Medical Marijuana Aerial View: Q&A with Brian Vicente, Author of Colorado's Statewide Cannabis Policy

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Brian Vicente - VICENTE SEDERBERG
  • Vicente Sederberg
  • Brian Vicente
Ohio's medical marijuana program has been legal and operational and, by all accounts, chugging along since September 2016. But it's not fully implemented yet, engendering much statewide confusion.

We published an extensive feature on some of the people involved in the different arenas of this law — businesses, city governments, hospitals, patients across Ohio — but we wanted to spotlight one of the interviews that didn't make the cut in print this week: Brian Vicente, one of the authors of Colorado's Amendment 64 and a co-founder of Vicente Sederberg, "the country's first powerhouse marijuana law firm," according to Rolling Stone.

Now that we've got our law on the books, how does Ohio fit into the medical marijuana narrative in the U.S.? It's a changing narrative, of course, and you've seen a lot of that.

I've been working full-time on marijuana and medical marijuana laws for a over a dozen years, so I definitely feel like I've got some insight and thoughts here. We currently have 28 states with medical marijuana laws dating back to 1996. Ohio is one of the newer ones. I think it falls in the middle of how these states break down in terms of having this available to the public without being a mask for legalization. I think it's a strong medical program that they've set up.

It follows the basic model of medical marijuana laws in that it establishes a regulatory structure overseen by the state government. It requires some degree of local buy-in, and a lot of communities around Ohio are setting moratoriums. That's been a somewhat troubling issue.

But the basic framework is there. They have a somewhat robust list of qualifying conditions. One trend we've seen in the last three years is new states like Ohio are adding post-traumatic stress disorder. That was something that advocates like myself pushed for years. The regulatory structure is similar to what we see in other places. You have basically four types of licenses: your stores, your cultivation facilities, your processors and your independent testing labs. It should make sense: They're in some ways mimicking other states around them. It's not dissimilar to Illinois, which is somewhat close by. I feel pretty confident it's going to work out for Ohio.

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Along with PTSD, Ohio also allows for chronic and severe pain. Is that also a new sort of trend?

It's interesting: In order to have a workable medical marijuana you have to have pain [as a qualifying condition]. Of the 28 states that have these laws, some of them are just what I consider to be unworkable as a patient advocate. You look at Louisiana, Texas, even New York: These states don't have pain [as a qualifying condition], and their patient numbers are so low because their only qualifying conditions are things like epilepsy and maybe HIV — conditions that not a lot of people have — whereas a fair amount of the American public that has pain issues. In order to have a robust patient population and to have stores that are sustainable and produce tax revenue for the state and produce jobs, you've got to have pain in there. You'll see maybe 70 to 80 percent of patients in Ohio will fall under the category of chronic pain.

And there's the broad umbrella of cancer, which comprises many patients.

Absolutely. I think Ohio's patient list is really pretty robust. You have Tourette syndrome, and you don't see that in many other states. Sickle cell anemia is sort of a new one. I have faith that it's going to help a fair amount of people.

With PTSD and other conditions here, I'm wondering how laws like this intersect with VA hospitals and federal law.

There's been some movement on this in the last several years. We live in this weird world where we have these states that have legalized marijuana or medical marijuana, and of course it's 100-percent illegal federally, right? There's that duality, and the question is: How are federal agencies going to deal with this? We see it with veterans, we see it with universities that receive federal funding. There are all these interesting questions.

In terms of the VA, they've actually gotten more positive on this in the last couple years. Previously, if you were receiving medication from the VA and you were also using marijuana for medical purposes — or tested positive for it — they would actually pull your pain meds. They would revoke you from their program, which was devastating. I still oversee a nonprofit called Sensible Colorado, and we've advocated for years for the most vulnerable patients. This is one we kept hearing about. Fortunately, the VA has shifted their position. They don't allow VA docs to prescribe or recommend marijuana, but they do allow their patients under the supervision of those doctors to use medical marijuana in addition to whatever they might be taking.

With all of these questions, the whole thing seems to be in a constant state of evolution — which, well, that's law for you — but it seems like each step brings lessons learned.

It's been a fascinating cultural shift. If you look in the 1960s, like eight percent of the American public believed in legalizing marijuana. Now it's like 58 percent. It's shifted in really powerful ways. It tracks like gay marriage and gay rights — two of the issues that in the last 20 years have really shifted in a major way. I find that fascinating.

There's this massive social change away from the way on drugs. So it's sort of akin to gay marriage, but the interesting thing is there's an intersection with the opportunity for commerce. Unlike the gay rights fight, we've made this no longer illegal and in fact created opportunities for people like Buckeye Relief and other people to bring jobs to the community and increase revenue. It's very exciting.

How do these laws intersect with the opiate addiction crisis? Have you seen trends in Colorado?

That's been a fascinating development. I do a fair amount of traveling around and meeting with elected officials. This is something where people are just being devastated by the opiate crisis. It's starting to affect middle-class white populations, so it's become a very big issue for politicians. But it's palpable. The fascinating piece of data is that anytime a state passes a medical marijuana law, we see opiate overdose deaths go down. There's a direct correlation there.

The causation there is that when people have an opportunity to use a painkiller legally under state law that doesn't lead to addiction or death, aka marijuana, they just have another option besides using Percocet or Oxycontin, and people choose that. Or, the other piece here, is that people who are on 10 Oxycontins a day or whatever, if they supplement that with medical marijuana can go down to two Oxycontins or something like that. It allows people to wean themselves off those drugs that obviously cause massive amounts of damage to the body but also can lead to overdose deaths.

We're running into an issue where elected officials are willing to look hard at the opiate addiction issue, but they're not really willing to accept that there may be a substitution effect with marijuana. That's pretty frustrating to folks who believe in science.

Among Ohio politicians, the two are rarely mentioned in the same sentence. [Note: Shortly after this interview, Gov. John Kasich publicly denied medical marijuana's role in the fight against the opiate addiction crisis.]

This is not necessarily intuitive, at least to me, and I've been working with patients for a long time. When these laws started passing, we started to see this effect. Like, wow, that's wild. That's not why we passed these laws — we passed these laws so that patients could get relief from marijuana — but it does seem that it leads to a direct decrease in opiate deaths. I think there's really something to it.

There are a lot of great byproducts. Like tax revenue and small business entrepreneurship, too. You mentioned moratoriums being implemented by cities; is there a chance that cities could be left out if they don't engage this law head-on right now while licenses are being doled out? Or as these laws evolve, have you seen the number of allowable licenses for cultivators increase with demand? [Note: The city of Cleveland currently has a moratorium on allowing medical marijuana businesses to open here.]

Basically, there's an arc that we see in states that pass medical marijuana laws. They pass a somewhat conservative or moderate law, and they almost treat this product like plutonium at the beginning. They sort of go over the top in terms of regulation and limiting the number of facilities. And then after a couple years they realize that it's not the negative they thought it'd be; in fact, it's producing jobs and the people running these business are doing a good job, and it's bringing in taxes, and it's helping people. Then they typically will expand the program in certain ways, and often that's allowing an expansion in the number of licenses or allowing companies that are currently producing marijuana to expand.

I think we do see that growth over time, but the other piece I would add — and in Colorado we dealt with this — is some states have a dual licensing system. That means that you have to have buy-in from the state government and you have to have buy-in from the local government. That's a little stronger than Ohio's, because in Ohio you don't need a [local] license, you just need generalized approval. Here, you have to have a local license. So some communities like Denver said, yes, we're going to do this, and other communities said they were going to wait. What we've found over time is that the cities that actually got on board with this and regulated it — it was really a major economic boon for them. And then their surrounding communities opened up and started allowing those shops because they saw all the revenue flowing into the early adopters. Folks who are against it now will realize find that it's generally a positive thing for the state and will eventually get on board.

Zooming in to your work with Buckeye Relief, I gather that you were at a public forum in January in Eastlake. What were your general impressions of the residents and council — and how the business idea was received?

It was interesting. Eastlake has taken this very seriously, and they wanted to get buy-in from the community. They held this public forum specifically for that purpose. We definitely did not expect such a large showing of community members. As it turned out, the vast majority of them were supportive. They weren't holding pitchforks or anything. They just wanted to learn more and meet the people who would be establishing this business in their community and ask them some questions. I honestly think it was a very positive thing. I salute Eastlake for taking the time to get that community input.

They've certainly come out as the vanguard in Northeast Ohio. As a wrap-around question, in general, going back the last few years, are there common misconceptions or frequently asked questions that follow medical marijuana laws?

There's often a kind of basic level where the public just needs to understand some of the ins and out of the law — and I know that's not the sexiest issue. But there's the fact that you can't smoke publicly. In fact, under Ohio's law you can't smoke at all. You aren't able to drive under the influence. It's important to know that there are rules and strict regulations around it.

One of the interesting things I've seen over the years is where we run into pushback from the public — it's not because the business is there, but it's because the public doesn't like the signage. I know that's sort of weird, but honestly the No. 1 complaint that we hear is that people just don't like a flashing green leaf sign. It's sort of unbelievable. That's a thing that we always stress to local communities and responsible business owners: Just have signage that blends in with the community. If communities and business owners want to minimize their headache, having smart signage — and I think Ohio is regulating this at some extent at the state level — is really the approach. It's the flashing weed leaf signs on Venice Beach that really get people fired up. That's just something interesting over the years that I've noticed.

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