Market for these patients in sixteen states and D.C. estimated at between $2 – $6 billion annually

MAY 31, 2011 - We don’t know his or her name, but somewhere in one of sixteen states and the District of Columbia is America’s 1,000,000th legal medical marijuana patient. We estimate the United States reached the million-patients mark sometime between the beginning of the year to when Arizona began issuing patient registry identification cards online in April 2011.

16 states, the Capitol, and ONE MILLION legal marijuana users.

Between one to one-and-a-half million people are legally authorized by their state to use marijuana in the United States, according to data compiled by NORML from state medical marijuana registries and patient estimates.  Assuming usage of one-half to one gram of cannabis medicine per day per patient and an average retail price of $320 per ounce, these legal consumers represent a $2.3 to $6.2 billion dollar market annually.

Based on state medical marijuana laws, the amounts of cannabis these legal marijuana users are entitled to possess means there is between 566 – 803 thousand pounds of legal usable cannabis allowed under state law in America.  These patients are allowed to cultivate between 17 – 24 million legal cannabis plants.  There may possibly be more, as California and New Mexico “limits” may be exceeded with doctor’s permission and some California counties explicitly allow greater amounts, so there may be as much as 1 million pounds of state-legal cannabis allowed under state law in America.

Yet after fifteen years, one million patients, and a million pounds of legal marijuana, few if any of the dire predictions by opponents of medical marijuana have come to fruition.  Medical marijuana states like Oregon are experiencing their lowest-ever rates of workplace fatalities, injuries, and accidents.  States like Colorado are experiencing their lowest rates in three decades of fatal crashes per million miles driven.  In medical marijuana states for which we have data (through Michigan in 2008), use by minor teenagers is down in all but Maine and down by at least 10% in states with the greatest proportion of their population using medical cannabis.

Fourteen of the seventeen medical marijuana jurisdictions have mandatory registries while two (California and Colorado) offer optional registries and one (Washington) has no registry system.  Estimating California’s patient numbers is hampered by its registry system being on a county-by-county basis.  California NORML’s Dale Gieringer estimates between 2% – 3% of the state’s population are holding medical marijuana recommendations – meaning possibly over one million medical marijuana patients in California alone.

California’s patient population can be estimated from data from other medical marijuana states where patients are required to register, shown in the table below. The top two of these are Colorado and Montana, which, like California, have a well developed network of cannabis clinics and dispensaries, and which report usage rates of 2.5% and 3.0%, respectively. Other states, where medical marijuana is less developed, report lower rates of 1% and less. However, California is likely to be on the high side because it has the oldest and most liberal law in the nation. Significantly, California is the only state that permits marijuana to be used for any condition for which it provides relief – in particular, psychiatric disorders, such as PTSD, bipolar disorder, ADD, anxiety and depression, which account for some 20%-25% of the total patient population. Adjusting for this, usage in California could be as much as 25% to 33% higher than in Colorado and Montana, which would put it well over 3% of the population (1,125,000).

A 2%+ patient population estimate is supported by data from the Oakland Patient ID Center, which has been issuing patient identification cards to its members since 1996. The OPIDC serves patients from all over the state, but especially the greater Oakland-East Bay area of Northern California, where its cards are honored by law enforcement. As of 2010, the OPIDC had issued ID’s to 19,805 members from five East Bay cities (Oakland, Berkeley, Alameda, Hayward and Richmond), amounting to 2.4% of the local population.Because the cards were issued over a period of 14 years, they include numerous patients who have lapsed, moved, or deceased. On the other hand, they do not include many other local patients who have current recommendations but never registered with the OPIDC.

We have made a similar estimate for Washington State’s patients, who are the only ones in the nation with no registry system in place (Gov. Gregoire recently signed a bill that initiates a voluntary registry).  With a law very similar to Oregon’s concerning qualifying conditions, applying Oregon’s 1.04% patient population figure gives us about 69,000 patients in Washington. However, Washington State’s larger urban centers (Seattle and Spokane), combined with a more liberal law than Oregon’s regarding who can sign recommendations (osteopaths, naturopaths, and nurse practitioners can recommend in Washington) and the lack of a state registry’s burden to patient compliance with the program suggests a higher estimate of 1.5% – 2% may be appropriate.  Numbers like Colorado’s 2.5% and Montana’s 3% are improbable as Washington lacks the greater patient access to dispensaries seen in those states.

Delaware, New Jersey, and D.C.’s programs are not operational yet, so they are not shown in our data table.  Most of the other state’s programs produce reports of patient registry numbers.  With Arizona signing up over 3,600 patients since mid-April, when it’s online-only registration went into effect, Arizona is on track to register over 30,000 patients this year.

Quick Facts about Medical Marijuana States:

• The 1.1 – 1.5 million estimated and registered medical marijuana patients in America are legally entitled to cultivate 17 – 24 million cannabis plants and possess 283 –  402 tons of harvested buds.
• The seventeen jurisdictions with medical marijuana encompass over 90 million Americans and 162 votes in the 2012 Electoral College.
• Patients make up over 3% of the population of Montana, almost 2.5% of Colorado, over 2% of California. and over 1% of Oregon, and Washington.
• After Michigan at 0.76% of population, every other medical marijuana state has less than 3 in 1,000 (0.3%) patients in its population.
• California, Colorado, Washington, Michigan, Oregon, and Montana comprise over 98% of the legal medical marijuana patients in America.
• More than 3 out of four (77% – 83%) of all medical marijuana patients live on the West Coast.
• Rhode Island and Vermont, two states where over 10% of the adult population uses marijuana monthly, have patient populations of 0.29% and 0.05%, respectively.
• Monthly teen use of marijuana is down in every medical marijuana state except Maine.
• Annual highway fatalities are down in every medical marijuana state except Rhode Island.
• Incidents of workplace injuries and illnesses are down in every medical marijuana state.

Paypal, the well-known internet payment company has told California NORML that it will no longer accept payments to our “type of business” because we accept listing payments from cannabis-recommending physicians.

After years of offering free listings to physicians and collectives at our website http://www.canorml.org, CaNORML began charging a yearly listing fee to cover our costs last year.

PayPal froze CaNORML’s account in June, saying that by accepting listing fees fromcollectives, we were violating their Acceptable Use policy, which says, “you may not use PayPal in the purchase or sale of narcotics.” Although narcotics were not being sold over the CaNORML site, we reluctantly agreed to stop accepting listings fees from collectives that dispense medical marijuana, recognizing that even though they are legal under state law, they are illegal under federal law.  However, we  continued to accept payments online from doctors, attorneys, and members.

Now PayPal has stopped accepting payments from the CaNORML site because we continued to accept listing payments from physicians.

Under a ruling upheld by the U.S. Supreme Court (Conant v. Walters, 2003), physicians have the first amendment right to discuss and recommend medical marijuana for their patients, although they may not distribute it or help patients in finding it. PayPal was informed of this and wrote back, “We are not arguing the legality of this issue; we are simply stating that we have made the business decision to not be involved with this type of business.”

Because of its discriminatory policy and  disregard of physicians’ first amendment rights, CaNORML submits that PayPal is not the “type of business” to be used by those who advocate for human rights. We will file a complaint with the federal banking committee over their practices.

Located in San Jose, California, PayPal was founded in 1998 and was acquired by eBay (California gubernatorial candidate Meg Whitman’s former company)  in 2002.

Complain to: PayPal, 2211 N 1st St, San Jose 95131 (408) 376-7400

Dale Gieringer, CA NORML

[Statement of Paypal's Accceptable Use]

Hello,

We appreciate the fact that you chose PayPal to send and receive payments for your transactions.

Under the Acceptable Use Policy, you may not use PayPal in the purchase or sale of narcotics, steroids, certain controlled substances, products that present a risk to consumer safety or drug paraphernalia.  PayPal makes such decisions after reviewing laws, regulations and other actions by governmental agencies, other available evidence, and marketing content related to the product.

The complete Acceptable Use Policy can be found at the following URL:
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To learn more about the Acceptable Use Policy, please refer to our Help Center page here: https://www.paypal.com/cgi-bin/helpweb?cmd=_help

We are hereby notifying you that, after a recent review of your account activity, it has been determined that you are in violation of PayPal’s Acceptable Use Policy regarding your sales at http://www.canorml.org/prop/collectivetips.html.  PayPal cannot be used to accept fees for listing information related to marijuana dispensaries, delivery services and cannabis physicians.

By Dale Gieringer, Ph.D, Director, California NORML

California NORML has recently heard increasing reports that Marinol patients are being drug tested and denied employment for use of marijuana. In particular, we have heard from legal Prop. 215 patients who were denied jobs despite presenting Marinol prescriptions after being re-tested specifically for marijuana. Until recently, Marinol and marijuana were indistinguishable on the standard drug tests, so that patients with a Marinol prescription had a valid medical excuse under federal law for testing positive for marijuana.

However, special testing techniques have been developed that make it possible to distinguish the two by testing for non-standard cannabinoids that appear in marijuana but not Marinol. Until recently, these tests were expensive and rarely used except in high-profile criminal cases. However, it appears that they are now being routinely used by certain laboratories in cases where Marinol use is claimed. In particular, we have heard reports of such testing being used to disqualify Marinol-using Prop 215 patients by the transportation industry and by Walmart.

California NORML has accordingly altered its drug testing information to warn against relying on Marinol RXs as a screen for marijuana use: http://www.canorml.org/healthfacts/testing.tips.html

There is of course no valid scientific or health justification for allowing patients to use Marinol but not marijuana. The only purpose is to enforce compliance with the law. It is a tribute to the power and influence of the drug testing industry that they have prevailed in foisting the costs of this unnecessary and obnoxious procedure on employers.

California NORML, 2215-R Market St. #278, San Francisco CA 94114

(415) 563-5858 / www.canorml.org