Safe and legal access to cannabis is the reason dispensaries have been created by patients and caregivers around the state. For many people, dispensaries remove significant barriers to their ability to obtain cannabis. Patients in urban areas with no space to cultivate cannabis, those without the requisite gardening skills to grow their own, and, most critically, those who face the sudden onset of a serious illness or who have suffered a catastrophic illness – all tend to rely on dispensaries as a compassionate, community-based solution that is an alternative to potentially dangerous illicit market transactions.
Many elected officials around the state recognize the importance of dispensaries for their constituents. As Nathan Miley, former Oakland City councilmember and now Alameda County supervisor said in a letter to his colleagues, “When designing regulations, it is crucial to remember that at its core this is a healthcare issue, requiring the involvement and leadership of local departments of public health. A pro-active healthcare-based approach can effectively address problems before they arise, and communities can design methods for safe, legal access to medical marijuana while keeping the patients’ needs foremost.”
Likewise, Abbe Land, mayor of West Hollywood says safe access is “very important” and long-time councilmember John Duran agreed, adding, “We have a very high number of HIV-positive residents in our area. Some of them require medical marijuana to offset the medications they take for HIV.” Jane Bender, mayor of Santa Rosa, says, “There are legitimate patients in our community, and I’m glad they have a safe means of obtaining their medicine.”
Oakland’s city administrator for ordinances, said safe access to cannabis is “very important” for the community. “In the finding the council made to justify the ordinance, they say ‘have safe and affordable access’.”
And Mike Rotkin, the longtime Santa Cruz elected official, said that this is also an important matter for his city’s citizens: “The council considers it a high priority and has taken considerable heat to speak out and act on the issue.”
It was a similar decision of social conscience that lead to Placerville’s city council putting a regulatory ordinance in place. Councilmember Marian Washburn told her colleagues that “as you get older, you know people with diseases who suffer terribly, so that is probably what I get down to after considering all the other components.”
While dispensaries provide a unique way for patients to obtain the cannabis their doctors have recommended, they typically offer far more that is of benefit to the health and welfare of those suffering both chronic and acute medical problems.
Dispensaries are often called “clubs” in part because many of them offer far more than a clinical setting for obtaining cannabis. Recognizing the isolation that many seriously ill and injured people experience, many dispensary operators chose to offer a wider array of social services, including everything from a place to congregate and socialize to help with finding housing and meals. The social support patients receive in these settings has far-reaching benefits that is also influencing the development of other patient-based care models.
RESEARCH SUPPORTS THE DISPENSARY MODEL
A 2006 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 seven different dispensaries in the San Francisco Bay Area. Dr. Reiman’s study cataloged the patients’ demographic information, health status, consumer satisfaction, and use of services, while also considering the dispensaries’ environment, staff, and services offered. The study found that “medical cannabis patients have created a system of dispensing 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 dispensaries ranked significantly higher than those reported for health care nationally.
Patients who use the dispensaries studied uniformly reported being well satisfied with the services they received, giving an 80% satisfaction rating. The most important factors for patients in choosing a medical cannabis dispensary were: feeling comfortable and secure, familiarity with the dispensary, and having a rapport with the staff. In their comments, patients tended to note the helpfulness and kindness of staff and the support found in the presence of other patients.
Patients in Dr. Reiman’s study frequently cited their relationships with staff as a positive factor. Comments from six different dispensaries include:
“I love this spot because of the love they give, always! They treat everyone like a family loved one!”
“This particular establishment is very friendly for the most part and very convenient for me.”
“The staff and patients are like family to me!”
“The staff are warm and respectful.”
“The staff at this facility are always cordial and very friendly. I enjoy coming.”
“This is the friendliest dispensary that I have ever been to and the staff is always warm and open. That’s why I keep coming to this place. The selection is always wide.”
MANY DISPENSARIES PROVIDE KEY SOCIAL SERVICES
Dispensaries offer many cannabis-related services that patients cannot otherwise obtain. Among them is an array of cannabis varieties, some of which are more useful for certain afflictions than others, and staff awareness of what types of cannabis other patients report to be helpful. In other words, one variety of cannabis may be effective for pain control while another may be better for combating nausea. Dispensaries allow for the pooling of information about these differences and the opportunity to access the type of cannabis likely to be most beneficial.
“There are legitimate patients in our community, and I’m glad they have a safe means of obtaining their medicine.”
–Jane Bender, Santa Rosa
Other cannabis-related services include the availability of cannabis products in other forms than the smokeable ones. While most patients prefer to have the ability to modulate dosing that smoking easily allows, for others, the effects of edible cannabis products are preferable. Dispensaries typically offer edible products such as brownies or cookies for those purposes. Many dispensaries also offer classes on how to grow your own cannabis, classes on legal matters, trainings for health-care advocacy, and other seminars.
Beyond providing safe and legal access to cannabis, the dispensaries studied also offer important social services to patients, including counseling, help with housing and meals, hospice and other care referrals, and, in one case, even doggie daycare for members who have doctor appointments or work commitments. Among the broader services the study found in dispensaries are support groups, including groups for women, veterans, and men; creativity and art groups, including groups for writers, quilters, crochet, and crafts; and entertainment options, including bingo, open mike nights, poetry readings, internet access, libraries, and puzzles. Clothing drives and neighborhood parties are among the activities that patients can also participate in through their dispensary.
Social services such as counseling and support groups were reported to be the most commonly and regularly used service, with two-thirds of patients reporting that they use social services at dispensaries 1-2 times per week. Also, life services, such as free food and housing help, were used at least once or twice a week by 22% of those surveyed.
“Local government has a responsibility to the medical needs of its people, even when it’s not a politically easy choice to make. We have found it possible to build regulations that address the concerns of neighbors, local businesses law enforcement and the general public, while not compromising the needs of the patients themselves. We’ve found that by working with all interested parities in advance of adopting an ordinance while keeping the patients’ needs foremost, problems that may seem inevitable never arise.”
–Nancy Nadel, Oakland
Dispensaries offer chronically ill patients even more than safe and legal access to cannabis and an array of social services. The study found that dispensaries also provided other social benefits for the chronically ill, an important part of the bigger picture:
[T]he multiple services provided by the social model are only part of the culture of social club facility. Another component of this model … is the possible benefit that social support has for one diagnosed with a chronic and/or terminal physical or psychological illness. Beyond the support that medical cannabis patients receive from services is the support received from fellow patients, some of whom are experiencing the same or similar physical/psychological symptoms…. It is possible that the mental health benefits from the social support of fellow patients is an important part of the healing process, separate from the medicinal value of the cannabis itself.
Several researchers and physicians who have studied the issue of the patient experience with dispensaries have concluded that there are other important positive effects stemming from a dispensary model that includes a component of social support groups.
Dr. Reiman notes 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 those who suffer the most serious illness, such as HIV/AIDS and terminal cancer, these groups of like-minded people with similar conditions can also help patients through the grieving process. Other research into the patient experience has found that many patients have lost or are losing friends and partners to terminal illness. These patients report finding solace with other patients who are also grieving or facing end-of-life decisions. A medical study published in 1998 concluded that the patient-to-patient contact associated with the social club model was the best therapeutic setting for ill people.
Dispensaries are proving to be an asset to the communities they serve, as well as the larger community within which they operate.
ASA’s survey of local officials and monitoring of regulatory activity throughout the State of California has shown that, once working regulatory ordinances are in place, dispensaries are typically viewed favorably by public officials, neighbors, businesses, and the community at large, and that regulatory ordinances can and do improve an area, both socially and economically.
Dispensaries – now expressly legal under California state law – are helping revitalize neighborhoods by reducing crime and bringing new customers to surrounding businesses. They improve public safety by increasing the security presence in neighborhoods, reducing illicit market marijuana sales, and ensuring that any criminal activity gets reported to the appropriate law enforcement authorities.
More importantly, dispensaries benefit the community by providing safe access for those who have the greatest difficulty getting the medicine their doctors recommend: the most seriously ill and injured. Many dispensaries also offer essential services to patients, such as help with food and housing.
Medical and public health studies have also shown that the social-club model of most dispensaries is of significant benefit to the overall health of patients. The result is that cannabis patients rate their satisfaction with dispensaries as far greater than the customer-satisfaction ratings given to health care agencies in general.
Public officials across the state, in both urban and rural communities where dispensary regulatory ordinances have been adopted, have been outspoken in praise of what. Their comments are consistent on and favorable to the regulatory schemes they enacted and the benefits to the patients and others living in their communities.
As a compassionate, community-based response to the medical needs of more than 150,000 sick and suffering Californians, dispensaries are working.
This essay was sent to me by the legendary Eugene Davidovich, of San Diego’s Americans for Safe Access Chapter