend an additional $15 per bottle to have it delivered? Does that seem reasonable? We don’t think so.

1 Trilling, David. “Marijuana Legalization: Research Review on Crime and Impaired Driving.” Journalists Resource, 23 Sept. 2016, https://journalistsresource.org/studies/society/drug-policy/marijuana-legalization-crime-driving-research

2 Armentano, Paul. “The Five Biggest Marijuana Myths and how to Debunk Them.” Freedom Leaf, 12 July 2017, https://www.freedomleaf.com/five-biggest-marijuana-myths/.

3 Krueger, Courtney, PharmD, BCPS, “Do NSAIDs Cause More Deaths Than Opioids?”
https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/ask-expert-do-nsaids-cause-more-deaths-opioids

The exhibit, open through September 25, 2016, is intended to encourage conversations and deeper understandings of a topic that is having increasing impact on our communities and our state. It does not promote any particular viewpoint related to marijuana use, but is timely because the question of legalization is one expected to appear on the state ballot in November. As Rossmoor resident, Jerome Neuman, noted,” The exhibit was quite wonderful! And it was neutral; they weren’t selling it, but rather simply getting you thinking about so many issues. I don’t think I’ve ever seen a more stimulating museum exhibit!”

The history of marijuana use is a major focus of the exhibit, covering changing images of typical users, particularly in California over the course of the 20^th century; the changing political context and legal status; scientific research especially on medical uses; economic implications; and perspectives on the plant’s relationship to creativity and spirituality. There is also a section on “Youth and Weed.” Multimedia exhibits include a variety of opportunities for visitors to share their personal experiences and voice their opinions on various aspects of the topic.

Museum goers learn that hemp and medical cannabis are the same species that has been bred for different purposes. One strain, cannabis Sativa, was used in India for thousands of years before it was brought to the Caribbean by indentured servants in the 1800s and from there to North America. Another strain, Indica, came directly from Afganistan in the 1970s. Both contain active compounds known as cannabinoids that are responsible for marijuana’s effects on the body. The most well studied of which are THC and CBD.

Many were surprised to learn that marijuana was sold in drugstores and could be ordered by mail here until California became the first state to outlaw marijuana in 1913, fourteen years before the Federal Marijuana Tax Act outlawed it at the Federal level. Criminalization, the exhibit indicates, historically has been intimately linked with racism. Mexican Americans, African Americans and even those of Arab heritage were identified with its proliferation from before the turn of the 20^th century, and often disproportionately persecuted and prosecuted for possessing it. Pie charts and maps make it clear that even today, despite comparable usage across ethnic groups, and reduced penalties, African Americans in California are many times more likely to be arrested for possession of marijuana, than those of other ethnicities.

In 1980, presidential candidate Ronald Reagan expressed the belief that “Marijuana, pot, grass, whatever you want to call it, it is probably the most dangerous drug in the United States.” By 1994, former Domestic Affairs advisor for President Nixon, John Erlichman, admitted, “By getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities …Did we know we were lying about the drugs? Of course, we did.” This admission may have helped California pass a statewide medical marijuana law in 1996, but much of the current greater acceptance of medicinal marijuana is attributed to AIDS activists who used it to help them tolerate the harsh side effects of treatment medications and promoted passage of the 1996 bill.

The exhibit makes clear that times have changed since the emphasis was on the “insanity, disgrace, and horror marijuana can bring to its victim.” Today, California treats marijuana like a parking ticket. Those caught with small amounts of marijuana get a fine of less than $100. In Oakland, the exhibit informs viewers, local law tells police to leave cannabis users alone, but adds, “everywhere in the US users are treated differently by law enforcement depending on who they are and what they look like.” Four states, Alaska, Colorado, Oregon and Washington have legalized marijuana possession; 15 more have decriminalized it, and 19 permit medical use.

While California is predicted to be next on the list of states legalizing recreational cannabis use, the exhibit makes it clear that such a change would require myriad additional decisions regarding regulation of packaging; labeling; advertising and marketing standards; taxation; and allowable modes of distribution. Even without legalization of recreational use, CA produces and sells more marijuana than any other state in the US. and Harborside Dispensary is Oakland’s largest taxpayer after the Port of Oakland.

The plant is becoming more widely accepted as a medical treatment with particular success in reducing pain, controlling nausea and aiding sleep. The exhibit informs us that “There are no studies yet that show marijuana can treat cancer in humans. A few early studies show that marijuana might prevent tumor growth in rat or cells in a lab, but much more research is needed.” Federal law has seriously impeded such research, but legal trends suggest this may soon change.

Clearly, as the exhibit shows, public images of marijuana users have changed dramatically over the course of the last century. Depending on the era, Californians have pictured marijuana users as dangerous criminals, avant-garde artists or enlightened free thinkers. Judging from the busload of Rossmoor residents attending the exhibit, the dominant image in the near future, whether of medical or recreational users, could be the kindly respectable grandparent.