Physician Advocates for Medical Marijuana

Vermont -- As he opened his remarks about medical marijuana, Dr. Joseph McSherry said he couldn't be as informative as he would like to be.

"I asked a very good friend, who happens to be a medical marijuana patient, what I should tell you today," McSherry said. "He said to tell you not to ask a doctor. Doctors don't know (expletive) about medical marijuana."

McSherry, a neurophysiologist and PhD associated with Fletcher Allen Medical Center and the University of Vermont, said his friend is largely correct: There have been few scientific studies on the effects of marijuana as a medicine, and even less research has been conducted on its medical effects in humans.

"You'll probably be more educated than your doctor by the time we get through," McSherry told his audience at the Godnick Center in Rutland on Friday.

He walked the audience through the limited medical data on cannabis and the properties of the chemicals in marijuana other than THC that can have beneficial effects.

Canabanoids, McSherry said, can boost the effectiveness of other painkillers, inhibit the growth of tumors and alleviate wet macular degeneration, which causes blindness in some cases.

McSherry said that inhaled marijuana can be very effective at treating sudden swift pains, while many other painkillers, including marinol — a legal prescription drug that is a capsule of THC in sesame oil — can take too long to take effect.

"I don't approve of smoking for anybody," he said. "There's got to be a better way of doing it, but the U.S. government hasn't been interested in doing any research.

"If you eat it, the chemicals peak in two to four hours. Eating it is probably the worst way of intaking THC," he said. "If you inhale it, THC levels peak in a few minutes and it actually goes away in the first hour."

He noted that researchers in other countries are trying to develop different types of medical cannabis for patients.

Two members of the audience who said they use the drug for medicinal purposes offered compelling testimony about its benefits. Neither identified themselves.

The first patient said that at one point he had been on 17 different medications to treat his multiple sclerosis — some to counteract the side effects of other medications.

"Now I think I'm on four medications now," he said. "I'm not on medications for the side effects of medication. I'm not drugged out or high. From 17 meds, down to four."

A second patient said he had lost more than 50 pounds while undergoing chemotherapy before using marijuana to counteract the nausea.

"I went from 236 pounds down to 176," he said. "Part of the problem was the sickness of chemo. I couldn't hold down food, and marinol did not work for me. Cannabis did work."

Members of the audience had many questions about medical marijuana, from its chemical properties to the intricacies of growing plants to use for medicine.

"If you have a seed that has a known history of consistent product, you will get a consistent product medically," McSherry said. "That's why I think patients ought to be able to grow their own."

One audience member wondered how patients who don't grow it can access medical marijuana.

McSherry said "compassionate clubs" have formed in California that allow medical marijuana patients to bring in prescriptions to be filled with marijuana of a known quality rather than forcing patients to rely on what they can find on the black market, he said.

"In Vermont, if you have a friend or a grandson … you can make a provision to register with the state that you're a registered patient and they're a registered grower," he said, adding that Vermont's medical marijuana law does not shield users or growers from federal prosecution.

McSherry sees access to the drug as an uphill battle. He said many doctors are resistant to the notion of medical marijuana.

"There are very definitely a lot of doctors who are very adamant it's not a medicine," he said. "There are doctors that believe if it were a medicine, the FDA would approve it and pharmaceutical companies would make cannabis that you can take as a product.

"If anyone can by any amount of any kind of pot for $2./oz., yes, I agree, people will not grow their own.

Change any of those parameters, and you might as well break out the grow lights."

That's silly. Illicit production and sales of marijuana is profitable today because of the high prices and because all the millions of marijuana smokers must buy from illicit sources. If prices remain the same when marijuana is legalized, illicit sales will become far less profitable because illicit sellers will see the brunt of their market share lost to legal suppliers. The only way they would be able to compete is to seriously undercut prices of legal marijuana, which would mean they would have to sell to far more people than they currently sell to to keep their profits up, and that would expose them to far greater risk of getting caught. If mass production and the absence of risk of arrest and seizures of product cause marijuana prices to go down from where they are today, illicit suppliers would be dead in the water.

Marijuana is extremely expensive to produce and distribute to end consumers through illicit channels. If it is grown outdoors it must be grown in rather small camouflaged plots way out in the boonies without all the tractors and combines and other modern farm equipment that significantly reduces the labor involved. There is a good risk that the crop will be detected and seized, and that those working the field will be arrested. Indoor crops are teeny tiny compared to large scale commercial grows of legal crops and the cost of all the high tech lighting, ventilation, and so on required adds a lot to production costs. Labor costs are particularly high for such small crops. Everyone involved expects to be handsomely paid because of the risks they are taking. Labor costs per pound would be far less if modern labor reducing farm equipment could be used and huge amounts of product were being produced for each laborer as is the case with legal crops.

And of course you have to take into account the big tax on illicit marijuana growers, and that is the risk of their crops being seized. They may be able to get high prices for their product but they get nothing for seized crops and that is reflected in the price of marijuana to consumers. That "tax" is felt at every step of the line from production to smuggling, transporting and distributing.

After the product is produced, it has to be distributed and it has to transported generally before it can be distributed. If it is imported, it must be smuggled before being transported to various parts of the country. These things are where a lot of the expense come in that drive marijuana prices up to where they are now. People who drive down the highway with a couple of hundred pounds of pot in their cars expect to be paid anywhere from $20 or so per pound on up to $100 a pound ($1.25 per ounce to $6.25 per ounce). Smugglers carrying over our borders usually want more. The product generally changes hands several times before it ever reaches the end consumer, and everyone who touches it expects to make a hefty profit. Even the little guy at the end up the distribution chain selling small bags to consumers expects a hefty profit, and he isn't selling in volume anything like retail sellers of most other consumable products. All the costs add up. That's why Mexican marijuana starts out costing a few dollars a pound in big bulk down there and ends up costing several hundred a pound or more here, depending on which part of the country it is sold in.

If marijuana was fully legal, production, transportation, and distribution costs would drop through the floor. Cost of production would be reduced dramatically if modern agricultural methods and equipment could be used and producers could produce on a much grander scale spreading their already reduced costs out further. Cost of transporting the product in bulk would drop dramatically as it would be trucked around like any other product in loads easily hundreds of times larger than the trunk loads we see today, and the guy driving the truck would be paid a good bit less for his trouble than the drug mule with a trunk load of pot, even though he could be carrying tens of thousands of pounds at a time instead of just a few hundred. And of course he won't be getting stopped by the law and getting his load seized by the police as many of the drug mules do. Per pound production and transportation costs would sink to a fraction of what they are today and those producing and transporting it could could take far less profits per pound and still make good money because they'll be dealing in much larger amounts than all of the illicit producers and mules out there now dealing in relatively small amounts at a time and having to make a lot more per pound to be profitable.

Distribution costs would drop through the floor too. As it is pot changes hands several times before it reaches the end consumer and everyone along the line expects to make a hefty profit to justify the risks they are taking. Most of the middlemen could be eliminated if it was legal. Product could either go straight to retailers from the farms, or to distributors who would distribute directly to retailers. And the retail business would be a lot different. Instead of having so many out there selling small amounts to a few people and still expecting hefty profits, we'd have a relative few retail outlets selling to all these people, doing many many times the volume that a little retail pot dealer does today and therefore able to make less profit per ounce but still cover overhead and make a nice profit.

Pot would be far cheaper all the way down the line. The only thing that could keep prices up are things like taxes, regulatory costs, and insurance. These costs would have to be pretty darned high to keep the price up to current levels on a product that could realistically be produced for a few dollars a pound at potency levels similar to current commercial grade marijuana. I think it is quite likely that even with really high taxes marijuana prices will actually go down some from where they are. And the Mexicans who supply most of our pot now would be dead in the water unless they also legalized and our country allowed imports. The costs for them would simply be too high if they had to compete with good quality American made product sold through legal channels for similar prices. No one is going to want to buy moldy brickweed from Mexico from shady illegal dealers if they can go into a nice clean shop and select from a wide variety of quality American product produced with strict quality control measures.

The only black market I can see thriving at all is a very unorganized market for homegrown pot people grow in their yards or closets where someone might sell his buddies some of what he grew for himself at prices far below retail after tax prices. This wouldn't be a huge market, because people are going to get used to the wide selection at licensed retail shops. They're going to find favorite brands they stick to.

There is something I don't think you quite get. Marijuana is already a cheap drug for the most part and marijuana consumers do not tend to consume that much of it. There are a relative few super heavy pot smokers who might smoke an ounce in a couple of days all by themselves. Most smoke considerably less than that. The government estimates that current pot smokers who have smoked at least once in the past thirty days smoke an average of seven grams per month, so an ounce would last four months. I don't know how accurate that average is. I suspect it is probably low because there are like I said people who will go through an ounce in a couple of days. But most pot smokers probably consume a good bit less than an ounce every month, maybe an average of seven grams per month if those few super heavy pot smokers are excluded. An evening pot smoker who smokes a little every night for instance like someone might have a couple of beers every evening is quite possibly smoking less than two grams a week if you don't count whatever he might share with others and only count that which he actually consumes. Someone who just smokes a little on weekends might very well just be consuming only a couple or three grams a month. I haven't smoked any pot in a long time but the last few years I was smoking it a quarter ounce (seven grams) was lasting me three months or more. I didn't smoke everyday, and I didn't smoke much when I smoked it.

Anyway, the point I am trying to make is that people don't tend to spend a fortune on marijuana. People who insist on buying the ridiculously expensive stuff might be spending a lot if they smoke it very much, but these people have the money and don't seem to mind paying those kinds of prices. They're going to be the ones who buy the over priced exclusive premium grade stuff at the store in fancy packaging to impress their friends. Most people who smoke it though really aren't spending that much on marijuana. If the average really is seven grams per month then around here anyway people would only be spending $25 a month or so on commercial grade stuff, unless they buy an ounce at a time in which case they'd be spending far less than that. If it was legal and they could buy it at a store with a wide selection, they're not going to feel the need to smoke homegrown some yahoo grew in his closet or backyard, and they certainly aren't going to feel the need to go to all the trouble of growing their own. The relatively few super heavy smokers would be probably be better off growing their own, but again they make up only a tiny fraction of all pot smokers.

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