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Home > Podcast > The Fight for Legalization — and Access
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10 min

The Fight for Legalization — and Access

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Twelve states will vote on cannabis legalization measures this November. Those ballot measures — and the momentum that has given a majority of Americans legal access to cannabis — don’t come out of nowhere. Groups like Americans for Safe Access have played a huge role in the cannabis legalization that has taken place over the past two decades.

But legalization isn’t the end of the story. Just because it’s legal doesn’t mean everyone has access. “There’s lots of patients that don’t even qualify to access cannabis in their state even though there’s a medical program,” Executive Director of Americans for Safe Access Debbie Churgai explained on The Cannabis Enigma podcast. 

From employees subject to drug testing to some minors to geographic restrictions to cost, there are a number of reasons why medical cannabis could be out of reach. “This medicine is not going to be accessible to everyone until insurance can cover it,” Churgai said, and that’s something ASA is working on.

Ultimately, two things will make federal legalization or descheduling more likely, explained Dustin McDonald, ASA’s policy director, education and pressure on elected officials, but more importantly, expanding the map of states that have legal cannabis programs.

“As we look at more controversial policy issues, whether it’s cannabis, whether it’s same sex marriage, the state and local governments tend to be the laboratories of democracy producing a lot of those reforms ahead of broad, full-scale federal action that addresses a more comprehensive top down approach,” McDonald explained.

The Cannabis Enigma Podcast is a collaboration between The Cannigma and Americans for Safe Access. This episode was edited, mixed, and produced by Michael Schaeffer Omer-Man. Music by Desca.

Full transcript:

Michael Schaeffer Omer-Man:  With me are Dustin McDonald and Debbie Churgai of Americans for Safe Access. Thanks so much for being with us today.

Dustin McDonald:  Thanks for having us.

Michael:  So I wanted to start by talking about all of the legislative and legal developments on the horizon. Um, but first I was hoping you could lay out, Dustin, I guess everything that’s changed in the past decade, you know, where are we today and, and how did we get here?

Dustin:  Well, it’s a huge question. And obviously there’s been a lot of activity that occurred over the last 10 years. At this point, you have 47 states that have reformed their cannabis policies to extend access. Initially in many cases to medical, some with limited medical models that mostly provide a limited access framework to CBD products that have low volumes and THC in them to full-scale medical, comprehensive medical regimes, that organized licensing for cultivation manufacturing, testing distribution, retail, everything to organize a full scale supply chain and delivery support system to provide a wide array of cannabis products to patients.

And that’s significant. That’s huge change across this country as we look at more controversial policy issues, whether it’s cannabis, whether it’s same sex marriage, the state and local governments tend to be the laboratories of democracy producing a lot of those reforms ahead of broad full-scale federal action that addresses a more comprehensive top down approach, which is the way our systems, a law, of laws are organized.

So now you’re starting to see in response to the state activity, to the local activity that’s occurred over the last 10 years on this, a pivot in Washington, D.C. to also focus on these issues over the last couple of congressional sessions, you’ve seen some pretty phenomenal things occur between just the volume of legislation introduced dealing with cannabis policy reform has increased as well as the content of that legislation.

It’s much more specific about what exactly needs to be changed. And there’s more of a, there’s more, there’s more of a discussion among advocates driving the reform agenda in the district among Capitol Hill lawmakers who are champions of this reform on exactly what the comprehensive framework of cannabis policy reform should look like at the federal level, thinking through everything from the regulatory framework, which ASA has some keen ideas on what that should look like as well as all the specific components, everything from housing and employment discrimination and ensuring that patients and adult use consumers may maintain a level of access that is a punitive, um, and, and reforming those laws associated with discrimination for possession use and stale and associated punitive measures to what the entire regulatory frameworks should look like, that will be the backbone supporting and overseeing this industry and how it operates and how it treats consumers.

Um, it’s a pretty, it’s a pretty huge conversation when you break down all the policy verticals and associated components, but I think that’s what we’ve really seen as exciting over the last 10 years is that Herculean effort and tireless effort by advocacy groups like ASA that regardless of what was going on politically maintained a focus on driving reform that we’re seeing the fruits of, bear out now.

Michael:  I imagine that a lot of that interest in DC happens because, you know, Congress people are representing constituents, business constituents in states where there is a proper cannabis economy where people have access, where the benefits of medical cannabis and, uh, perhaps, um, you know, the, the demons, um, that and stereotypes that, that were, that were prevalent before have been shown to, to not be quite as extreme if, uh, if real at all. Um, but I’m wondering what percentage of Americans have access to, to cannabis today, medical or recreational. And let’s just separate it by saying with THC

Dustin:  At this point, you’ve got the majority of Americans, I think it’s over 60%. I don’t recall that figure off the top of my head, but I believe it’s sort of sixty s- 60% of Americans now have access through their states. Again, you’ve got 47 states in the district online with medical access in some form, and then a webinar. Those markets also have adult use layered on top expanding the volume of constituents that are able to utilize cannabis in their home state. And to your point, exactly imposing pressure on Washington lawmakers, to be responsive to those constituents and their states, because in the end, it’s not just about possession and use. It’s all a- also about how states have organized these models, which are full scale commercial models.

Um, there’s legitimate licensing regimes providing businesses with an opportunity to grow their workforce. So we’re talking about jobs, we’re talking about business tax payments made to states as well as individual tax payments that emerge from those jobs. So you’ve got a full scale economic engine in the cannab- in the world of cannabis that lawmakers are now kind of waking up to and educating themselves on and through the resources that in the work of groups like ASA are getting a, a true understanding about what medical cannabis is about, what the real applications are to health conditions, what the framework should look like for organizing sufficient oversight, the regulatory structure for those things, all that’s being born out of the work done at the state level.

And we’re going to see a lot more of that happen at the federal level, with that dialed up pressure. I know going into November, you’ve got 12 states with ballot initiatives that will expand that map to assuming those ballot issues are successful. You’re going to see states online who’s, who’s federal lawmakers were not engaged in this conversation previously, but who now will have to be.

Debbie Churgai:  And can I just cut in here? I want to also mention that while it may seem like most of the country has access, um, what the reality is, is even though all these states have some form of a medical cannabis program, there are so many patients and potential patients that still don’t have access. Um, we have a campaign called no patient left behind, which kind of focuses on those patients that, um, still don’t have access.

We’re talking about federal employees because it’s not federally illegal. They’re not allowed, um, access to cannabis, uh, veterans, people, um, in states that have r- qualifying condition lists. There’s lots of patients that don’t even qualify to access cannabis in their state, even though there’s a medical program, um, employees that are subject to drug testing, patients in hospice centers, treatment centers that may be federally funded. Minors in school. Um, people living in poverty, people that can’t afford access, um, you know, most of the, the country, uh, live in areas that might not have access because they can’t afford it or because of these other state by state restrictions.

Um, so even though it may seem like the country is, is full of access, there are these pockets of issues that we here at ASA are still working on, um, to make sure that everyone in the country not only has access, but has, you know, equal access, no matter where you live.

Dustin:  That’s a really good point, Debbie. And one that I’d like to double down on a little bit, while you’ve got all this huge proliferation of state policy models that are attempting to extend medical access to patients. Most of those frameworks don’t function very well. There’s a lot of modifications that states need to make over time to make those systems work. And oftentimes what we see happening or states wait into the world of cannabis policy through, through a limited medical model that then is os- often expanded to a comprehensive medical model at which point adult use ballot initiatives are entered into the policy equation in that market.

Those ballot initiatives, while expanding the level of access to non-patients tend to be disruptive to policy models designed for medical access because those models are often being built cumulatively over time. Um, and when you layer on adult use, the ballot initiative mechanism forces lawmakers to have to address the ballot initiative in the next cycle, uh, the, the initiative forces, the legislator if you ever work on the adult use piece and set down the medical piece where they start working out all the kinks on the adult use piece.

Um, so it can be challenging to maintain those models in a functional way. Um, and even ensure that they’re, they’re working at all. You see a number of states where that conundrum exists. Um, that’s a function of either insufficient policy, organization, or insufficient policy implementation. And sometimes there are other issues ex- existing like in some states there are laws that are codified or there are rights and responsibilities that are codified in state constitutions, like local control over zoning and land use that’s preventing local governments from really lifting their part and licensing cannabis, medical cannabis, retail businesses, so that patients have access.

Local governments that have this responsibility oftentimes are less concerned about issuing licenses for supply side operators, production, cultivation, manufacturing, lab testing, even distribution. But when it comes to medical retail, where patients can actually secure legal access, most local governments are reluctant to introduce that into their communities, leaving patients with few options with the illegal market.

Michael:  So I want to go back to the federal question, but also address some things that both of you said right now. Um, one of the biggest issues that we hear about is the issue of banking and cannabis, you know, and I assume most places in the US it’s still primarily a cash business because banks are federally regulated and therefore they’re afraid to, to do any business in the cannabis world. First off, you know, if there’s anything you can tell us about that, but also what impact does that have on other issues like access, you know, for instance, the prospect of there being insurance reimbursements for medical cannabis or, or other issues, you know, housing and, and the other things that, that are standing in the way of access for, for a lot of Americans.

Dustin:  Banking is a huge challenge across the industry. Obviously, they’ll… It’s not so much the inability of cannabis industry participants to do business with banks. Certainly banks have the freedom to do that under existing federal laws. It’s the risk tolerance that banks are willing to assume in extending those services. So you see credit unions and others waiting into that space more wholly than you do traditional, um, financial in- institutions like banks, but ultimately, you know, in dealing with that issue, providing… First off in enabling industry participants to utilize banks, you remove, removing a huge public safety issue that’s born out in a lot of communities because of the lack of access, you, in some markets actually have bands organized gangs who target cannabis businesses to try to rob them because they know that they’re operating on cash.

Those problems can be addressed through a federal, uh, for, through, through federal legislation that would address the problem like the SAFE Banking Act. Um, but then obviously there’s a trickle down effect as all that goes. If, if a retail, if a cannabis retailer cannot bank, then that means that customers coming into their store also have to do business all in cash.

That becomes a burden on medical cannabis patients, both in, you know, additional trips having to go to the bank to get cash before you go to the dispensary, or let’s say you get to the dispensary and they have an ATM inside. Well now you’re being up-charged the premium. So you can have cash to conduct that transaction. So that’s a challenge there as well. So I think, you know, overall the, the lack of ability to, the lack of capability to utilize traditional financial services, that’s really being carried by this industry trickles down on adult use consumers and patients alike. And it’s an, it’s an issue that needs to be addressed for sure. I know Debbie may have some specific thoughts though, on the, on the insurance piece.

Debbie:  Well, yeah, that is a huge thing, uh, that really separates the medical program from adult use. Um, I know a lot of people like to say it’s the same thing, but we are really hoping that insurance, um, will eventually cover cannabis as a medicine, as it covers other medicine. Right now, um, there are some states where, uh, insurance will cover the cost of the doctor visit or the cost of the medical cannabis card.

Illinois has a program where, um, if you get an opioid prescription, you can turn in that prescription for a medical cannabis card. So you don’t have to pay for the card. Um, but the cost of the medicine is still on the patient. And so we are working with some insurance companies, we’ve been doing this for years. And about two years ago, we had a big meeting just to talk about insurance and we called it our five-year plan. So we have about three more years to work on this, but we are, we are trying to work with insurance companies, uh, to see what we can do to get that covered. ‘Cause that is a really important piece for us. Uh, this, this medicine is not going to be accessible to everyone until insurance can cover it.

Michael:  Well, one last question about the federal legislation and how that, how that works. And actually from, I want to ask it from the other direction, which is to what extent does the prospect of descheduling or rescheduling or legalizing or decriminalizing cannabis on a federal level depend on public perception and opinion and attitudes and, and smaller changes as you were saying, you know, everything is local, but you know, what, what needs to happen for that to happen? You know, what, what education, what, um, what, what perception, what changes in perception need to, need to occur before we can even begin to, to think about that in a realistic way.

Dustin:  I think he touched on a huge issue there when you raised perception, as it pertains to how perception among consumers and constituents ultimately influences the outcome of full-scale federal policy reform that results in rescheduling or descheduling it’s specifically perception and stigma that drive any issue and get it to resonate with lawmakers. And I think with respect to this issue, you’ve got 80 years of federal demonizing of cannabis that trickled down across state governments and local governments. As you look at the state by state prohibitions imposed on cannabis, possession, use and sale from 1913, all the way through the seventies, um, when you had full-scale federal, um, war on drugs, really get going.

It’s been, it’s been a steady trickle of driving at that perception that cannabis is really some kind of devil plant or something, but we all know that, that’s not true from all the research and sciences out there, patient experiences. So I think that’s exactly, yet it’s changing that perception. It’s changing that stigma in people’s minds, and that comes over time. It comes with a tremendous amount of dedicated education. Some groups like ASA, who can meet directly with lawmakers and their staff at all levels of government explained to them what the benefits of cannabis as a medicine are, um, provide them anecdotal evidence and information, demonstrating utility of cannabis as a medicine, discuss all the policies that states have organized, what’s working and what’s not working.

Um, there, there’s a lot that can be done there and that is being done there, but ultimately it will be an expansion of that map to weave in some federal lawmakers that aren’t engaged in it’s, this discussion that we need engaged in this discussion. And we’ll ultimately need a lot of constituents talking to their federal lawmakers at federal town hall meetings when members are back in their districts over not only the August recess, but when they’re back home campaigning in October and November, or in September and October, really talking to their, their federal elected about what this cannabis as a medicine means to them and how desperately patients need their support for organization of federal reforms.

So I think that, that conversation will continue. Um, it’s getting louder. It’s getting deeper traction as we drive into the 2122 federal session, depending on what goes on the November elections. I think we have a tremendous opportunity to see advancements in cannabis policy reform at the federal level. Already this year, you know, or 2019 anyway you saw SAFE Banking Act passed the House as the first piece of standalone cannabis authorization legislation ever to clear the house.

So that’s exciting, but it’s also the beginning. You’ve got a good 40 or 50 cannabis bills that were introduced in Congress this year. Plus the association, associated appropriations amendments that maintain preservation of state medical systems, all those pieces will get deeper traction as we drive into the next session with all driven by really kind of consumer patient engagement with their lawmakers.

Debbie:  And, and I, if I can just say, I think that, um, when we talk about, um, acceptance of cannabis, I think sometimes the statistics that you see out there are a little bit misleading. Like for instance, you may see something that says 90% of Americans believe, you know, in medical cannabis, but when you ask some of these people, do you want it in your state? Do you want it in your county? Do you want it in your neighborhood? A lot of them will suddenly change their mind. I think the acceptance of medical cannabis has definitely grown a lot.

In fact, I was just reading something, um, that was published in 2010 and it said over 50% of Americans want to legalize cannabis. We’re 10 years later and we still haven’t legalized cannabis. And that’s because people see it at, when they see it as a greater, you know, when people see it as a whole view, yes, they believe that medical cannabis, um, should be legalized, but when you make it personal to their state or their county or where they live, sometimes their opinion changes and suddenly they don’t want it where they live.

Sure you can use it, but just keep it away from me. So I think we have to be careful when we see those wonderful statistics that talk about, um, uh, a cannabis acceptance throughout the country. I think there are still a lot of pockets of areas in the country that, um, don’t want to legalize it. And, um, but they, they’re not, their voices aren’t as loud as those that do want to legalize it.

Dustin:  I think that’s a really good point Debbie, again, getting back to how this, how these policy reforms ultimately materialize when the rubber meets the road in local communities, you can have a well organized state policy model on paper that fails to deliver on the ground, uh, because of pushback from people in local communities not wanting to see commercial cannabis in their communities, at the same time not acknowledging that unlicensed cannabis is pretty well-spoken for in their communities.

And there’s a large public safety challenge associated, um, tax dollars being diverted to dealing with illegal cannabis that could be addressed with organization of the functional reform model. It’s. it’s that same, I- it’s getting back to that issue of perception. There’s that perception that hey, medical cannabis is good. People should have access, but once the rubber meets the road and is coming to your backyard, people go back and retreat to their same stigma about cannabis as the devil’s lettuce and having, I guess, their, their issue is that they haven’t seen a model where they see cannabis working well, that they’re going, “Okay yeah, that’s what I want in my community.” So there’s, there’s the education piece, there’s stigma. And there’s kind of a lack of understanding about how, how this functions in the real world.

Michael:  And how do you, how do you address that? I mean, how do you get somebody in Nebraska to, you know, think of it as something that could work in their state as opposed to what those radicals in California are doing, and what is ASA’s role in that? What are some programs that you guys have and what are some things that have been effective in the past in various places?

Dustin:  Well, there are certainly programs that ASA runs that are specifically dedicated to providing high level and deep levels of education to state lawmakers and regulators about how cannabis policy should be organized to deliver functional access to patients. Uh, I know Debbie has a lot of thoughts on a couple of those programs, our CCC and PSE programs. And before we dive into that, I just would like to say a word about our state chapters though, which is that they tend to be our driving force that we coordinate with from the national level in working out policy reforms in states, driving through our state chapters and coordinating with them.

We can meet directly with state lawmakers, with state regulators to educate them on their policy model. What’s working within it, where are their deficiencies and how those deficiencies can be overcome. And on that front, we get a lot of questions from lawmakers at all levels of government about state models and which ones did it right. And the answer to that is none of them really build a model that was fully functionally appropriate for patient access.

However, there are many features of many different state models that are worth sharing across states and so forth for that ASA runs a report every year called the state of the stage report, which provides a summary of how all those state programs have been organized, getting background on that and how we got to where we are today and each one of those dates, and then actually providing a grade as to how each one of those models are performing. And from that report, it really gives us a platform to meet with state lawmakers and regulators, and really kind of do that heavy work of chopping through what’s working. What’s not working. What do we need to get up on the decks for the coming legislative year to make reforms to the system that either need to come from the legislature or it can happen executively.

Debbie:  And I do want to say, um, you know, our, we have chapters all over the country and the chapters are really the backbone of our organization because policy makers aren’t going to do something just because it’s right. They’re going to do it because their constituents want them to do it. So advocates, um, going to the capital, lobbying on behalf of, of medical cannabis, bringing patients, bringing caregivers, children, bringing with- them to policymakers are the key to changing their mind. They want to hear from their constituents in order to change their mind.

And that’s part of what we do at ASA is we help people learn how to advocate for themselves so that their voices can be loud and heard. That’s the only way to change policymakers’ minds. You need to educate them and you need to bring patients to their faces and show them how cannabis is helping.

Michael:  And what about educating the medical profession and patients even?

Debbie:  For me, I feel like that’s one of the most important aspects of what we do here at ASA. Um, I believe that doctors are really the key to making, um, medical cannabis seen as a real medicine. We need to get more doctors on board. We have a program here called cannabis care certification. Um, and it’s a program for patients and medical professionals to get educated on cannabis of the patient’s side, um, is an easy kind of cannabis 101 program that teaches them the basics of cannabis, how it works in our bodies about the endocannabinoid system, methods of administration, um, how to talk to your family about it.

Um, the medical professional side, we work with a partner group called the answerpage.com and they actually have CME credits. Those are continuing medical education credits that all doctors need to take on cannabis specific topics, and it’s all online. Um, it’s, if doctors can use the code CCC 2020 and get, uh, $50 off any of the CME courses through that website. Uh, but we really feel like it’s important for doctors to listen to their patients. Patients are coming to their doctors, talking about cannabis. And what we hear from patients is doctors dismiss them, or don’t want to talk about it or say they just don’t know enough.

And so I think that it’s the doctor’s responsibility to — if your doctor, if your patient is coming to you asking about something to get educated on it. And so I think it’s really important for doctors to start learning about cannabis and talk to their patients about it.

Michael:  How far away do you think we are before that’s actually taught in medical schools, you know, more than just, you know, in passing and you know, when mainstream medical associations are providing the same types of courses?

Debbie:  It’s a great question. And I know that the biggest drawback for doctors is that there’s not enough research out there. There’s not enough science out there. There is a lot of research out there, just not enough, maybe clinical trials, but I think that, you know, doctors have a responsibility, they, they have liability. So I understand their concerns. But I think starting to teach about the endocannabinoid system in medical schools is really necessary.

We need to get that going, and we have been trying for a long time to get medical schools to start teaching it, you know, and until it becomes federally illegal, I’m, I’m just not sure, um, nationally that, that, that’s going to start happening. I really hope that medical associations will start being more outspoken about cannabis and start talking about it more often and not just use the excuse that they don’t know enough about it. Uh, they need to do the work, they need to start reading about it. They need to start researching it. They need to start including it in their education.

Michael:  A lot of doctors that I’ve spoken to have said that a lot of that pressure or incentive or, uh, impetus for them to do exactly that has come from their patients, coming and asking questions, and, and then realizing that they didn’t have enough information. And, you know, even on a drug interaction level, like it’s, it’s important for, for doctors to know-

Debbie:  Yes.

Michael:  … what people are using.

Debbie:  It’s so important. And, you know, unfortunately we get calls all the time from patients saying, um, I don’t know how to talk to my doctor about this, or I’m afraid to talk to my doctor. So how can I go about getting a medical cannabis card without talking to my doctor? But we feel that is so important for patients to talk to their doctors. Even if they’re afraid their doctor is going to say no, or dismiss them. We want patients to talk to their doctors so that doctors will know patients are asking about this.

Doctors need to know that patients are going to use it, whether they, whether the doctor wants them to or not. So as a doctor, they should really have a responsibility to listen to what their patient needs and talk to them about it, especially when they’re using other medications. Patients really need to understand that there are some, um, drug, drug and drug interactions that they need to be careful about. And so it’s really important to talk to your doctor if you are using medical cannabis.

Michael:  Is there any fear that Adult Use Legislation will actually move people away from the medical system when it comes to using marijuana as a treatment because they don’t have to see a doctor in order to get it anymore?

Debbie:  Yes, absolutely. We’ve seen that happen in several states. And the reason is, is because in most states it’s more expensive to become a medical cannabis patient because you have to pay for the doctor appointment, you have to pay for the medical cannabis card. That’s why we’re really fighting for tax reductions for, for patients and also insurance to cover it because once insurance covers it, then I think that patients will see the need for the medical cannabis program.

But yeah, until that happens… And we know that many patients, um, we should say, sorry, let me start over again. We know that many people out there are using the adult use market, but are still using it for medical purposes. So sometimes you’ll see a state where 90% are adult use and only 10% are card holding medical cannabis patients. But that’s because sometimes it’s just easier to and cheaper to just use the adult use market rather than the medical market. And we’re really hoping to change that.

Dustin:  And you see typically when states will, will layer on an adult use model to a medical model, as they pivot to address a lot of the concerns with the adult use market, the industry responds in kind. So while you might’ve had an industry organized previously prior to the layering on of adult use, that was geared and designed to cater to medical patients where you had staff, whether it was at the cultivation and manufacturing level that understood that the products that they were designing were specific to treatment of medical conditions were folks on the retail side who could actually speak with patients and understood which products they had in their inventory that matched with treating that, that patient’s chronic health issues.

As the market changes and states entertain adult use, the industry recognizes that there’s a larger population of healthy adult use consumers than there are versus patients. And they make that business decision to cater to that larger audience. Oftentimes when that occurs some of the products, in some cases, many of the products that patients were utilizing for treatment and care fall away from the shelves and patients tend to be kind of forgotten under those systems.

So yes, this continues to be a problem. There are a number of states that provide anecdotes as to exactly that phenomenon, but certainly it’s a challenge when adult use is layered on and there needs to be a focus maintained among lawmakers and regulators on organizing improvements to ensure that the medical access systems functions and patients aren’t left behind.

Debbie:  And, and when you’re talking about an adult use market, you’re leaving out one of the main groups of advocates that started this industry, pediatric patients, pediatric patients can’t utilize the adult use market. And they’re one of the populations that need this medicine the most. And so we really do need to think about it as two separate, um, programs.

Michael:  This is one of a lot of different areas and where cannabis programs can get it wrong, where, you know, state cannabis programs. Um, I was hoping you guys could give me some examples of states or elements that have done it right?

Dustin:  I guess, in terms of states that have done it right. I don’t think so much about specific states as much as I do about some specific elements of policy that are appropriate for either expanding patient access and easing patient access, including features like, like not just, okay, we’re, this, as a state, we’re going to authorize the sale of medical cannabis and allow for a certain capped population of retail access sites that patients can go to secure medical access.

I think that’s, that’s one very fundamental design, but patients need the full suite of access options that are afforded to patients of traditional pharmaceutical products, pharmacies proliferate beyond just standalone storefronts. They’re integrated into grocery stores, into big box stores. Um, many pharmacies have delivery features associated with the way they do business, allowing them to reach patients in their homes or places of business.

I think you see some states that have organized models like that previously, where they entertained a delivery option to patients, but states have a real mixed approach to that in California. For example, you’ve got a state that organized such a feature, and you’ve got 25 state cities in the state suing the state, arguing that if delivery is licensed in the community next door and patients in the community that government is overseeing, shouldn’t be allowed to get access from that licensee in the, in the neighboring jurisdiction.

So it remains controversial, but in the end, it’s a patient access feature, an issue that states ought to consider incorporating. You saw some states go through and when they organize their emergency response measures to COVID, they incorporated expansion components like that. Whether it was delivery from storefront to patients, they also offered patients the ability to pick up, to pre-order their medicine and pick it up curbside to maintain patient safety.

And then they also include some other features, some existed in states previously, but many states organize these features specific to COVID, where they allowed patients to auto renew their existing enrollment in the state patient certification program. Or they allow those patients to utilize a telehealth feature instead of having to go visit their doctor and expose themselves potentially to COVID. And they could use telehealth for re-evaluation and re-enrollment. So you see a lot of those features are merged in COVID that some states had already started experimenting with that now ASA and other patients and patient groups are, are really working to try to see maintained as states move forward after COVID.

Michael:  I hear a lot that the declaration of medical cannabis and recreational cannabis in some places as an essential service definitely, you know, shows how far, how far we’ve come, but also that, you know, it, it, it couldn’t itself change perceptions. You know, that, you know, if it’s being declared an essential service by the governor of your state, then you know, maybe this is not what we were told it is or, or think it is. Uh, do you think that’s a real thing either of you or, or is it just a sort of trope that people have been latching onto?

Dustin:  I think it’s helpful in advancing greater accessibility of cannabis among traditional constituents, that either aren’t using cannabis as a medicine or using it in an, as adult use consumers, or they don’t have any family members who are needing to utilize cannabis for medical applications. So I think for those consumers that aren’t really kind of touching this whole conversation it’s helpful in, in really kind of getting them to acknowledge that yes, your state reformed their laws on cannabis.

And when they did, they made medical a priority in that. And it’s such a priority that we’re ensuring that patients maintain access to that medicine during an emergency time in their communities. You saw a number of states do that. I think it’s helpful in, in, in kind of driving that acceptance. Um, but I also think with respect to industry and contain, cannabis consumer and patient kind of support of that and grabbing hold of that, I think that enthusiasm is common among all of those factions, right?

You’ve got folks who have been really putting their shoulder to the wheel, driving this policy conversation forward as difficult as it’s been over the last 30, 40 years. And they’re seeing some real progress. And when you start to see things like this happen, where you’ve got state governors, regulators, and legislature saying that these are essential businesses, they need to stay open for patients to maintain access. It’s very exciting for folks in the cannabis community, because this is a complete sea change to what they’ve experienced previously. In the past they probably wouldn’t have, we probably wouldn’t even have cannabis storefronts, medical cannabis storefronts to offer retail access. Not, not only do we have them, but our access to them is being declared essential. And that’s not a small thing.

Debbie:  And, and I also want to note that, you know, that didn’t happen on its own. You know, when COVID first hit the United States, ASA had an emergency meeting with stakeholders from around the country, industry lawyers, medical professionals, patients, um, to talk about what needed to happen in order to maintain access to cannabis. And that didn’t just mean keeping dispensaries open, that also meant keeping cultivators open, manufacturers open. We didn’t want this COVID to end in a few months and suddenly there’s no medicine available because cultivators had to close.

So we had an emergency meeting, from that meeting we got eight recommendations. Um, those recommendations we sent to every single governor in the country and asked them to please keep these recommendations. Um, and those recommendations included delivery, uh, telehealth, um, virtual renewal of cards for existing patients and new patients, um, and being clear on these, these changes with their communities to make sure patients knew that medicine would still be available.

Obviously, number one on that list was making cannabis businesses essential. And we really feel happy with the followup from that. Several states officially declared cannabis as essential. Some of them kept it more quiet, but, uh, we also are including this in our state of the state’s report as a bonus score. So we have a bonus score that we use every year in the state of the state’s report. Last year it was regarding how states responded to the opioid epidemic. And this year it’s about how states responded, uh, to COVID.

And so that’ll be really interesting to see how the different states have responded and how patients have really appreciated it. We also did a patient survey and a feedback survey, and so many patients are really hoping that these temporary regulations, especially the telehealth and delivery will be maintained a- after, post COVID, I guess I should say.

Michael:  So we’ve heard a lot about what ASA does. Um, maybe you can tell us a little about what it is.

Debbie:  Sure. Well, ASA has been around for 18 years now. It was, um, created in 2002, um, to help ensure safe and legal access to medical cannabis. In 2002, there were only about 11 dispensary’s open in the country. They were all in California and they were all working illegally. So we saw this need for, you know, protection from the people that were, that were providing this medicine for patients, the heroes that were providing this medicine for patients illegally and protection for the patients to get medicine.

So from there we started, you know, working across the country, trying to change laws, but it’s not just about laws for us. Once, once a state has a medical cannabis program, like we said, there’s still issues of safety and access. So we want to make sure that it’s not just people that can afford the medicine that’s, that has access, or it’s not just people that have, that are lucky enough to have the qualifying conditions.

We need to make sure that everyone across the country, no matter what condition they have, no matter how much money they have, have access. So we started, you know, programs, our Cannabis Care Certification program. And then we also started a program called patient focused certification PFC program, which is about, uh, educating and training the industry on safety. We wanted to make sure that everyone working in the industry was working compliantly and safely.

Um, so we started this certification and education program, which helps us feel better about knowing that patients are getting safe access to medicine. One of the many differences about the programs across the country is the way medicine is tested for impurities. And so that varies across states the way medicine is tested, these are things that we want to make sure are equal throughout the country so that, you know, we really care about not just access, but safety of the patients.

Um, we, and we don’t just want to educate people that already think cannabis is a medicine or already know. We like to partner with organizations like the US, US Pain Foundation, MS Society, Michael J. Fox Foundation. We want to educate people that don’t even know that they can use cannabis as an option. There are so many patients out there that are using other types of medicine that might not be as safe for them because they don’t even know that cannabis is an option because no one’s talking to them about it.

So part of what we do is, um, trying to educate the country, trying to educate, um, policy makers, trying to educate doctors, trying to educate lawyers about the therapeutic abilities of cannabis. The heart of ASA is really about patients. So everything we do is for patients, every decision we make, every program we create is to make sure that patients are the priority and that they have safe access to medicine.

Michael:  Well, that seems like a perfect place to tell our listeners that starting this week, uh, ASA is a partner in the Cannabis Enigma podcast, along with the Cannigma. And, uh, so you’ll be hearing from updates and various other, uh, segments from ASA in addition to hopefully more conversations like this.

Debbie:  Yes. And we’re really excited to partner with you guys. Uh, we had been looking to kind of create a podcast for a long time, um, just to help you, like we said, to help educate others out there and we found your podcast and it focused on the same goals that we focus on, medical, science, research, and we just thought it would be a perfect partnership.

Michael:  Well, we’re really happy. Um, this episode was really fascinating for me. I learned a lot and thank you guys so much for coming on.

Debbie:  Thank you.

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