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California was the first state to legalize cannabis usage for medical purposes in 1996. On November 8, 2016 voters approved Proposition 64 (“Adult Use of Marijuana Act”), which effective immediately allowed adults 21 and over to possess and gift up to 1 oz. of marijuana or 8 oz. of cannabis concentrate, consume cannabis on private property, and cultivate up to six plants per residence.1 The proposition also permitted licensed cannabis companies to cultivate, manufacture, and commercially sell cannabis to individuals over 21.2 On January 2, 2018, licensed California stores commenced "adult-use" sales of cannabis to anyone over the age of 21. However, individuals who receive a cannabis “recommendation” from their physicians can take it to their local public health department to receive a medical cannabis "card", which will exempt them from certain taxes at cannabis dispensaries. Individuals convicted of cannabis crimes under prior state laws can have their criminal offenses retroactively eliminated.3 Offending minors may receive drug education and community service but not imprisonment.3 Employers are still legally allowed to fire employees or deny them work for testing positive for cannabis usage on drug tests, even if they were not using it during work hours.7 Cannabis consumption is only legal on private property—it is illegal to consume in vehicles, before operating machinery, in areas accessible to the public (such as a restaurant or park), or where children are present. Cannabis is still illegal under federal law, and thus federal agents may arrest and prosecute you for violating federal law.6
Despite state legalization, cannabis and its main active ingredient, tetrahydrocannabinol (THC), are classified as “Schedule I Drugs” in the United States under the U.S. Controlled Substances Act.8 Schedule I drugs are defined as having a high potential for abuse and have no currently accepted medical use.8 They include drugs like heroin and LSD. California physicians cannot dispense or prescribe Schedule I drugs, but they can “recommend” cannabis use to patients.11 A federal court case established case law that physicians may discuss treatment options including medical cannabis use with patients, and federal agencies cannot take action against physicians solely because they recommended cannabis in the routine course of medical care.5 A physician may not recommend a specific cannabis product or a specific dispensary, or otherwise help the patient obtain cannabis. Under state law, the California Medical Board cannot take action (such as revocation of license, investigation, or other disciplinary action) against a physician for recommending cannabis if the recommendation is made within accepted standards of medical care.4 The Medical Board of California has released these latest guidelines for recommending cannabis.
1: “Proposition 64: The Adult Use of Marijuana Act.” The Judicial Council of California, http://www.courts.ca.gov/prop64.htm
2: “AB-64 Cannabis: licensure and regulation.” Bill Text. California Legislature. 27 June 2017, www.leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB64.
3. “The Adult Use of Marijuana Act.” Adult Use of Marijuana Act (AUMA) text, www.adultuseofmarijuanaact.com/#section-8.
4. The Medical Board of California "Marijuana for Medical Purposes." www.mbc.ca.gov/Licensees/Prescribing/.
5. United States District Court, "Conant v. McCaffrey" text. https://www.wamm.org/conant-v-mccaffrey.pdf
6. “Proposition 64. Marijuana Legalization. Initiative Statute.” Prepared by the Attorney General. http://vig.cdn.sos.ca.gov/2016/general/en/pdf/prop64-title- summ-analysis.pdf
7. “Drug Testing at Work.” Findlaw, employment.findlaw.com/workplace-privacy/drug- testing- at-work.html.
8. "Drug Fact Sheet." Drug Enforcement Administration. https://www.dea.gov/
9. "The Role of the Physician in 'Medical' Marijuana." President’s Action Committee on Medical Marijuana of the American Society of Addiction Medicine. https://www.asam.org/docs/publicy-policy-statements/1role_of_phys_in_med_mj_9- 10.pdf?sfvrsn=0
10. “Compassionate Use Act of 1996” California Legislative Information. https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtmlsectionNum=11362.5.&lwCode=HSC
11. “Physician Recommendation of Medical Cannabis: Guidelines of the Council on Scientific Affairs Subcommittee on Medical Marijuana Practice Advisory.” California Medical Association, https://www.mbc.ca.gov/Publications/guidelines_cannabis_recommendation.pdf.