Category Archives: Uncategorized

Just Where Exactly did that 9% Dependence Figure Come From

2014-01-27-drew_hart_cnn-thumbWe recently attended a screening of the relatively supportive documentary WEED, by Dr. Sanjay Gupta. It cites, and spends a great deal of time repeating the often cited statistic that 9% of marijuana users become addicted to marijuana. Likewise, today’s paper includes an Op-Ed by Kevin Sabet of the prohibitionist group Project SAM that repeats this dubious claim. If you hear that figure and think that it sounds high, you’re right. Here’s an excellent piece by doctor Sunil Aggarwal explaining the faulty science behind it.

The truth is that this study was done in 1994 by the anti-drug government body NIDA, and involved asking self reported “cannabis users” a series of questions like “do you often spend a long time on activities necessary to get the substance, taking the substance, or recovering from its effects?” If people answered yes, they were coded as cannabis dependent, whether or not they considered themselves dependent on cannabis. Even more importantly, people who infrequently used marijuana would be much less likely to identify themselves as cannabis users, especially in the early 90’s when it was much more strongly stigmatized than it seems to be today. Let’s get rid of this particular piece of “data” when we talk about marijuana.

Big Island Public Hearing

You may know that the dispensary task force has recently done a public hearing in Hilo, on the Big Island. This was a forum for people to give their input on what they need in a dispensary system. If you want to watch it, it is available here:


A Media Frenzy About the Dispensary Task Force

The Dispensary Task Force had its September meeting (there will still be two Public Input Hearings later in September) and it has been getting a lot of media attention.

Here’s a smattering of it, in no particular order:

This piece on KHON2, this piece from the Hawaii Independent, this excellent story from Chad Blair on Civil Beat, and this front page story from the Star Advertiser.

There were also stories on the Hawaii Public Radio, and on KITV and Hawaii News Now:

These stories don’t get it all right. One major source of confusion was about the report. The Legislative Reference Bureau (a group that does research for the state government) presented a report to the task force at the September meeting, but some news outlets seemed to think that this was instead the report that the Task Force is working on.

Other media outlets got confused about the types of hearings. There are two “public input hearings” in September on the 10th and 24th in addition to the regularly scheduled Task Force meeting on Sept. 9th.

Still, despite these oversights one thing stood out about all of these reports: they approached the topic with compassion and support. Maybe the tide is turning on dispensaries, especially as more and more news outlets start carrying this story: at the end of the day, dispensaries are about compassion for the sick. I’m glad that message is starting to come through.

Legislative Reference Bureau Releases Report on Medical Marijuana

The Legislative Reference Bureau has just released a new report entitled “Is the Grass Always Greener” that outlines features of Medical Marijuana programs in other states and how we can adapt them to Hawaii. This report will be one of the things that the Dispensary Task Force will consider when it makes its recommendation about dispensaries in Hawaii.

This report has been getting a certain amount of attention. Here’s what Chad Blair of Civil beat has to say about it.

Here’s what Henry Curtis of Ililani Media had to say.

Hawaii News Now also ran a piece about the report, emphasizing the fact that even 14 years later, there is still a great deal of uncertainty about the program and still no dispensary system in Hawaii. It is past time for us to put patients first.

Anyone who has the time, and I recognize that it can take a while, should give the report a read, and let us know what you take away from it.

Story from a Hawaii Patient

As you may know, we recently had to postpone an upcoming talk story event. I asked patients to write me an email if they felt like sharing their stories electronically. Here is one:

idonotuseittogethighI am 75  yrs old. My knees were very bad. I was using a cane and I was considering a walker. I started using marijuana oil on my knees. I applied the oil and wrapped my knees in plastic for about 2-3 hours. First it was daily, then every other day, then twice a week then once a week then twice a month then once a month. Now I don’t have to do it at all. I walk normally AND I can climb up and down stairs with out a problem.

Two months ago I was diagnosed with breast cancer. While I was waiting for my surgery, I used marijuana leaves and buds in a fruit smoothie every day for three weeks.

My tumor was 7mm at diagnosis and was 5mm when removed. I wish that I could have taken it for the whole time to see if it would have shrunk even more.

The problem I have is that I live on my meager Social Security. Because of the current legal status, the cost of the  license and the cost of the product are a real burden. I do not smoke it.

I do not use it to get “high”. I use it to get well.

If you would like to share your story, contact us.


Harm Reduction Conference Registration is Now Open!

Harm Reduction 2014: The Tipping Point  November 7, 2014

HFH-Symposium1_zps12de066eRegistration for this excellent conference put together by our friends at CHOW project is now open! We’ll be putting together a breakout session on marijuana. It should be an exciting and informative day!

Click here to register or learn more.

8:00 – 4:30 Friday, November 7th 2014

Honolulu Community College

Harm Reduction

Harm Reduction is a philosophy and set of strategies for working with people engaged in potentially harmful behaviors. The main objective is to reduce the potential dangers and health risks associated with such behaviors, even for those who are not willing or able to completely stop.  Harm reduction uses a non-judgmental, holistic and individualized approach to support incremental change & increase the health and well-being of individuals and communities.

The Tipping Point

The tipping point is the time when many small changes become significant enough to create larger, more important changes. Many in Hawaii and across the country feel we are at the tipping point in our response to drug use, drug users and recovery. A collaboration of service providers, community organizations, and concerned citizens will convene for a one-day interactive conference to discuss ways of developing more holistic and culturally appropriate evidence-based interventions in the context of harm reduction practice.

Conference Topics Include:

  • Housing first, homelessness & drug use
  • Harm reduction and recovery
  • Trauma informed care
  • Youth and drug use
  • Marijuana and medicinal cannabis
  • Drugs and sex work
  • Prescription drugs and overdose
  • Self-care for harm reduction workers
  • Kupuna and drug use
  • Overview of harm reduction

Conference Partners Include:

AIDS Education Project * AIDS Community Care Team * Community Alliance on Prisons * Drug Policy Forum of Hawai’i * Gay Straight Alliance Hawai’i * Gregory House Programs * Hale Kipa *Harm Reduction Hawai’i * Hawai’i Appleseed * Hawai’i Department of Health’s Injury Prevention and Control Section * Hawai’i Department of Health’s STD/AIDS Prevention Branch * Hawai’i Island HIV/AIDS Foundation * Hawai’i Pacific University’s School of Social Work * Hawai’i Public Health Association * Hawai’i Youth Coalition * Hawai’i Youth Services Network * Hep Free Hawai’i * Hepatitis Support Network of Hawai’i * Hina Mauka * Kawai Foundation * Life Foundation* Mālama Pono * Maui AIDS Foundation * Mental Health America of Hawai’i * Planned Parenthood of Hawai’i * University of Hawai’i at Mānoa John A. Burns School of Medicine, Department of Psychiatry * University of Hawai’i at Mānoa School of Nursing and Dental Hygiene *Waikiki Health Care-A-Van Program




The Struggle Between Employer Drug Testing and Legalized Marijuana

Read the full story at the fix.

Acon_marijuana_drugtest_DTH114There are a lot of problems that we in Hawaii will need to deal with that surround medical marijuana. Employer drug testing is one of them. We have reported in the past about the case of Brandon Coats, an employee of Dish Network, who was fired for his off duty use of legal medical marijuana. This must be a reminder that we need to be vigilant about protecting patient rights as they are affected by laws and policies outside the medical marijuana program.

A Tale of Two California Dispensaries

A report by Kat Brady, Vice President of the Drug Policy Forum of Hawaii.


Submitted by Kat Brady

Vice President of Drug Policy Forum of Hawai`i

Key points:

  • CA has 215 Dispensaries
  • All Dispensaries in CA are nonprofits – AG opinion
  • Patients are allowed to grow (by county ordinance)
  • San Francisco has 28 Dispensaries (some on the same block)
  • Local law enforcement has been assisted in solving neighborhood crimes
  • Caring about the communities they serve has led to the success of these two dispensaries.




Peace In Medicine – Sebastopol, CA

In preparation for a trip to California, I made arrangements to visit a medical marijuana dispensary in Sebastopol called Peace In Medicine* that has been operating since 2007.

On Tuesday, July 22, 2014, I walked into the facility that resembles a doctor’s office and is located in a house-like building with a porch/lanai in the back. I was greeted very professionally by a woman who asked if I was a new patient. (If I were, the process would be to hand over my identification and my doctor’s recommendation, which the receptionist would then verify by calling the doctor directly while I filled out what looked like a standard new patient questionnaire).  After verification, the person is given the Peace In Medicine member handbook.


The reception area has a literature table with all sorts of information about community events, yoga classes, and other helpful information.  The staff understands that some people may be nervous about entering a dispensary therefore it is set up as a warm and welcoming environment where everyone wants to help the patient find the best relief for their ailments.

I asked many questions about how they got started, the type of dispensary Peace In Medicine is (for-profit, non-profit or government-run), and their interactions with the community and law enforcement. I learned that an AG’s opinion states that all dispensaries in CA are non-profits.

California has 215 dispensaries and allows patients to grow on their own medicine as well. The California system is set up to protect anonymity. This led to the question of why the Hawai`i Department of Health would need a database when the recommendation could be verified with the patient’s physician, especially when Hawai`i’s Constitution is particularly strong on privacy.

Peace In Medicine has no cap on the number of patients and to date have approximately 60,000 patients. All patients must be at least 18 years old. This is verified by requiring identification and a state recommendation in order to enter.

How do they find/hire staff for the various aspects of Peace In Medicine? The person must be presentable, articulate and pass a complete background check. I asked if they would hire a person with a felony conviction. They replied that after a complete check to determine that the person would present no problem, they would.

After meeting with the knowledgeable administrators of the facility, whose backgrounds are in health administration and biology, we were taken through the entire operation.

First the retail section that is behind a locked door and not visible from the reception area. Inside the retail area they had two counters with product. Each sample is labeled to educate the patient on the health effects of each strain (i.e. addresses nausea, reduces swelling, etc.). There is also plenty of information on a bookshelf, such as:

  • About Lab testing and information about CBDs
  • Ask Your Doctor if CBD is Right for You
  • Understanding the Effects of Cannabis on the Your Body and Mind
  • The Endocannabinoid System
  • Eating Cannabis for the First Time
  • Literature on Terpenes with a Chart
  • Literature on Cannababinoids

Next there is the weighing room where two employees are responsible for weighing, packaging and labeling the products after they are received from the quality assurance/quality control division.

Product that is brought in is tested in a lab and then goes through another series of tests. We asked how many samples of products they receive and how many of those are accepted. The answer was for every hundred products they receive and test, only 5 or 6 are accepted.

Next was a tour of the farm from which Peace In Medicine receives about 30-40% of their product. The farm is behind a security gate. This extremely well-run farm has several greenhouses growing different strains of cannabis. The law is posted on big boards in every greenhouse. When applicants are interviewed they are asked if they know that cannabis is still illegal in federal law. We were told that all employees responded that they believed in the plant to help people and they were willing to take the risk.

What was most impressive was the professionalism of both PEACE IN MEDICINE Dispensary and the farm. Everyone understood what their role was and could articulate their responsibilities clearly and concisely. This kind of openness was refreshing and non-threatening for patients of all ages.  We observed a very diverse clientele while at the Dispensary.

Peace In Medicine also has another dispensary in Santa Rosa that has been in operation since 2010. Both PEACE IN MEDICINE locations have established themselves as a vital part of their communities by participating in community events (tabling, booths) and supporting the community in various ways.

SPARC_BRANDMARKSan Francisco Patient & Resource Center (Sparc) – San Francisco, CA

 San Francisco has 28 dispensaries. We asked the people at Peace In Medicine for an introduction to a dispensary in an urban area and they were kind enough to make an appointment with the manager of the sparc dispensary.

This dispensary is right in the heart of San Francisco on Mission Street. It has won architectural awards for its clean and spacious design. The goal was to make it a welcoming place that women would not be afraid to enter alone.

There is a gentleman who sits outside the dispensary (a nice looking storefront) to check the identification and cards of the patients. Once admitted, the person is greeted at the reception desk by a welcoming staff member. If new, the patient is given a new patient form to fill out while the physician’s recommendation is verified. After verification, the patient is given the sparc member handbook.

Then the patient proceeds to one of the three identical retail counters where the product is displayed with signs revealing the THC percentage and the CBD percentage of the different strains of cannabis. There are a range of other cannabis products like creams and salves and edible products from chocolate bars to mints and cookies. All packages are labeled with instructions and the THC content.

Like Peace in Medicine, sparc receives many samples of different strains and after extensive testing, accepts only 2 or 3 products to sell.

Unlike Peace in Medicine, sparc allows patients to use the product on site.

The atmosphere is professional (although different from the doctor’s office style) and the dispensary is clean, well-managed by a person who understands the mission and marketing of this medicine to patients, with a staff that is trained by Americans for Safe Access. We were told that they pay a living wage, provide health benefits, and every employee enjoys a day off on their birthday.

A few doors down from sparc, there is a dispensary in another storefront with blacked-out windows and a grate in front; completely opposite from the clean and professional sparc dispensary.




It was important to see two different types of dispensaries and in two different locations. Both of these dispensaries are well-run and very professional with committed and knowledgeable staff who want to help patients get the relief they are seeking.

The claims about increased crime and drug use that Hawai`i’s law enforcement has been touting appear to be centered in Los Angeles before any regulations were in place.

When asked about the interaction with law enforcement, both of the dispensaries we visited, said that their relationship was very good because they followed the letter of the law. Both even said that the police have used their video surveillance cameras to help solve crimes in their neighborhoods.

Both dispensaries emphasized that their product was from local farmers.

Dispensaries in Hawai`i, sourcing product from small local farms could be a big boon to Hawai`i’s small farmers.  As the farm we visited made clear, this is an agricultural product just as anything else sold at a farmer’s market. It takes science, knowledge, and a commitment to make it work.

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Israeli Study Shows Cannabis is a Good Way to Treat PTSD

You can read a story about the study at Medical Jane, or if you’re feeling academical, take a look at the study itself.

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This is certainly an interesting study. We in Hawaii currently have no psychological or psychiatric disorders on the list of conditions that can qualify for a medical cannabis recommendation. This is clearly wrongheaded.

Moreover, this is not the only study supporting the claim that cannabis is an effective treatment for PTSD. Another study, with a much much larger group (this israeli study only had 10 participants) has stalled after one of our nation’s only medical marijuana researchers was fired for political reasons.

This study is good, but it is only enough to tell us we should learn more about how to treat PTSD with medical marijuana. This is one of the most compassionate uses for medical cannabis, and it is shameful that we know so little about how it works.