Friday, March 10, 2017

Medical Cannabis Personal Production License Plant Increase & Part(B):Establishment of Patient Run Cooperative/Collective’s

Jason Barker - Medical Cannabis Patient & Organizer with LECUA Patient’s Coalition Of New Mexico LECUA_thc_cbd.png

dukecitywellness.blogspot.com

Tuesday, February 28th 2017


New Mexico State Department of Health
Medical Cannabis Advisory Board
Medical Cannabis Program
PO Box 26110
Santa Fe, NM, 87502-6110



Petition: Medical Treatment; Adequate Supply:
Part(A):Patient Medical Cannabis Personal Production License Plant Increase & Part(B):Establishment of Patient Run Cooperative/Collective’s or “Licensed Personal Patient  Collectives (LPPC)”

Table of Contents
Pg.  1 Cover Page
Pg.  2 - 4 Petition Introduction
Pg.  4 - 17 Petition Purpose and Background
Pg.  17 - 20 Relief Requested In Petition
Pg.  20 References
Pg.  20-21 Appendix A

 

Printing Provided By:

Petition Introduction: Requesting the Medical Treatment; Adequate Supply:
Part(A):Patient Medical Cannabis Personal Production License Plant Increase & Part(B):Establishment of Patient Run Cooperative/Collective’s or “Licensed Personal Patient  Collectives (LPPC)”

New Mexico’s medical cannabis history started in 1978, after public hearings the legislature enacted H.B. 329, the nation’s first law recognizing the medical value of cannabis. The New Mexico’s medical cannabis program (MCP)  is the only program in the U.S. that places sole responsibility for regulation on the state’s Department of Health. Doctors must comply with state requirements for patients to be considered for applying to the medical cannabis program.

The Santa Fe New Mexican reported on February 13th (2017) that the New Mexico Medical Cannabis program has grown dramatically from 9,000 patients in 2013 to more than 33,000 today. The Department of Health estimates approximately 500 to 800 new patients join the program weekly. The tremendous growth of the Medical Cannabis Program with new program participants, an increase of 75% during 2016, so that currently means we have almost 45,000 patients benefiting from medical cannabis. The medical cannabis program office is currently processing applications in a 12-14 day range and recommends submitting renewal and new patient applications a minimum of 60 days prior to expiration to allow ample time for processing. Due to the incredible growth in the medical cannabis program participants, there needs to be a clear increase to the plant count allowed for by the licensed producers from the Department of Health. In order for the Department of Health Medical Cannabis Program to allow for the beneficial treatment with medical cannabis, the Department must properly have “adequate supply”.

There are 35 licensed producers growing medical cannabis, operating 41 dispensaries around the state, and 23 of these dispensaries are located in the Albuquerque area.  Current state law does not limit the number of plants that can be grown by the state’s licensed producers. Each one of the licensed producers is can choose to grow up to 450 medical cannabis plants, the maximum allowed under the Department of Health program rules and regulations. The department may issue two classes of producer licenses; to a qualified patient who holds a valid personal production license and to a non-profit producer who operates a facility.

The 2016/17 licensure list for the medical cannabis program shows a total of 13,800 medical cannabis plants licensed by the 35 producers for the All patients in the program.
In the Lynn and Erin Compassionate Use Act, (2007) the law states; The Secretary of Health shall establish an advisory board consisting of eight practitioners representing the fields of neurology, pain management, medical oncology, psychiatry, infectious disease, family medicine and gynecology. The practitioners shall be nationally board-certified in their area of specialty and knowledgeable about the medical use of cannabis. The members shall be chosen for appointment by the Secretary from a list proposed by the New Mexico Medical Society. A quorum of the advisory board shall consist of three members.
The advisory board shall:
A. review and recommend to the department for approval additional debilitating medical conditions that would benefit from the medical use of cannabis;
B. accept and review petitions to add medical conditions, medical treatments or diseases to the list of debilitating medical conditions that qualify for the medical use of cannabis;
C. convene at least twice per year to conduct public hearings and to evaluate petitions, which shall be maintained as confidential personal health information, to add medical conditions, medical treatments or diseases to the list of debilitating medical conditions that qualify for the medical use of cannabis;
D. issue recommendations concerning rules to be promulgated for the issuance of the registry identification cards; and
E. recommend quantities of cannabis that are necessary to constitute an adequate supply for qualified patients and primary caregivers.

First, do no harm.  As an important step in becoming a doctor, medical students must take the Hippocratic Oath. And one of the promises within that oath is “first, do no harm”.  

Dr. William Johnson, former chair of the New Mexico Medical Cannabis Advisory Board in 2014 told KUNM public radio that many of the changes proposed by the Department of Health would hurt patient access to medical cannabis.  After the Rules and Regulations changes from the medical cannabis meetings in 2014 went into effect in February of 2015, the results for patients and caregivers in the program has been clearly harmful to patient well being and overall program health. And it is the patient’s,  producers, and medical cannabis community members that are now paying the price in regards to health and financial costs.

We have a sound law in the Lynn and Erin Compassionate Use Act, yet we are unable to provide “adequate supply” and it can not be properly defined by the Department by using unknown variables it has not collected then this leads to further examination of how these definitions pertaining to adequate supply were determined in the past years.

In order for the Department of Health Medical Cannabis Program to allow for the medical treatment of cannabis, the Department must properly have “adequate supply”.  For the Department to have “adequate supply” they would need to know the different amounts of plant material that goes into all the different types of medicine being produced in the MCP. Dried cannabis flower (bud), pre-rolls, edibles, tinctures, topicals/salves, and concentrated forms of cannabis- all require different amounts of cannabis plant material to produce. This is empirical data that has not been collected, studied or researched within the state’s medical cannabis program by the Department of Health.

The current law for the Medical Cannabis Program, passed in 2007, states the following, (Page 1/Section 2) “PURPOSE OF ACT.--The purpose of the Lynn and Erin Compassionate Use Act is to allow the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments.”

Mosby’s Medical Dictionary states that “medical treatment” means; the management and care of a patient to combat disease or disorder. Medical treatment includes: Using prescription medications, or use of a non-prescription drug at prescription strength; and or treatment of disease by hygienic and pharmacologic remedies, as distinguished from invasive surgical procedures. Treatment may be pharmacologic, using drugs; surgical, involving operative procedures; or supportive, building the patient's strength. It may be specific for the disorder, or symptomatic to relieve symptoms without effecting a cure.(Mosby's Medical Dictionary, 9th edition.)

What is a chronic medical condition?
A chronic disease is one lasting 3 months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear. Harvard Medical Dictionary defines chronic as: Any condition that lasts a long time or recurs over time; chronic pain as: Pain that persists after an injury has healed or a disease is over; and chronic pain syndrome as : Long-term, severe pain that doesn't spring from an injury or illness, that interferes with daily life, and is often accompanied by other problems, such as depression, irritability, and anxiety.
What is the meaning of debilitating?
Something that's debilitating seriously affects someone or something's strength or ability to carry on with regular activities, like a debilitating illness. Debilitating comes from the Latin word debilis, meaning "weak." That's why you'll often see the adjective used to describe illness, despite the negative reference.
Petition Purpose and Background

The purpose of this Medical Treatment petition is for addressing; Requesting the Medical Treatment; Adequate Supply:
Part(A):Patient Medical Cannabis Personal Production License Plant Increase & Part(B):Establishment of Patient Run Cooperative/Collective’s or “Licensed Personal Patient  Collectives (LPPC)”.

The MCP should have a Plant Count that is based on ratio of patients to serve AND inclusion of empirical data for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine.

A increase for Patient / Caregiver PPL plant count to allow for 6 immature seedlings /clones / cuttings, 6 plants in vegetative stage, and 6 plants in flowering stage for total of 18 medical cannabis plants; and The addition of patient run cooperative/collective PPL’s or “Licensed Personal Patient  Collectives” (LPPC) as these LPPC’s would be and are greatly needed for patients in the underserved rural areas of New Mexico.
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This petition for the Medical Treatment that pertains to Requesting the Medical Treatment; Adequate Supply:
Part(A):Patient Medical Cannabis Personal Production License Plant Increase & Part(B):Establishment of Patient Run Cooperative/Collective’s or “Licensed Personal Patient  Collectives (LPPC)”, is being provided to bring the state Department of Health Medical Cannabis Program in compliance with the Lynn and Erin Compassionate Use Act.

While some patients with long-term illnesses or injuries have the time, space, and skill to cultivate their own cannabis, the majority of patients, particularly those in urban settings, do not have the ability to produce it themselves. For those patients, dispensaries are the only option for safe and legal access. This is all the more true for those individuals who are suffering from a sudden, acute injury or illness. Many of the most serious and debilitating injuries and illnesses require immediate relief. A cancer patient, for instance, who has just begun chemotherapy will typically need immediate access for help with nausea, which is why a Harvard study found that 45% of oncologists were already recommending cannabis to their patients, even before it was legal in any state. It is unreasonable to exclude those patients most in need simply because they are incapable of gardening or cannot wait months for relief.

If you don’t own your property then you must have written permission from the property owner to get your Personal Production License to grow your own medicine. I believe this to be a HIPPA violation as it forces the patient or caregiver to reveal private information about their own health to the property owner. And then this further opens up the great potential for bias toward the patient from the a property owner and discrimination of their health condition.  And the State Department of Health is opening itself up to even more future lawsuits in doing this.

 A large number of patients or caregivers in the program do have their Personal Production License, mainly to secure the right of having it, as about a ⅓ of these PPL’s are being used. The start up cost for the proper equipment to cultivate medical cannabis is between $1000-$1300.  The addition of patient run cooperative/collective PPL’s or “Licensed Personal Patient  Collectives” (LPPC) and further protections to property owners renting to patients. ( so patients are not forced into the demeaning situation of telling a landlord of their personal health issues; as foster discrimination by a landlord in many other aspects in renting) This would allow for more adequate supply of medical cannabis and empower the patient community.

Currently for patients and primary caregivers in the medical cannabis program, the rules and regulations established limit patients and primary caregivers, “who holds a valid personal production license is authorized to possess no more than four mature female plants and a combined total of 12 seedlings and male plants, and may possess no more than an adequate supply of usable cannabis, as specified in department rule.  A personal production license holder may additionally obtain usable cannabis, seeds, or plants from licensed non-profit producers.  The primary caregiver of a qualified patient who holds a personal production license may assist the qualified patient to produce medical cannabis at the designated licensed location that is identified on the personal production license; the primary caregiver may not independently produce medical cannabis” and to having 230 Units (grams) of any amount of medical cannabis for a three month period.  And the patient PPL Application states the follow: “Pursuant to Department rule, a personal production license holder may possess no more than four (4) mature cannabis plants (flowering) and twelve (12) immature plants (non-flowering and male plants). A qualified patient may also possess no more than 230 units of usable cannabis within a three-month period. A unit is defined as one gram of dried usable cannabis plant material, or 0.2 grams (200 milligrams) of THC in a cannabis-derived product.”

Above is the ratio of stem, leaf and bud that NIDA and the DEA documented.

How much of the cannabis plant is useable medicine? (The flower or bud)
Chris Conrad, former director of Safe Access Now, author and court-qualified cannabis expert did a research study “Cannabis Yields and Dosage: A Guide to the Production and Use of Medical Marijuana”. This information is current as of April 15, 2015.
Cannabis takes root as either seedlings or cuttings (clones). Later, male plants are cut out of the garden to prevent pollination. Female plants grow to full maturity before being cut and harvested. About 75% of the fresh weight is moisture that is lost in the drying process. Almost half the dry plant matter is stem; only about a quarter (18% to 28%) remains after the herb is cured and manicured into medical-grade flower that has a coating of resin glands with cannabinoids, the active compounds. Contrary to cannabis’ reputation as a weed, it is not so easy to grow quality medicine. Not all gardens have ideal conditions and few patients are trained botanists.

Federal cannabis yield study
Ratio of sinsemilla bud to leaf, excluding stems and branches.
The canopy size predicts yield
The US Drug Enforcement Administration (DEA) conducted scientific research with the National Institute on Drug Abuse (NIDA) at the University of Mississippi, published in the 1992 DOJ report, Cannabis Yields. Both seeded and sinsemilla plants of several seed varieties were measured. The NIDA data in Table 3 includes leaf with the bud, and therefore requires an additional adjustment to arrive at the true garden yield below.
Canopy is a term used in agriculture to describe the foliage of growing plants. The area shaded by foliage is called the canopy cover. The data on this page are based on the higher yielding, more potent seedless buds, sinsemilla. The federal field data show that, on average, each square foot of mature, female outdoor canopy yields less than a half-ounce of dried and manicured bud (Table 4), consistent with growers’ reports and gardens that have been seized by police as evidence and I have later weighed and examined.
All other things being equal, a large garden will always yield more than a small one, no matter how many plants it contains. This is true for skilled and unskilled gardener alike. Restricting canopy will therefore limit any garden’s total bud yield, no matter which growing technique is used or how many plants make up the combined canopy cover. Most patients can meet their medical need with 100 square feet of garden canopy.
Above is the amount of leaf plus bud produced on the average federally grown marijuana plants.
After you remove the stems, the ratio of leaf to bud is shown above. This ratio applies to the data in Table 3; multiply those figures by 0.48 to get the amount of mature female flowers, or "bud," as shown below.
Using that formula you get the above amount of cannabis bud, expressed as dried and processed yield per square foot of mature female sinsemilla canopy.
For indoor cannabis cultivation, Ed Rosenthal, author of a number of books on cannabis cultivation, in evidence to the U.S. Congressional Sentencing Commission, stated that a mature cannabis plant grown under modern indoor conditions can usually be expected to yield 10 grams of marijuana (i.e. dried flowering tops), and that each "marijuana garden" should be treated on its own merits[xviii].  Knight et al[xix] grew plants hydroponically under optimum conditions with mesh support for branches (‘screen of green’) yielding a mammoth average yield of 687g per plant.  In more typical hydroponic growing conditions in the Netherlands Toonen et al[xx] reported an average yield of 33.78g per plant, and Huizer et al[xxi] reported an average 22g per plant. (Source: http://www.idmu.co.uk/cannabis-plants-cultivation-yields.htm )

In the Rule and Regulations for the Medical Cannabis Program, Title 7-Chapter 34-Part 2 Advisory Board Responsibilities and Duties defines Adequate Supply as the following:
 “Adequate supply” means an amount of cannabis, derived solely from an intrastate source and in a form approved by the department, that is possessed by a qualified patient or collectively possessed by a qualified patient and the qualified patient’s primary caregiver, that is determined by the department to be no more than reasonably necessary to ensure the uninterrupted availability of cannabis for a period of three months or 90 consecutive calendar days.
In the Rule and Regulations for the Medical Cannabis Program, Title 7-Chapter 34-Part 4: Medical cannabis licensing requirements for producers, couriers, manufacturers and laboratories states a “Personal production license” means a license issued to a qualified patient participating in the medical cannabis program, to permit the qualified patient to produce medical cannabis for the qualified patient’s personal use, consistent with the requirements of department rule.

7.34.4.8                 PRODUCER LICENSING; GENERAL PROVISIONS:
               A.            The department may license two classes of producers:
                               (1)           A qualified patient who holds a valid personal production license.  A qualified patient who holds a valid personal production license is authorized to possess no more than four mature female plants and a combined total of 12 seedlings and male plants, and may possess no more than an adequate supply of usable cannabis, as specified in department rule.  A personal production license holder may additionally obtain usable cannabis, seeds, or plants from licensed non-profit producers.  The primary caregiver of a qualified patient who holds a personal production license may assist the qualified patient to produce medical cannabis at the designated licensed location that is identified on the personal production license; the primary caregiver may not independently produce medical cannabis.
                               (2)           A non-profit producer that operates a facility and, at any one time, is limited to a combined total of no greater than 450 mature female plants, seedlings and male plants, and an inventory of usable cannabis and seeds that reflects current patient needs, and that shall sell cannabis with a consistent unit price, without volume discounts or promotional sales based on the quantity purchased.  A non-profit producer shall not possess a quantity of either mature female plants or seedlings and male plants that exceeds the quantities authorized by their licensure and associated licensing fee.  A licensed non-profit producer may sell and distribute usable cannabis to a person or entity authorized to possess and receive it. A licensed non-profit producer may obtain plants, seeds and usable cannabis from other licensed non-profit producers.

In the Part 2 of the Rules and Regulation (Title 7-Chapter 34-Part 2) are the following definitions:
                    “Unit” means a quantity of usable cannabis, concentrate, or cannabis-derived product that is used in identifying the maximum supply that a qualified patient may possess for purposes of department rules.
                   “Usable cannabis” means the dried leaves and flowers of the female cannabis plant and cannabis-derived products, including concentrates, but does not include the seeds, stalks, or roots of the plant.

And then that will bring us to Title 7-Chapter 34-Part 3: Registry Identification Card for the complete definitions in Rules and Regulations for “unit” and “useable cannabis” :
QUANTITY OF USABLE CANNABIS THAT MAY BE POSSESSED BY A QUALIFIED PATIENT OR PRIMARY CAREGIVER:
               A.            Maximum quantity:  A qualified patient and a qualified patient’s primary caregiver may collectively possess within any three-month period a quantity of usable cannabis no greater than 230 total units.  For purposes of department rules, this quantity is deemed an adequate supply.  (For ease of reference: 230 units is equivalent to 230 grams, or approximately eight ounces, of dried usable cannabis plant material.)  A qualified patient and primary caregiver may also possess cannabis seeds.
               B.            Calculation of units:  For purposes of department rules, one unit of usable cannabis shall consist of one gram of the dried leaves and flowers of the female cannabis plant, or 0.2 grams (200 milligrams) of THC for cannabis-derived products.
               C.            Maximum THC content of concentrates:  A qualified patient or primary caregiver shall not possess a concentrated cannabis-derived product that contains greater than seventy percent (70%) THC by weight.
               D.            Medical exception:  A greater quantity of usable cannabis, not to exceed 115 additional units, may be allowed, and a concentrated cannabis-derived product with THC content greater than seventy percent (70%) by weight may be allowed, at the department’s discretion, upon the submission of a statement by a medical practitioner explaining why a greater number of units of usable cannabis, or a higher concentration of THC in concentrated cannabis-derived product, is medically necessary.  Any such allowance shall be reviewed for approval by the program’s medical director. [7.34.3.9 NMAC - N, 2/27/2015]” http://164.64.110.239/nmac/parts/title07/07.034.0003.htm

7.34.4.18               QUALIFIED PERSONAL PRODUCTION APPLICATION AND LICENSURE REQUIREMENTS:
               A.            A qualified patient may apply for a personal production license to produce medical cannabis solely for the qualified patient’s own use.
               B.            A qualified patient may obtain no more than one personal production license, which license may be issued for production to occur either indoors or outdoors in no more than one single location, which shall be either the patient’s primary residence or other property owned by the patient.
               C.            No more than two personal production licenses may be issued for a given location, with proof that a second registered patient currently resides at the location.  Multiple personal production licenses may not be issued for non-residential locations.
               D.            Qualified patients shall provide the following in order to be considered for a personal production license to produce medical cannabis:
                               (1)           applicable non-refundable fee;
                               (2)           a description of the single indoor or outdoor location that shall be used in the production of cannabis;
                               (3)           if the location is on property that is not owned by the applicant:  a written statement from the property owner or landlord that grants to the applicant permission to grow cannabis on the premises;
                               (4)           a written plan that ensures that the cannabis production shall not be visible from the street or other public areas;
                               (5)           a written acknowledgement that the applicant will ensure that all cannabis, cannabis-derived products and paraphernalia is accessible only by the applicant and their primary caregiver (if any), and kept secure and out of reach of children;
                               (6)           a description of any device or series of devices that shall be used to provide security and proof of the secure grounds; and
                               (7)           a written acknowledgement of the limitations of the right to use and possess cannabis for medical purposes in New Mexico.
[7.34.4.18 NMAC - Rp, 7.34.4.9 NMAC, 2/27/2015]

Facts About The Medical Conditions That Qualify For The Medical Cannabis Program.
Patients in New Mexico diagnosed with one or more of the following medical conditions qualify into the program and are allowed legal protection under the Lynn and Erin Compassionate Use Act:
Amyotrophic Lateral Sclerosis (ALS) : Can't be cured, but treatment does help. Chronic: lifelong.
Cancer : Chronic disease, can be treated, & average treatment plan length 5 years or more.
Crohn’s Disease : Can't be cured, but treatment does help. Chronic: Lasting several years or lifelong.
Epilepsy : Is a chronic neurological disorder. Can't be cured, but treatment does help.
Glaucoma : Chronic, can't be cured, but treatment does help.  ( Can braille cards be printed ? )
Hepatitis C : Chronic, but treatment does help.
HIV/AIDS : Can't be cured, but treatment does help. Chronic: lifelong.
Huntington’s Disease : Can't be cured, but treatment does help. Chronic: lifelong.
Hospice Care :Palliation of a chronically ill, terminally ill or seriously ill patient's pain and symptoms.
Inclusion Body Myositis : Can't be cured, but treatment does help. Chronic: lifelong.
Inflammatory Autoimmune-mediated Arthritis Can't be cured, treatment does help. Chronic: lifelong.
Multiple Sclerosis Can't be cured, but treatment does help. Chronic: lifelong.
Damage to the nervous tissue of the spinal cord :No cure, treatment does help. Chronic: lifelong.
Painful peripheral neuropathy :Can't be cured, but treatment does help. Chronic: lifelong.
Parkinson’s disease :Can't be cured, but treatment does help. Chronic: lifelong.
Post-Traumatic Stress Disorder (PTSD) :Can't be cured, but treatment does help. Chronic: lifelong.
Severe Chronic Pain :Can't be cured, but treatment does help. Chronic: lifelong.
Severe Anorexia/Cachexia :Often a sign of disease, such as cancer, AIDS, heart failure, or advanced chronic obstructive pulmonary disease (COPD). Chronic but treatment does help.
Spasmodic Torticollis (Cervical Dystonia) :Can't be cured, but treatment does help. Chronic: lifelong.
Ulcerative Colitis: Can't be cured, but treatment does help. Chronic: lifelong.
All of these types of debilitating medical conditions have some common medical facts; treatment plan for 5 years if not lifelong, most all have no cure, all of them are chronic health conditions, and sadly some take a person’s life. They all also require a medical treatment plan with several visits to more than one medical practitioner throughout the course of a year.
For those rules and regulations that have been established limiting patients and primary caregivers to; “Pursuant to Department rule, a personal production license holder may possess no more than four (4) mature cannabis plants (flowering) and twelve (12) immature plants (non-flowering and male plants). A qualified patient may also possess no more than 230 units of usable cannabis within a three-month period. A unit is defined as one gram of dried usable cannabis plant material, or 0.2 grams (200 milligrams) of THC in a cannabis-derived product.”.  This current format being used by the Department of Health Medical Cannabis Program in devising adequate supply does not allow for the beneficial use of medical cannabis. This in fact prevents patients from fully being able to alleviate symptoms caused by debilitating medical conditions and their medical treatments and that creates a liable situation for the state being out of compliance with the LECUA, 2007.  

How Is The Medical Cannabis Program Out Of Compliance With The LECUA, 2007?  

For  example, a cancer patient in the medical cannabis program, to be able to receive beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments under the current law; cancer patients would need to be allowed to posses a minimum quantity of usable medical cannabis of 425.243 grams per 3 months (or 2.5 ounces every two weeks). For this patient scenario, in the patient having a PPL - the addition of two more medical cannabis plants or Patient / Caregiver safe access to medical cannabis via LPPC, would allow for this treatment. (Patient / Caregiver PPL plant count increased to allow for 6 immature seedlings /clones / cuttings, 6 plants in vegetative stage, and 6 plants in flowering stage for total of 18 cannabis plants. )
Types of medicine made from the medical cannabis plants for treating cancer is a concentrated medical cannabis oil. A three month supply of this concentrated medical cannabis oil requires 450-500 grams (or Units) of dried cannabis flower plant material.  (The oil is also known as, hemp oil, Phoenix Tears, and Rick Simpson Oil (RSO), whole-plant cannabis oil can be orally administered or applied directly to the skin. Sublingual delivery is the preferred method of treatment for many cancer patients.)
To understand how cannabis oil, or Rick Simpson Oil (RSO) and CBD oil are different, one must first understand that there are many different types of CBD oil currently available on the market.
The first type of CBD oil is whole-plant oil derived from the highly resinous buds of the cannabis plant and is only legal in MMJ-friendly states because it contains other minor cannabinoids (although CBD is the most abundant cannabinoid in these types of products).
The second type of CBD oil is usually marketed as legal across all 50 states and typically sources industrial hemp (non-psychoactive cannabis hemp stalk with < .03% THC). CBD oil derived from hemp stalk/seeds is not the preferred oil choice for many medical marijuana patients looking to treat a specific ailment or health condition because it lacks other cannabinoids like THC that have significant medical benefits.
Along with the massive medicinal benefits of CBD oil, RSO also contains THC and other key cannabinoids resulting in patients having a much more euphoric medicating session than if they took CBD oil on its own. Research has found tetrahydrocannabinol (THC) to offer very promising therapeutic benefits for many conditions. This is one reasons some patients prefer whole plant cannabis oil over individual cannabinoids. ( Source )

A 30 day supply of cannabis oil is 60 grams or ml of oil with a dose of 2 grams or ml per day. It requires 450-500 grams of dried cannabis flower plant material to make high quality cannabis oil. So a 90 day supply or three months is 180 grams or ml of oil or 1425 grams of dried cannabis flower plant material ( Source: Rick Simpson ). Those rules and regulations that have been established limiting patients and primary caregivers to having only 16 medical cannabis plants with only 4 in flower for a PPL, and the limit to 230 Units (grams) of any amount of medical cannabis for a three month period does not allow for the beneficial use of medical cannabis and further prevents the purpose of the law to be fulfilled as stated in section two. This also does not allow for the beneficial use of medical cannabis for other medical cannabis medicine products like tinctures and medibles, which further prevents the purpose of the law to be fulfilled.

Medical cannabis patients registered in the New Mexico MCP use the different kinds of cannabis oil with all types of conditions including, but not limited to, Amyotrophic Lateral Sclerosis (ALS), Cancer, Crohn’s Disease, Epilepsy, Glaucoma, Hepatitis C, HIV/AIDS, Huntington’s Disease, Hospice Care, Inclusion Body Myositis, Inflammatory, Autoimmune-mediated Arthritis, Multiple Sclerosis, Damage to the nervous tissue of the spinal cord, Painful peripheral neuropathy, Parkinson’s disease, Post-Traumatic Stress Disorder (PTSD), Severe Chronic Pain, Severe Anorexia/Cachexia, Spasmodic Torticollis (Cervical Dystonia), Ulcerative Colitis, arthritis, diabetes, depression, osteoporosis, psoriasis, insomnia, asthma, burns, migraines, regulation of body weight, chronic pain, and mutated cells (polyps, warts, tumors).

Those rules and regulations that have been established limiting patients and primary caregivers to having only 16 medical cannabis plants with only 4 in flower for a PPL, and the limit to 230 Units (grams) of any amount of medical cannabis for a three month period;  and this current format being used by the Department of Health Medical Cannabis Program in devising adequate supply does not allow for the beneficial use of medical cannabis. This in fact prevents every patient in the MCP from fully being able to alleviate symptoms caused by all of the qualifying debilitating medical conditions and their medical treatments and creates a liable situation for the state being out of compliance with the LECUA, 2007. Even if the patient or primary caregiver is granted the “Medical Exception” and provided the additional 115 Units (or grams) for a total of 345 Units (or grams), the state and MCP would still not be in compliance with the LECUA law.

Washington State Medical Marijuana Program Cooperatives (Established 7/2016)

Medical marijuana cooperatives allow up to four medical marijuana patients or their designated provider to join together to grow marijuana for the patients’ personal use.
Every member must be entered into the medical marijuana authorization database and have a medical marijuana recognition card. The total number of plants authorized for the participants may not exceed 60 plants.
Cooperatives must register with the Washington State Liquor and Cannabis Board (WSLCB) and follow all regulations.

Cooperative members may ONLY:

  • Be in a cooperative if they have a valid medical marijuana recognition card.
  • Form a four member cooperative.
  • Participate in a cooperative if they are at least 21 years of age.
  • Grow up to the total number of plants authorized, with a maximum of 60 plants.
  • Belong to one cooperative.
  • Grow plants in the cooperative and not anywhere else.
  • Use the marijuana and its products, and not sell or give away marijuana or marijuana products to anyone who is not in the cooperative.

A cooperative must be:

  • Located at one of the member’s homes or personal property.
  • Limited to one cooperative per tax parcel.
  • Enclosed by an 8-foot fence, if outdoors, and cannot easily be seen or smelled.

Learn more with Washington’s Collectives: A Patient's Guide to Medical Marijuana Cooperatives (PDF).
Colorado’s Medical Marijuana Collective Cultivation System
An adult patient’s cultivation options are listed below:
A patient can cultivate all of their medical marijuana themselves.
A patient can cultivate a portion themselves and have a caregiver cultivate the rest.
A patient can cultivate a portion themselves and have a center cultivate the rest.
A patient can have a caregiver cultivate all of their medical marijuana.
A patient can have a center cultivate all of their medical marijuana.
Patients are allowed to cultivate the number of plants recommended by their physician; however, Senate Bill 15-014 limits patients to cultivating no more than 99 plants.
Cultivating caregivers can cultivate up to 99 plants for medical marijuana patients. If caregivers cultivate more than 99 plants, they will be required to register with DOR ( Department of Revenue) as a licensed business. (A licensed medical marijuana business cannot also register as a primary caregiver.) Caregivers must register the address of all cultivation and transportation locations with the DOR along with the number of patients and plant/ounce count associated with each address. (Source:https://www.colorado.gov/pacific/cdphe/medical-marijuana-online-registration-system-frequently-asked-questions-faq#cul4)
California also allows patients to form collectives. (Cal. Health & Safety Code §§ 11362.5, 11362.775)
DIFFERENTIATING LNPP’s FROM LPPC’s IS IMPORTANT
Reason: Private patient collectives, in which several patients grow their medicine collectively
at a private location, should not be required to follow the same restrictions that are placed on retail medical dispensaries, since they are a different types of operation. A too broadly written ordinance may inadvertently put untenable restrictions on individual patients and caregivers who are providing
either for themselves or a few others.
Americans For Safe Access, the leading national organization representing the interests of medical cannabis patients and their doctors, notes these findings: Because cannabis comes in literally thousands of different strains with very different effects on the body, it is important for patients to be able to determine which strains work best for their particular condition and to be allowed to cultivate those strains for consistency and quality. In addition, obtaining cannabis from the illicit market or through legal distribution centers can be prohibitively expensive for patients, whereas self-cultivation can significantly reduce that financial burden. Patients should not have to rely exclusively on a centralized production and distribution system, which often falls short in meeting their needs.

Position: Patients should have the right to grow their own medical cannabis in a variety of ways. Patient cultivation is necessary to ensure that patients have safe and affordable access to medical cannabis.

Background: The California medical cannabis law, encouraging federal and state governments “to implement a plan for the safe and affordable distribution of marijuana.” Despite a failure by the federal government to help California develop such a plan, ingenuity and compassion on the part of patients developed a community-based solution for distribution. Community based access refers to innovative and flexible medical cannabis distribution plans developed by patients and providers to meet patient's’ needs. Community based access may include personal and collective cultivation, local access to affordable medicine, and other services designed to meet the needs of patients. The California legislature adopted a system for locally authorized distribution in the form of dispensaries, and subsequently paved the way for hundreds of such facilities to operate across the state. Taking California’s queue, similar community-based dispensaries took root in states like Colorado, Washington and Oregon. This development has prompted the implementation of statewide distribution programs in New Mexico, Rhode Island, Maine and New Jersey.

Findings: Cannabis is a plant with thousands of different strains, which affect patients differently. Not only is it difficult to cultivate cannabis with consistency and optimum quality, it is often too difficult or too impractical for patients that reside in public housing. The vast majority of the hundreds of thousands of patients in the U.S. cannot grow medical cannabis themselves and, therefore, rely on a Caregiver, Patient/Caregiver Collectives, or dispensaries to access it. A study by Amanda Reiman, Ph.D. of the School of Social Welfare at the University of California, Berkeley, examined the experience of 130 patients spread among different Collectives in the San Francisco Bay Area. The study found that “patients have created a system at collectives with medical cannabis that also includes services such as counseling, entertainment and support groups, all important components of coping with chronic illness.” She also found that levels of satisfaction with the care received at Patient/Caregiver Collectives, or dispensaries ranked significantly higher than those reported for other health care services nationally. Dr. Reiman noted that, “support groups may have the ability to address issues besides the illness itself that might contribute to long-term physical and emotional health outcomes, such as the prevalence of depression among the chronically ill.” For cannabis to be successfully used therapeutically, patients need more help using it. It’s not possible to believe that any patient who is going to need cannabis can grow and harvest the medicine by the time they’re going to need it.

Position: ASA supports community-based access models because they are proven to bring safe access to medical cannabis to all patients in need

Rules, Regulations, & Policy Solution For Adequate Supply
This petition for the Medical Treatment that pertains to Requesting the Medical Treatment; Adequate Supply:
Part(A):Patient Medical Cannabis Personal Production License Plant Increase & Part(B):Establishment of Patient Run Cooperative/Collective’s or “Licensed Personal Patient  Collectives (LPPC)”, approval would bring the state Department of Health Medical Cannabis Program in compliance with compassionate spirit and legal intent of the Lynn and Erin Compassionate Use Act.

And then that will bring us to Title 7-Chapter 34-Part 3-Section A: Medical cannabis registry identification cards, where the definitions in Rules and Regulations for “unit” and “useable cannabis” needs to be defined properly & adjusted with a quantity of usable cannabis increased to 425.243 grams per 3 months (2.5 ounces every two weeks). Along with the inclusion of a medical exception that would still allow for the patient or primary caregiver to petition the MCAB for a medical exception increase of units (or grams) with the amount of the medical exception increase to be determined by a patient's medical practitioner.
      1. Plant Count that is based on ratio of patients to serve AND inclusion of empirical data for varying amounts cannabis plant material needed to manufacture different forms of medical cannabis medicine.
        1. Patient / Caregiver PPL plant count increased to allow for 6 immature seedlings /clones / cuttings, 6 plants in vegetative stage, and 6 plants in flowering stage for total of 18 cannabis plants.
        2. The addition of Cooperative/Collective PPL’s
          1. Whereas Rules and Regulations for Personal Production License should additionally include:
            The Department shall issue a individual cultivation registration to a qualifying patient or their personal caregiver. No more than 4 qualified patients may collectively cultivate 80 cannabis plants, and each participating patient must obtain a collective cultivation registration. The Department may deny a registration based on the provision of false information by the applicant. Such registration shall allow the qualifying patient or their personal caregiver to cultivate an area of limited square footage of plant canopy, sufficient to maintain a 90-day supply of cannabis, and shall require cultivation and storage only in a restricted access area.
            A qualifying patient or personal caregiver shall not be considered to be in possession of more than a 90-day supply at the location of a restricted access area used collectively by more than one patient, so long as the total amount of cannabis within the restricted access area is not more than a 90-supply for all the participating qualifying patients. A copy of each qualifying patient’s written recommendation shall be retained at the shared cultivation facility
          2. Qualified patients shall provide the following in order to be considered for a personal production license to produce medical cannabis:
            (1)  a description of the single indoor or outdoor location that shall be used in the production of cannabis;                
            (2)  a written plan that ensures that the cannabis production shall not be visible from the street or other public areas;
          3. (3)  a written acknowledgement that the applicant will ensure that all cannabis, cannabis-derived products and paraphernalia is accessible only by the applicant, collective members and/or their primary caregiver (if any), and kept secure and out of reach of children;
          4. (4)  a description of any device or series of devices that shall be used to provide security and proof of the secure grounds; and
            (5)  a written acknowledgement of the limitations of the right to use and possess cannabis for medical purposes in New Mexico.
          5. Cultivation facility” means a business that:
            1. Is registered with the Department of Agriculture; and (we should be having Dept. of Ag involved all producers)
            2. Acquires, possesses, cultivates, harvests, dries, cures, trims, and packages cannabis and other related supplies for the purpose of delivery, transfer, transport, supply, or sales to:
            (a) dispensing facilities;
            (b) processing facilities;
            (c) manufacturing facilities;
            (d) other cultivation facilities;
            (e) research facilities.
            (f) independent testing laboratories.

The approval of this petition and providing the proper increase to the “PPL”, “LPPC”, and “useable cannabis” would bring the Department of Health in compliance with the intent of the law and uphold the spirit of the Lynn and Erin Compassionate Use Act, 2007.

In order for the Department of Health Medical Cannabis Program to allow for the medical treatment of cannabis, the Department must properly have “adequate supply” and have it properly defined.  And for the Department to have “adequate supply” they would need to know the different amounts of plant material that goes into all the different types of medicine being produced. Dried cannabis flower (bud), pre-rolls, edibles, tinctures, topicals/salves, and concentrated forms of cannabis all require different amounts of cannabis plant material to produce. Adequate Supply can not have a set definition in the rules and regulations and needs to be reviewed to coincide with MCP growth and patient/caregiver needs. Adequate Supply should be reviewed quarterly (4 times per year) with a current census completed of qualified patients, caregivers and licensed non-profit producers.

(Ad·e·quate: (ˈadəkwət/) adjective; satisfactory or acceptable in quality or quantity.
Sup·ply (səˈplī/) verb; 1. make (something needed or wanted) available to someone; provide.
"the farm supplies apples to cider makers" or a noun; 1. a stock of a resource from which a person or place can be provided with the necessary amount of that resource.)

This is empirical data that has not been collected within the state’s medical cannabis program by the Department of Health. Therefore “adequate supply” can not be properly defined by the department by using unknown variables it has not collected. This further prevents the Department of Health from being able to set a proper plant count for each kind of licensed producer in the program for the means of achieving adequate supply within the medical cannabis program as required by law.

This is empirical data has been studied and researched by the state of Colorado by the Colorado Department of Revenue: “An assessment of physical and pharmacokinetic relationships in marijuana production and consumption in Colorado”.

How is the purpose of the law able to be fulfilled without knowing Adequate Supply and by preventing patients from properly treating themselves due to adequate supply limits?
Section 2. PURPOSE OF ACT.--The purpose of the Lynn and Erin Compassionate Use Act is to allow the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments.
“ARTICLE 2B. LYNN AND ERIN COMPASSIONATE USE ACT
N.M. Stat. Ann. § 26-2B-2 (2009)
    § 26-2B-2. Purpose of act
The purpose of the Lynn and Erin Compassionate Use Act [26-2B-1 NMSA 1978] is to allow the beneficial use of medical cannabis in a regulated system for alleviating symptoms caused by debilitating medical conditions and their medical treatments.
HISTORY: Laws 2007, ch. 210, § 2.
EFFECTIVE DATES. --Laws 2007, ch. 210, § 12 makes the act effective July 1, 2007.”

The approval of this would bring the Department of Health in compliance with the intent of the law and uphold the spirit of the Lynn and Erin Compassionate Use Act, 2007.  New Mexico’s medical cannabis history started in 1978.  After public hearings the legislature enacted H.B. 329, the nation’s first law recognizing the medical value of cannabis...the first law.

References
The solution provided above was derived from the following sources:
Americans For Safe Access [http://www.safeaccessnow.org/policy_shop], Colorado Medical Marijuana Program [https://www.colorado.gov/pacific/cdphe/medicalmarijuana], Colorado Department of Revenue- An assessment of physical and pharmacokinetic relationships in marijuana production and consumption in Colorado [https://www.colorado.gov/pacific/sites/default/files/MED%20Equivalency_Final%2008102015.pdf],  Cannabis Yields and Dosing by Chris Conrad (court qualified cannabis expert) [http://chrisconrad.com/], and the Hawaii Medical Cannabis Program-Medical Marijuana Dispensary Task Force Study 2015 [http://files.hawaii.gov/auditor/Reports/2014/14-12.pdf].

Appendix A: An Americans for Safe Access (ASA) national report was released on December 8th, 2016 and calls for an end to contradictions between federal and state guidelines with regard to medical cannabis policies. The Americans for Safe Access briefing book, “Medical Cannabis in America”, showing that not only do opiate related deaths drop an average of 24.8% in states with medical cannabis laws, the report also notes that the Department of Justice has spent an estimated $592 million to date in arrests, investigations, enforcement raids, pretrial services, incarceration, and probation.

Plant Count For Producers Based On Patient Population Growth For Adequate Supply Proposed: Legislators could easily solve this by looking to Americans For Safe Access for this policy.

About Americans for Safe Access.
The mission of Americans for Safe Access (ASA) is to ensure safe and legal access to cannabis for therapeutic use and research.  ASA was founded in 2002, by medical cannabis patient Steph Sherer, as a vehicle for patients to advocate for the acceptance of cannabis as medicine. With over 100,000 active members in all 50 states, ASA is the largest national member-based organization of patients, medical professionals, scientists and concerned citizens promoting safe and legal access to cannabis for therapeutic use and research. ASA works to overcome political, social and legal barriers by creating policies that improve access to medical cannabis for patients and researchers through legislation, education, litigation, research, grassroots empowerment, advocacy and services for patients, government's, medical professionals, and medical cannabis providers.



WHEREAS cannabis (marijuana) has been used as a medicine for at least 5,000 years and can be effective for serious medical conditions for which conventional medications fail to provide relief;

WHEREAS modern medical research has shown that cannabis can slow the progression of such serious diseases as Alzheimer’s and Parkinson’s and stop HIV and cancer cells from spreading; has both anti-inflammatory and pain-relieving properties; can alleviate the symptoms of epilepsy, PTSD and multiple sclerosis; is useful in the treatment of depression, anxiety and other mental disorders; and can help reverse neurological damage from brain injuries and stroke;

WHEREAS the World Health Organization has acknowledged the therapeutic effects of cannabinoids, the primary active compounds found in cannabis, including as an anti-depressant, appetite stimulant, anticonvulsant and anti-spasmodic, and identified cannabinoids as beneficial in the treatment of asthma, glaucoma, and nausea and vomiting related to illnesses such as cancer and AIDS;

WHEREAS the American Medical Association has called for the review of the classification of cannabis as a Schedule I controlled substance to allow for clinical research and the development of cannabinoid-based medicines;

WHEREAS the National Cancer Institute has concluded that cannabis has antiemetic effects and is beneficial for appetite stimulation, pain relief, and improved sleep among cancer patients;

WHEREAS the American Herbal Pharmacopoeia and the American Herbal Products Association have developed qualitative standards for the use of cannabis as a botanical medicine;

WHEREAS the U.S. Supreme Court has long noted that states may operate as “laboratories of democracy” in the development of innovative public policies;

WHEREAS twenty-eight states and the District of Columbia have enacted laws that allow for the medical use of cannabis;

WHEREAS seventeen additional states have enacted laws authorizing the medical use of therapeutic compounds extracted from the cannabis plant;

WHEREAS more than 17 years of state-level experimentation provides a guide for state and federal law and policy related to the medical use of cannabis;

WHEREAS accredited educational curricula concerning the medical use of cannabis have been established that meets Continuing Medical Education requirements for practicing physicians;

WHEREAS Congress has prohibited the federal Department of Justice from using funds to interfere with and prosecute those acting in compliance with their state medical cannabis laws, and the Department of Justice has issued guidance to U.S. Attorneys indicating that enforcement of the Controlled Substances Act is not a priority when individual patients and their care providers are in compliance with state law, and that federal prosecutors should defer to state and local enforcement so long as a viable state regulatory scheme is in place.


Lynn & Erin Compassionate Use Act Patient’s Coalition of New Mexico ~ A GrassRoots Movement!
UNITE-NETWORK-GROW-INFORM-KNOW-EDUCATE-ACTIVISM-VOTE-HEALTH-WELLNESS
(All Rights Reserved 04/20/2016)

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