100,000 REASONS: MEDICAL MARIJUANA IN THE …

100,000 REASONS:

MEDICAL MARIJUANA

IN THE BIG APPLE

New York City Comptroller

John C. Liu

AUGUST 2013

100,000 Reasons:

Medical Marijuana

In The Big Apple

Contents

1 Medical

2 More

Marijuana in New York City: An Urgent Need

Than 100,000 New Yorkers Could Benefit

3 Medical

4 Twenty

Marijuana¡¯s History in New York

States and Counting

5

Conflict with Federal Law

7

Scientific Evidence Supporting Medical Marijuana

7

Policy Recommendations

August 2013

10

Conclusion

Published by the New York City

Comptroller¡¯s Office

11

Appendix: Methodology

John C. Liu

Comptroller

First Deputy Comptroller

Ricardo Morales

Deputy Comptroller

for Public Affairs

Ari Hoffnung

Chief Economist

Frank Braconi

Special Assistant for

Public Affairs

Jacqueline S. Gold

Executive Director for Budget

Jonathan Rosenberg

Director of Policy

Carolyn Karo

Rachel Bardin

Doug Giuliano

Tomas Hunt

Andrew McWilliam

Susan Scheer

About the New York City

Comptroller¡¯s Office

The New York City Comptroller, an independently elected official, is

the Chief Financial Officer of the City of New York. The mission of the

office is to ensure the financial health of New York City by advising

the Mayor, the City Council, and the public of the City¡¯s financial

condition. The Comptroller also makes recommendations on City

programs and operations, fiscal policies, and financial transactions. In

addition, the Comptroller manages the assets of the five New York City

Pension Funds, performs budgetary analysis, keeps the City¡¯s accounts,

audits City agencies, manages the City¡¯s debt issuance, and registers

proposed contracts. His office employs a workforce of more than 700

professional staff members. These employees include accountants,

attorneys, computer analysts, economists, engineers, budget, financial

and investment analysts, claim specialists, and researchers, in addition

to clerical and administrative support staff.

About Regulate Marijuana NYC

Regulate Marijuana NYC advocates for regulating and taxing the

sale of marijuana for personal use for adults in New York City. It

recognizes that marijuana has great medical potential and should be

available to patients as well as researchers for further study. It also

calls for the creation of an interagency task force comprising the

Police Department, Administration for Children¡¯s Services, Department

of Education, Department of Health and Mental Hygiene, District

Attorneys, and Department of Consumer Affairs to study issues related

to regulation and work collaboratively with the New York State Senate

and Assembly in order to pass appropriate legislation.

Acknowledgments

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The Comptroller¡¯s Office is grateful to Dr. Sunil Kumar Aggarwal, M.D.,

Ph.D., Senior Resident Physician at New York University Langone Medical

Center and Executive Science Director of the Center for

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the Study of Cannabis and Social Policy. His expertise,

insight, and guidance contributed greatly to the research

in this report.

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New York City Comptroller

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100,000 REASONS: Medical Marijuana In The Big Apple

AUGUST 2013

MEDICAL MARIJUANA IN NEW YORK CITY: AN URGENT NEED

With the New York State Legislature poised to consider at least one bill that would legalize marijuana,1 and with

Comptroller John C. Liu¡¯s proposal to legalize, regulate, and tax marijuana in New York City2 generating wide discussion,

the Comptroller¡¯s office undertook a study of how New York City residents might benefit from the legalization of

medical marijuana, an idea gaining currency in our State.

Public polling and the legislative history suggest that New York State may indeed legalize medical marijuana soon

because New Yorkers overwhelmingly support the idea. According to a May 2013 poll conducted by the Siena College

Research Institute and Drug Policy Alliance, 82 percent of State and 79 percent of City registered voters support

medical marijuana. In 2012, the City Council overwhelmingly passed (44-3)3 a resolution calling on Albany to pass

medical marijuana legislation being considered then (A.7347/S.2774).4

On June 3, 2013, the New York State Assembly voted 99 to 41 in favor of establishing a medical marijuana program.5

The bill died in the State Senate, but given the Assembly¡¯s strong support it seems likely to see reintroduction. The

legislation would have allowed healthcare professionals to recommend medical marijuana for New Yorkers suffering

from serious conditions such as cancer, HIV/AIDS, multiple sclerosis, Parkinson¡¯s disease, and more. Physicians could

grant written certification to qualifying patients, and the Department of Health would be charged with monitoring

marijuana use and promulgating rules and regulations for registry identification cards for patients and designated

caregivers. Marijuana possession for patients would be restricted to two and a half ounces. New Yorkers under the

age of 18 with a qualifying condition could receive medical marijuana, so long as the application for a registry ID card

is completed by a person age 21 or older, and the minor has an appropriate adult designated caregiver.

NEW YORK STATE & CITY RESIDENTS OF ALL TYPES

OVERWHELMINGLY SUPPORT LEGALIZING MEDICAL MARIJUANA.

82%

?

79%

?

New

?York

?State

?

?

New

?York

?City

?

Liberal

?

?

Moderate

?

?

Conserva7ve

?

?

80%

?

77%

?

92%

?

85%

?

82%

?

83%

?

18-?©\34

?

?

35-?©\54

?

?

55+

?

?

White

?

?

La7no

?

?

Black

?

?

67%

?

85%

?

77%

?

84%

?

81%

?

Male

?

?

Female

?

?

0%

?

10%

? 20%

? 30%

? 40%

? 50%

? 60%

? 70%

? 80%

? 90%

? 100%

?

Source: Siena College Research Institute and Drug Policy Alliance, May 2013

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1 Liz Krueger New York State Senator, ¡°Top News,¡± Posted May 29, 2013, , accessed on August 22, 2013.

2 New York City Comptroller¡¯s Office, ¡°Regulating and Taxing Marijuana: The Fiscal Impact on NYC,¡± August 14, 2013, .

3 The Fix, ¡°NYC Inches Towards Medical Marijuana,¡± March 2, 2012, , accessed on August 20,

2013.

4 ¡°Resolution 0094-2010,¡± , accessed on August 20, 2013.

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5 New York State Assembly, ¡°Bill No. A06357¡±,

=Y&Votes=Y, accessed on August 20, 2013.

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100,000 REASONS: Medical Marijuana In The Big Apple

AUGUST 2013

The bill attempted to shield practitioners and

patients from federal prosecution, stating: ¡°State or

local law enforcement agencies shall not cooperate

with or provide assistance to the government of the

United States or any agency thereof in enforcing the

Controlled Substances Act¡­solely for actions and

conduct consistent with this title, except as pursuant

to a valid court order.¡±6 It also protected medical

marijuana patients and designated caregivers from

discrimination by schools, employers, or landlords,

stipulating that they may not refuse to enroll, employ,

or lease to them, unless there is a conflict with federal

law or one of the above actions could result in a lost

federal contract or lost funds.

Beverly McClain, a New York stage 4 cancer patient, describes

how medical marijuana helps alleviate her pain and suffering

from chemotherapy treatments.

Notably, the bill did not require insurers or health

plans to cover medical marijuana.

Source: Compassionate Care NY

Prominent members of the medical community

strongly supported the bill. New York Physicians for

Compassionate Care, a group of more than 750 physicians in New York State, advocated for the Albany legislation.

The bill was also endorsed by New York health organizations such as the Hospice and Palliative Care Association

of New York State, New York State AIDS Advisory Council, New York State Nurses Association, New York State

Psychological Association, the Public Health Association of New York City, and others.7

Despite majority support in the State Assembly, significant challenges remain in Albany. Thus far, Governor Cuomo has

not backed legislation to establish a medical marijuana program, although in April 2013, he said of medical marijuana

that ¡°the situation is an evolving one,¡± indicating that he might be flexible if the Senate could also pass a bill.8

MORE THAN 100,000 NEW YORKERS COULD BENEFIT

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6 Ibid.

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 ompassionate Care NY, ¡°Healthcare Practitioners across New York Support a Carefully Regulated Medical Marijuana Program,¡±

, accessed on August 20, 2013.

8P

 aybarah, Azi, ¡°As Cuomo evolves on medical marijuana, Savino urges him to hurry up,¡± April 23, 2013,

article/politics/2013/04/8529346/cuomo-evolves-medical-marijuana-savino-urges-him-hurry, accessed on August 20, 2013.

9S

 ee the Appendix for a detailed methodology.

10 Marijuana Policy Project, ¡°Federal Obstruction of Medical Marijuana Research,¡± , accessed on August 20, 2013.

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If New Yorkers widely support medical marijuana, it is because they know many people who could benefit from it.

The Comptroller¡¯s office decided to quantify that figure. We estimate that more than 100,000 New York City residents

suffering from serious conditions such as cancer and chronic pain could benefit if an effective and implementable

medical marijuana program were established today,9 deriving our estimate from most recently reported or estimated

registered medical marijuana patients in states where the drug is legal. Moreover, we believe this is a conservative

estimate because registration for medical marijuana programs in the various states falls short of the potential. Patients

experience social stigma and related social sanctions for using medical marijuana, and many doctors are not familiar

with its benefits. Moreover, the federal government has created unnecessary obstacles for academic and research

institutions to study marijuana, thereby impeding research that could lead to a broader use of medical marijuana.10

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100,000 REASONS: Medical Marijuana In The Big Apple

AUGUST 2013

MEDICAL MARIJUANA¡¯S HISTORY IN NEW YORK

Medicinal uses for marijuana were officially recognized in the 1850

edition of the United States Pharmacopeia.11 However, in the

beginning of the 20th century, a cohesive movement organized

to outlaw the use of marijuana, along with alcohol, morphine, and

opium. This culminated in the enactment of the Marihuana Tax

Act in 1937, which the American Medical Association opposed

because it instituted marijuana registration processes, compliance

requirements, and taxes that significantly deterred physicians from

prescribing it.12 In 1944, New York City Mayor Fiorello LaGuardia

commissioned The New York Academy of Medicine to study

marijuana. Its findings debunked many claims that inspired the

Marihuana Tax Act: marijuana did not lead to significant addiction

in the medical sense of the word, nor did it lead to morphine,

heroin, or cocaine addiction.13

An advertisement for Cannabis Americana in

New York, 1917

Source:

In 1970, the federal Controlled Substances Act classified marijuana as a Schedule I drug, banning it from medicinal

use. However, by 1982, more than 30 states passed laws recognizing the medical value of marijuana. In 1980, New

York State passed the Controlled Substances Therapeutic Act. Though largely unknown, it remains in the state¡¯s

public health laws today in Article 33-A. It states, ¡°¡­recent research has shown that the use of marijuana may alleviate

the nausea and ill-effects of cancer chemotherapy, may alleviate the ill-effects of glaucoma and may have other

therapeutic uses¡­there is a need for further research and experimentation with regard to the use of marijuana for

therapeutic purposes under strictly controlled circumstances.¡±14

Photo of Mayor Fiorello LaGuardia¡¯s 1944

report on marijuana.

The law created a Patient Qualification Review Board to approve patients

for research. Several hospitals participated in research to determine the

effectiveness of inhaling marijuana, which was supplied by the only federal

farm, in preventing the nausea and vomiting caused by chemotherapy in

patients that did not respond to other treatments.15 By 1985, 208 patients

had received marijuana therapy, 199 of whom were evaluated. North Shore

Hospital reported that marijuana effectively reduced vomiting 92.9 percent

of the time, compared to 89.7 percent at Columbia Memorial Hospital,

and 100 percent at Upstate Medical Center, St. Joseph¡¯s Hospital, and

Jamestown General Hospital.16 Nevertheless, the Department of Health

abandoned the program by the late 1980¡¯s.17

Source: New York City Municipal Archives

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11 HOPES Huntington¡¯s Outreach Project for Education at Stanford, ¡°Medical Marijuana Policies in the United States,¡± May 15, 2012, .

edu/group/hopes/cgi-bin/wordpress/2012/05/medical-marijuana-policy-in-the-united-states/, accessed on August 20, 2013.

12 American Medical Association Bureau of Legal Medicine and Legislation, ¡°American Medical Association Opposes the Marijuana Tax Act of 1937,¡± July

10, 1937, , accessed on August 20, 2013.

13 New York Academy of Medicine, the Mayor¡¯s Committee on Marijuana, The LaGuardia Committee Report, New York, USA, 1944,

wp-content/uploads/2012/12/laguardia.pdf, accessed on August 20, 2013.

14 Public Health Laws of New York, Article 33-A, available at

&QUERYDATA=$$PBH3397-A$$@TXPBH03397-A+&LIST=LAW+&BROWSER=BROWSER+&TOKEN=12248217+&TARGET=VI

EW, accessed on August 20, 2013.

15 Zeese, Kevin, ¡°Research Findings on Medicinal Properties of Marijuana,¡± January 1997, , accessed on

August 20, 2013.

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17 Karlin, Rick, ¡°Bureaucracy Stalls Medical Marijuana,¡± Times Union, June 18, 2012,

Bureaucracy-stalls-medical-marijuana-3639647.php#page-1, accessed on August 20, 2013.

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