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(Fortune Magazine) — Aback Irvin Rosenfeld, 56, picks me up at the Fort Lauderdale airport, his SUV reeks of marijuana. The carnality admiral for sales at a bounded allowance firm, Rosenfeld has been smoker 10 to 12 marijuana cigarettes a day for 38 years, he says.

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That’s apparently abnormal in itself, but what makes Rosenfeld aberrant is that for the able 27 years, he has been copping his edger anon from the United States government.

Every 25 canicule Rosenfeld goes to a pharmacy and picks up a tin of 300 federally developed and formed cigarettes that accept been beatific there for him by the Civic Institute of Biologic Abuse (NIDA), acting with approval from the U.S. Food and Biologic Administration.

Rosenfeld smokes the marijuana to abate abiding affliction and beef spasms acquired by a attenuate cartilage disease. Aback he was 10, doctors credible that his skeleton was riddled with added than 200 tumors, due to a activity accustomed as assorted complete cartilaginous exostosis. Admitting seven operations, he still lives with arrangement of tumors in his bones.

Rosenfeld is one of four bodies in the United States whom the federal government food with medical marijuana. Anniversary is a alive aberration because, officially, the U.S. Biologic Administration Administration, NIDA, and the FDA all booty the position that marijuana has “no currently accustomed medical use.”

That’s the abandoned way federal law can abide to allocate marijuana, like heroin, as a “Schedule I controlled substance,” banned from actuality assigned by doctors. (Numerous dangerous, psychoactive, and addictive opium derivatives, by contrast, are added agilely classified as Schedule II drugs, accepting decree use.)

Over the years the government’s position has become progressively added embattled, if not untenable.

Thirteen states now accept laws that let association use marijuana medicinally, about to allay abiding affliction (particularly assumption affliction acquired by diabetes, AIDS, and hepatitis); administer movement disorders and beef spasticity (especially for assorted sclerosis patients); as an anti-nausea and anti-ing abettor (for those, say, ability chemotherapy); and as an appetence analeptic (yes, as in “the munchies”) for those with crumbling diseases like AIDS and cancer.

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Another 15 states are belief legislation or election initiatives that could about-face them into medical marijuana states by aing year.

The accepting of medical marijuana has implications that extend far aloft allowance those adversity from life-threatening diseases. It is one of several factors — including demographic changes, the banking crisis, and the broadly perceived abortion of the war on drugs — reopening the country’s 40-year-old on-again, off-again shouting bout over whether marijuana should be legalized.

This commodity is not accession argumentation about why it should or shouldn’t be. Today, in any case, the pertinent catechism is whether it already has been — at atomic on a local-option basis. We’re apropos to a cultural abnormality that has been evolving for the able 15 years, topped off by a acute activity changeabout that was agilely instituted by Admiral Barack Obama in February.

First, some all-important background. Beneath Admiral George W. Bush (and beneath Admiral Bill Clinton afore him, for that matter), the U.S. Justice Department advised accompaniment medical marijuana laws as nullities. Such laws were contradicted and accordingly preempted by federal biologic laws, the Justice Department reasoned, and the U.S. Supreme Cloister upheld that position in 2005.

Accordingly, the federal government has periodically raided and prosecuted defendants who at atomic claimed to be acknowledging with accompaniment medical marijuana laws, and aback it did, defendants were banned from cogent juries about the actuality of those laws.

In backward February, Admiral Obama signaled a new approach. His apostle general, Eric Holder, accepted at a columnist appointment that he would no best accountable individuals who were acknowledging with accompaniment medical marijuana laws to federal biologic raids and prosecutions.

This chaste act — a simple acceding not to act, absolutely — could accept astronomic consequences. It potentially leads to absolutely the aforementioned endpoint as the Twenty-First Amendment, which repealed the federal prohibition on alcoholic acknowledgment sales.

Here’s how. Aback states accomplish a acknowledged artifice accepting medical use of marijuana, they charge attack with the blowzy catechism of what absolutely constitutes medical use. Afterwards all, doctors consistently appoint able drugs like Valium, Viagra, Prozac, and — accord us a breach — Botox to patients who are hardly at death’s door.

If a accompaniment doesn’t deeply absolute what “medical use” means, the biscuit can get its adenoids beneath the tent.

That’s what happened in California. Like best medical marijuana states, California permits doctors to “recommend” marijuana use for patients who anguish from specific austere diseases. (Drafters of the law abhorred the chat “prescribe” in an attack to abstain action with federal law.)

California’s law again adds a catchall accouterment that lets doctors additionally accept marijuana use for “any added affliction for which marijuana provides relief.” In practice, doctors — abundantly adequate from second-guessing by acquaintance privileges — accept been chargeless to accomplish the final alarm as to which altitude those ability be.

This is, afterwards all, the barometer vis–vis medicines. Already a biologic has been FDA-approved for one use, doctors can accurately appoint it for other, alleged off-label purposes, alike admitting the biologic has not yet been certified as safe or able for them.

Accordingly, California doctors are acceding patients to booty marijuana to abate such ailments as anxiety, headache, premenstrual syndrome, and agitation sleeping. “You could get it for writer’s block,” comments Allen St. Pierre, the controlling ambassador of the Civic Organization for the Ameliorate of Marijuana Laws.

Some California doctors voluntarily abode the breakdown of accommodating medical altitude for which they accept accustomed marijuana use in the Alameda, Calif., medical newsletter O’Shaughnessy’s.

They frequently abode that added than a division of their marijuana authorizations accept been prompted by patients adversity from altitude like “anxiety” or “insomnia.” (The best accepted complaint is “chronic pain.”)

As a result, in best of California’s littoral burghal areas, marijuana is finer acknowledged today. Any citizen beforehand than 18 who gets a agenda from a doctor can accurately buy the stuff, and doctors acutely acquisitive to abode such notes, about in barter for a $200 appointment fee, acquaint in newspapers and on websites.

There are an estimated 300,000 to 400,000 medical marijuana patients in the accompaniment now, and the amount is rapidly growing.

More astonishingly, there are about 700 medical marijuana dispensaries now operating in California aboveboard distributing the drug.

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These dispensaries — alleged “compassionate-care clinics” by the austere and “pot shops” by the agnostic — are absolutely outpatient facilities, with not a few patients accession on bicycles, roller skates, or skateboards. (They about get discounts for accomplishing so, because it’s greener than appliance a fossil-fuel-powered car.)

The dispensaries advertise marijuana and its concentrated adhesive forms, hashish and kif, sometimes alongside a ambit of enticing, non-inhaled alternatives, including marijuana-imbued brownies, cookies, gelati, honeys, ers, affable oils (“Not So Virgin” olive oil), bottled algid drinks (“enhanced” lemonade is the best popular), capsules, lozenges, spray-under-the-tongue tinctures, and alike topically activated salves.

In Los Angeles a high-end three-store alternation alleged the Farmacy employs a pastry chef to baby-sit assembly of all its broiled goods. Best dispensaries additionally advertise abridged plants and seeds for patients who are either thrifty or entrepreneurial.

All these establishments are affianced in what federal chastening statutes still humorlessly ascertain as narcotics trafficking. The dispensaries’ affiliated marijuana farms and bulb nurseries are sometimes of acceptable admeasurement to accountable operators to mandatory-minimum five-year federal bastille terms.

And this, apperception you, is a bearings that acquired about absolutely during the Bush administration, aback the U.S. Biologic Administration Administering was still commonly aggressive berth landlords with damage of their premises, periodically raiding clinics and abduction inventories, and criminally prosecuting the best aboveboard calumniating operators.

Luke Scarmazzo, who aired a rap video on YouTube two years ago boasting of all the money and abundant he was accepting from alive the California Healthcare Aggregate in Modesto, Calif. — “Fuck the feds!” was one brash lyric — was bedevilled in federal cloister this able December to about 22 years of imprisonment on a continuing bent activity conviction. (He has appealed.)

While the bearings in California is unusual, it’s acceptable beneath so. There are now 15 dispensaries in Colorado, according to weedmaps.com, one of abounding online marijuana berth and physician (“pot-doc”) locator services. In Oregon about one in four alive physicians has accustomed at atomic one of his patients to abound marijuana for medical use.

New Mexico hopes to accept the nation’s aboriginal state-licensed medical marijuana acreage and distributorship up and alive by the time this commodity is published. New Mexico’s law was allowable two years ago, but accompaniment admiral hadn’t dared apparatus it until Apostle Accepted Holder blew the all bright in February.

This is the faculty in which Admiral Obama’s chaste acceding not to baffle with accompaniment medical marijuana laws potentially achieves for that booze what the Twenty-First Amendment able for beer, wine, and booze during the Abundant Depression.

Repeal, remember, artlessly alternate to the states the appropriate to adjudge whether to admittance alcoholic acknowledgment sales, and, if so, aback and how. If a accompaniment acceptable sales, it could additionally accomplish minimum- age requirements, absolute abundance hours, set zoning restrictions, and burden taxes. If it banned sales, it could insolate in appropriateness but exercise no ascendancy over the cartage that would activity anyway.

Over time about every accompaniment fell in band abaft the tax-and-regulate model. (During Prohibition, federal law did accommodate an barring accepting alcoholic acknowledgment sales for medical purposes. Nevertheless the case for medical booze was never compelling, and afterwards aition no accompaniment chose to activity the amends of booze sales aloft a d of medical need.)

“I anticipate we’re activity to accept absolutely that affectionate of bounded advantage with marijuana [that we now accept with alcohol],” says Keith Stroup, 65, NORML’s founder, backstab able controlling director, and accepted acknowledged counsel. “Once that happens it will be like gambling.”

Initially abandoned Nevada acceptable gambling, and again it was aloof Nevada and New Jersey. “But over a aeon of time,” Stroup says, “the chastity allotment of the affair affectionate of dissipated, and there were added and added needs for new revenue, and today about every accompaniment in the country allows legalized gambling.”

Marijuana activists anticipation they were aing to amends already before. From 1973 to 1978 activists won decriminalization in 11 states. (“Decriminalization” is a grab-bag appellation but usually refers to schemes beneath which first-time ascendancy of babyish quantities of marijuana becomes a noncriminal violation, affiliated to a parking ticket. Decriminalization avalanche abbreviate of legalization, in that auction and administration abide austere felonies.)

In 1977, Admiral Jimmy Carter accustomed a federal decriminalization bill. But the bill went nowhere, and anon the movement was all but abandoned by the acknowledgment beat of the cultural pendulum, now accustomed as the Reagan Revolution. There would be no new accompaniment or federal marijuana reforms for the aing 16 years.

“Here’s what’s altered now,” asserts Ethan Nadelmann, the arch of the Biologic Activity Alliance, which favors marijuana amends on a tax-and-regulate model. “First, in the backward 1970s no added than 30% of the American accessible accurate authoritative marijuana legal. Now it’s breaking 40%.”

That jump reflects an important demographic change, Nadelmann notes. “Back again there was a accomplished beforehand bearing of Americans who didn’t apperceive the aberration amid marijuana and heroin,” he says. “Now that bearing is mostly gone. The bodies in ability are babyish boomers, a majority of whom absolutely smoked marijuana.”

The able three Presidents accept all added or beneath accepted aggravating the drug, Nadelmann continues, and the accepted one, aback asked if he inhaled, abundantly retorted, “I anticipation that was the point.”

Beyond the demographic change, there is a acumen that afterwards 40 years of blood, sweat, and tears, the war on drugs — formally declared by Admiral Richard Nixon in 1969, a ages afore the Woodstock anniversary — has bootless to abate the availability of actionable drugs, has accomplished and empowered organized-crime gangs, and has subjected millions of bodies to arrest who affectation little blackmail to anyone but themselves.

On top of that, we’re now mired in the affliction bread-and-er ambiance aback the Abundant Depression, which makes the anticipation of accession taxes on marijuana sales as adorable to a politicians as beer, wine, and liquor taxes looked to Admiral Franklin Delano Roosevelt and his affair aback they took appointment in 1933, the year Prohibition was repealed.

Assuming a civic customer bazaar for marijuana of about $13 billion annually, Harvard economist Jeffrey Miron has estimated that amends could be accepted to accompany accompaniment and federal governments about $7 billion annually in added tax revenue, while extenuative them $13.5 billion in prohibition-related law administration costs.

In California, breadth the budgetary crisis is so grave that the accompaniment has had to affair vendors added than $1 billion in IOUs, a Field Poll arise in April showed that 56% of the state’s citizenry advantaged legalizing marijuana, bidding Gov. Arnold Schwarzenegger to alarm for an “open debate” on the question. A amends bill has been alien in the accompaniment legislature, and the accompaniment lath of equalization has estimated that if passed, it would accompany in $1.4 billion in new revenue, a acutely bourgeois estimate.

It’s alike accessible that amends would abate civic health-care costs, by abatement abode for cher pharmaceuticals.

In the best contempo affair of O’Shaughnessy’s, one doctor arise that his cannabis patients had either chock-full or cut aback their use of “analgesics of all kinds [including] Tylenol, aspirin, and opioids; psychotherapeutic agents including anti-anxiety medications, anti-depressants, anti-panic, obsessive-compulsive, anti-psychotic, and bipolar agents; gastrointestiminal agents including anti-spasmodics and anti-inflammatory medications; cephalalgia preparations; anticonvulsants; appetence stimulants; immuno-modulators and immunosuppressives; beef relaxants; assorted sclerosis administration medications; ophthalmic preparations; allaying and anesthetic agents; and Tourette’s affection agents.”

“Medical marijuana is God’s little antic on the [marijuana] prohibitionists,” says Richard Cowan, 69, a longtime amends activist who claims he’s smoked about every day aback 1967. “There is acutely a medical need, and it ranges from accessory to life-saving…. From my perspective, the adding band amid medical and nonmedical should not be absitively by the police.”

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Medical marijuana is acutely the consummate agency authoritative things altered this time. Not abandoned is it alteration perceptions of the drug, but it has additionally accustomed amends advocates in California a first-ever befalling to devise and advertise a business prototype.

They’ve been afforded the adventitious to appearance a agnostic accessible that a safe, seemly, and amenable arrangement for distributing marijuana is possible. If they succeed, they’ll argue the fence sitters and advance the way to a civic metamorphosis.

If they fail, the backfire will be savage. If communities cannot abundantly adapt the dispensaries, they’ll alight into unsightly, youth-seducing, crime-ridden playgrounds for gang-bangers, and this amour with amends will achieve the way the aftermost one did: with a abrupt and barbarous beat of the pendulum.

Pot’s medical history

Marijuana, whose botanical name is cannabis, has been acclimated medicinally — and as an intoxicant, of advance — for accoutrements of years in Eastern cultures. It is believed to accept been alien to Western anesthetic in the aboriginal 19th aeon by a British doctor, W.B. O’Shaughnessy, who abstruse about it while stationed in India (and for whom the medical cannabis newsletter is named).

Several acclaimed biologic companies, including Eli Lilly (LLY, Fortune 500), awash cannabis in delicate or blush forms in the aboriginal 20th aeon as a painkiller, antispasmodic, sedative, and “exhilarant.” (For this commodity Fortune asked Eli Lilly for actual accommodation on its cannabis sales, but a backer responded, “Due to aggressive priorities, we … are clumsy to facilitate your query.”)

Though cannabis remained listed in the U.S. Pharmacopeia — a accepted lath advertence for drugs — until 1942, its use in Western anesthetic began crumbling in the backward 1800s, according to a history of cannabis accounting by Harvard analyst Lester Grinspoon blue-blooded “Marijuana: The Banned Medicine.”

The decline, Grinspoon writes, was due in allotment to the acceleration of added abiding and able pharmaceuticals — admitting abounding of them afterwards accepted to accept grave abeyant ancillary furnishings — and because avant-garde hypodermic syringes could bear faster affliction abatement appliance opiates. (Opiates were soluble; cannabis wasn’t.)

Then, in the aboriginal 1900s, states began outlawing cannabis, which had become associated in legislators’ minds with agitated abomination and psychosis. The biologic was again actuality acclimated in the U.S. mainly by Mexican casual workers in the West and African Americans in the South, so apprehensions about it may accept been intertwined with ancestral and indigenous fears. In 1937 the federal government, over the objections of the American Medical Association, finer banned cannabis.

Modern-day medical assessments of marijuana’s backdrop accept not corroborated the outsize dangers that assembly had attributed to the plant. While it is a “powerful drug,” assured an Institute of Anesthetic abode conducted in 1997 at the bidding of the White Abode Appointment of Civic Biologic Ascendancy Policy, its “adverse furnishings … are aural the ambit of furnishings acceptable for added medications.”

Yes, accession who is aerial on marijuana shouldn’t drive — his motor abilities and brainy admiral are burst — but that’s accurate of booze and abounding decree drugs too.

The abiding risks to abiding users arise to centermost mainly on the all-encompassing dangers of smoker (respiratory anguish and possibly lung cancer) and aloft the “mild and short-lived” abandonment affection that a boyhood of marijuana users experience, according to the IOM experts. They advised marijuana beneath addictive than tobacco, codeine, or Valium.

Still, abounding doctors are annoyed about advising marijuana to patients — putting a issues of acknowledged liability. To activate with, best pharmaceuticals abide of a single, antiseptic actinic compound. Such drugs are affected to double-blind, placebo-controlled testing, and already they are approved, doctors can appoint accustomed dosages.

Marijuana, in contrast, consists of the dried, ground-up flowers of a awful capricious plant. It is fabricated up of at atomic 400 compounds, including added than 60 that are altered to cannabis, accustomed as cannabinoids, several of which are believed to accept ameliorative effects. The accommodation of these compounds alter abundantly from bulb to plant. A bulb may allure adverse molds.

Lighting a bout to the mix again introduces a accomplished new set of variables. Finally, smoker — alike putting a its bloom risks — is an appropriate commitment system. Everyone smokes differently, so one never knows how abundant of which compounds the accommodating is receiving. These factors all accomplish marijuana adamantine for admiral to assay advisedly and adamantine for doctors to appoint confidently.

Accordingly, alike those doctors who admit the ameliorative admiral of marijuana about adopt the angle of attractive for one or two key alive accommodation in it, isolating them, and again devising a commitment arrangement that would not absorb smoking.

And that’s been done. In 1986 the FDA accustomed a constructed adaptation of what has connected been accustomed to be the basic consciousness-expanding additive of marijuana — delta-9-tetrahydrocannabinol, or THC. Afterwards accurate testing, the FDA activate THC to be safe and able for the assay of nausea, ing, and crumbling diseases. This lawful, Schedule II drug, trade-named Marinol, is taken orally, by capsule.

The agitation is, for abounding patients Marinol turns out to be inferior to acceptable ancient pot. Smoked marijuana is abundant faster acting and, as a consequence, easier for patients to ascendancy in acceding of dosage. The accommodating inhales as abundant as he needs and again stops. In contrast, with a THC us the accommodating can calmly blot added than he can handle.

“Oral THC is apathetic in access of activity but produces added pronounced, and about unfavorable, consciousness-expanding furnishings that aftermost abundant best than those accomplished with smoking,” according to a 2008 abode arise by the American Academy of Physicians. (Incidentally, the FDA-approved warnings for Marinol — authentic THC — do not flatly forbid patients from alive beneath its influence. Rather, they artlessly attention patients not to do so “until it is accustomed that they are able to abide the biologic and to accomplish such tasks safely.”)

Still, admitting the black achievement of articulate THC, abounding doctors appetite to abide exploring faster-acting THC commitment systems, including a bark appliance or a suppository.

Meanwhile we’re still apprehension adamantine affidavit that smoker marijuana can absolutely annual lung cancer. That affirmation has accepted decidedly elusive, maybe in allotment because archetypal marijuana users smoke so abundant beneath than archetypal tobacco smokers.

In any case, marijuana users are added axis to a agency of assimilation that does not absorb smoker accustomed as vaporization. With a aerosol — the Volcano cast is the best accustomed — users calefaction marijuana to a temperature acceptable to vaporize the cannabinoids but bereft to atom agitation and best of its associated baneful gases. The abasement are captured in a airship and again inhaled.

The government’s compassionate-use program

As a jailbait Irv Rosenfeld was a able adversary of marijuana use. He would sometimes accord talks adjoin marijuana at bounded schools. “I’d authority up accoutrements of my decree drugs and say, ‘Be beholden you’re healthy,'” he recounts. He was again demography decree beef relaxants, sleeping pills, anti-inflammatories, and a ambit of addictive, debilitating, opioid painkillers, including codeine, Demerol, and Darvon.

Shortly afterwards Rosenfeld started academy at the University of Miami, he caved in to associate burden and approved pot. “Nothing happened,” he says. (To this day Rosenfeld maintains that he never has been able to get aerial from marijuana. In my six or so hours with him, during which he collection me from Fort Lauderdale to Miami and back, all the while chain-smoking joints, I never noticed any credible appulse on him, added than an casual cough.)

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Rosenfeld connected smoker socially aback others did. “About the 10th time,” he continues, “I was arena chess aback I accomplished that I’d been sitting still for 30 minutes.” Normally he couldn’t do that because his anatomy would activate to anguish and he’d accept to change position. “I hadn’t taken a us in six hours. Aloof again accession handed me the joint, and it hit me. The abandoned affair I’d done altered was smoke pot.”

Rosenfeld ran again experiments, and both he and his surgeon became assertive that marijuana helped him added than his decree drugs, with beneath ancillary effects. In 1971, with the absolution of his doctors and the allowance of affectionate badge officials, he began smoker marijuana to amusement his pain.

Then, in 1976, Rosenfeld abstruse of the amazing case of Bob Randall (now deceased). Randall, who had astringent glaucoma, had been prosecuted that year for marijuana ascendancy in the District of Columbia but won absolution afterwards advancing a “medical necessity” defense. Randall’s doctors had testified that he risked activity dark afterwards marijuana to abate the burden aural his eyeballs.

Randall again brought a civilian clothing adjoin the government. In 1978 a extraordinary adjustment was reached: The government agreed to accumulation Randall with marijuana for the blow of his life.

The government had the accommodation to bang such a accord because aback 1968, NIDA had been growing a babyish abundance of marijuana for assay purposes beneath arrangement with the University of Mississippi’s pharmacy school. FDA and NIDA admiral theorized that the U.S. government could accurately become Randall’s supplier if they empiric the pretense that he was allotment of a analytic abstraction to investigate a abeyant new drug. A assay “protocol” was fatigued up, admitting the abstraction architecture alleged for aloof one patient: Randall.

Rosenfeld drew up a agnate acceding for a analytic abstraction of himself. With the advice of admiring doctors and aggressive lawyers, Rosenfeld became the additional accommodating to pry his way into what became accustomed as the compassionate-use analytic new biologic program.

By 1991 the compassionate-use affairs had developed to accommodate 13 patients. That year, afterwards Randall counseled AIDS advancement groups on how to seek acceptance to the program, it aback activate itself deluged with 40 new applications. In aboriginal 1992, seeing the absurd administration in which affairs were headed, the government shut the affairs down, admitting the 13 absolute patients were grandfathered in. Today aloof four are left, including Rosenfeld.

For them, federal marijuana developed at the University of Mississippi is beatific to a architect in Assay Triangle Park, N.C., breadth it is formed into cigarettes on an old apparatus acquired from the bounded tobacco industry. About every bristles months the architect sends six tins of the cigarettes to the pharmacy breadth Rosenfeld picks them up.

Rosenfeld’s edger is hardly adept affection by a California berth standards. The government grows its crops abandoned sporadically, so it dries the harvested flowers and places them in algid storage. Aback I visited him in June, Rosenfeld was smoker marijuana harvested nine years earlier. Because Rosenfeld finds the government’s cigarettes too dry, he unwraps them, rehydrates the marijuana by acceding it in a alembic with lettuce, and again re-rolls his own joints, he says.

Rosenfeld’s cigarettes are additionally not actual almighty by a standards. They accommodate about 3.5% THC, which was about the boilerplate backbone of blockhead bedeviled in calm artery busts in 1996, according to NIDA data.

By contrast, marijuana bedeviled from such busts in 2007 had an boilerplate authority of about 4.8%, while the beginning “manicured bud” accessible at today’s best California dispensaries avowal THC agreeable alignment from about 6% to 22%.

It’s as if Rosenfeld were accepting boilerplate ice chrism joylessly fabricated in the Soviet Union and stored for decades, aback there’s beginning Ben & Jerry’s Chocolate Chip Cookie Dough for auction aloof about the corner.

Still, Rosenfeld’s not complaining. The government accuse him nothing, so his abandoned costs are medical consultations and pharmacists’ fees — about $50 a month. Subpar or not, the 8.3 ounces he receives every 25 canicule would amount him added than $2,000 on the street.

The action to approve marijuana

After the compassionate-use affairs was shut down, medical marijuana activists had one aftermost achievement for alteration federal policies. Aback in 1972, NORML and added groups had sued the antecedent of the DEA to force the rescheduling of marijuana as a prescribable drug, and incredibly, two decades later, the action was still raging.

During 14 canicule of hearings in 1986 the plaintiffs had presented abounding anecdotal accounts of about amazing adventures patients had had with marijuana. Rosenfeld testified, as did the analyst and medical historian Grinspoon, who accompanying not abandoned the affirmation his assay had unearthed but additionally a claimed anecdote.

In 1972, Grinspoon’s own boyish son, who had leukemia, began ability chemotherapy. “He would alpha to barf anon afterwards assay and abide abhorrence for up to eight hours,” as Grinspoon afterwards declared the affliction in his book. “He ed in the car as we collection home, and on accession he would lie in bed with his arch over a brazier on the floor.”

Having heard that marijuana could help, Grinspoon’s wife proposed that the brace let their son try it, but Grinspoon banned because it was illegal. His wife again defied him, secretly smoker marijuana with the jailbait afore one of his treatments. This time there was no ing, and in fact, on the way home the adolescent asked to stop for a abysmal sandwich. “From again on he acclimated marijuana afore every treatment, and we were all abundant added adequate during the actual year of his life,” according to Grinspoon’s account.

In 1988 the authoritative law adjudicator audition the case disqualified in NORML’s favor. “Marijuana, in its accustomed form, is one of the safest therapeutically alive substances accustomed to man,” Adjudicator Francis Adolescent concluded. Adolescent was apropos to the actuality that it is about absurd to antithesis fatally on marijuana, a accident that distinguishes it from about any added drug. “By any admeasurement of rational analysis,” Adolescent concluded, “marijuana can be cautiously acclimated aural a supervised accepted of medical care.”

In one of those maddening circularities of federal authoritative law, however, the DEA’s abode from Adjudicator Young’s cardinal was heard by John C. Lawn, again ambassador of the DEA itself. Not surprisingly, in 1989, Lawn chaotic all of Young’s findings.

Lawn gave abbreviate shrift to anecdotes like Grinspoon’s and Rosenfeld’s. “These belief of individuals who amusement themselves with a mind-altering biologic … charge be beheld with abundant skepticism,” he wrote. “Many of these individuals had been recreational users of marijuana above-mentioned to acceptable ill. These individuals’ admiration for the biologic to abate their symptoms, as able-bodied as a admiration to rationalize their marijuana use, removes any accurate amount from their accounts.”

Lawn additionally fatigued the absence of any controlled analytic studies proving marijuana’s assurance or efficacy. He was right; such studies didn’t abide (at that time), both because of the inherent difficulties of d them on a accomplished bulb and the altered difficulties of d them on an actionable plant. To alike access marijuana for such tests, admiral would accept had to aboriginal win approval from three federal bureaucracies – the DEA, the FDA, and NIDA — a alarming assignment alike d the best of acceptable will on everyone’s part.

As for the controlled studies d that marijuana’s arch consciousness-expanding additive — THC, in the anatomy of Marinol — was safe and able for alleviative assertive medical conditions, Lawn saw them as artlessly proving absolutely that there could be no believable alibi for smoker marijuana. To whatever admeasurement THC ability be helpful, patients could use Marinol.

In 1994 the federal cloister of appeals for the District of Columbia upheld Lawn’s decision, and the activists’ aftermost achievement for accomplishing ameliorate at the federal akin died.

So they angry to accompaniment government. In 1996 a accumulation of marijuana activists in California got abundant signatures to put a aldermanic action on the election accustomed as Proposition 215. It alleged for acceptance medical marijuana patients or their “primary caregivers” to acquire marijuana on the “recommendation or approval” of a physician.

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The admeasurement anesthetized with a 56% majority, and California became the aboriginal medical marijuana state. Absolutely what that meant, though, remained absolutely unclear. Prop. 215 did not specify how abundant pot patients could possess, and it said annihilation about the way patients would access it. Annihilation in the action absolutely legalized sales or administration of any kind.

Nevertheless, a few audacious souls opened dispensaries.

Dispensaries – A acknowledged gray area

“In the actual deathwatch of access of Prop. 215 in 1996,” recalls Stephen DeAngelo, who would afterwards accessible what is now Oakland’s better dispensary, “local governments tended to booty a hands-off attitude adjoin medical cannabis.” They wouldn’t absolutely authorization dispensaries to open, he says, but they additionally didn’t acquaint the badge to go shut them down. “Dispensaries were acceptable but not sanctioned.”

Even those bounded politicians who accurate the goals of Prop. 215 were afraid to adapt in the area, because any such accomplishment would accept had to activate with berth operators bushing out forms accouterment incriminating advice about themselves. Any such abstracts could again accept been subpoenaed by federal prosecutors and acclimated to shut the operators bottomward or put them in prison.

DeAngelo, now 51, was again a longtime marijuana activist but additionally a businessman. From 1990 to 2000 he founded and headed the automated hemp aggregation accustomed as Ecolution. (Hemp, from which braiding and added articles are made, is a non-psychoactive ache of cannabis. Hemp articles are acknowledged in this country, but growing hemp is not.) Excited by the medical cannabis abnormality in California, DeAngelo confused there in 2001, aback the acknowledged ambiance was still acutely gray.

He activate two basic types of berth managers operating at that time, he recalls. “The best of them were the well-motivated activists who brought absolutely acceptable intentions … but had, for the best part, no business acquaintance whatsoever and no basic to invest. Admitting that, they managed to thrive, artlessly because they were the abandoned d in town.

“This engendered a additional beachcomber of operators, who were admiring by the money, as adjoin to the cause,” DeAngelo continues. “A accomplished new beachcomber of dispensaries got befuddled up, which I accredit to as ‘thug dispensaries.’ These were operations run by bodies who had a accomplishments in adulterous activities, whether it was affairs cannabis or added drugs on the street, or trading in actionable firearms, or in the porn industry or bank industry — bodies adequate operating in the gray zone. Actual rapidly you began to see some big problems. Several armed robberies. You had a access of belief about operators actuality arrested.

“As a patient,” says DeAngelo — he uses marijuana to abate affliction from a degenerative deejay anguish — “I was greatly black about it. As an activist I became anxious because these types were absolutely affliction the accessible angel of medical cannabis.”

In an accomplishment to advance the Wild West atmosphere, the California assembly again anesthetized Senate Bill 420 (“420” is a argot appellation for pot), which took aftereffect in 2004. This law fleshed out a bit added about the way Prop. 215 would work, acute counties to affair identification cards to patients who approved them (to advice them in their interactions with the police) and ambience up minimum guidelines for how abundant marijuana patients could possess: eight ounces of broiled marijuana additional either six complete plants or 12 adolescent plants. (Counties could acquiesce academy amounts.)

Though SB 420 was still bashful on the affair of dispensaries, it did accommodate a accouterment that adequate patients or caregivers who “associate … in adjustment collectively or cooperatively to breed marijuana for medical purposes.” Accordingly, about all the dispensaries in California now affirmation to be accommodating “collectives” or “cooperatives,” adequate beneath this provision.

At the aforementioned time accession accouterment of SB 420 seemed to cut adjoin the abstraction that dispensaries were acknowledged — at atomic as abounding of them were (and still are) actuality run. It said that annihilation in the law should be construed to “authorize any abandoned or accumulation to breed or administer marijuana for profit.”

“In my opinion,” says Bill Panzer, a criminal-defense apostle and marijuana amends apostle who helped abstract Prop. 215, “the vast, cutting majority [of dispensaries] are not legal, because they’re not collectives or cooperatives. If somebody owns the store, sells marijuana, and at end of day takes the added money and puts it in his abridged and goes home, that’s not a collective.”

The proof-of-concept challenge

DeAngelo opened the Harborside Bloom Centermost berth in Oakland in October 2006 as a proof-of-concept that ability appearance the blow of the nation how such an enactment could accommodate top-flight accommodating services, attach to the letter of the law, and collaborate with the surrounding association beneficially.

His clinic, beyond from a breathtaking amplitude of Oakland harbor, is articular abandoned by its abode — a large, block-letter “1840” corrective on the faade of an inconspicuous, gray-blue one-story architecture on Embarcadero Drive.

On the central it’s a spacious, wood-trimmed, alluringly appointed allowance that blends clean, a curve with sparingly active Eastern alleviative themes: a bedlam Buddha here, a dancing goddess cartoon there.

The affection is burst abandoned by the metal detector at the aperture and the assorted casino-style cameras anchored in the ceiling. Oakland has a aerial abomination rate, and precautions charge be taken. There are at atomic three aegis guards central the ability at all times, as able-bodied as two added outside, patrolling Harborside’s 100-car parking lot.

“Whenever a accommodating comes into the berth for the aboriginal time,” explains DeAngelo, “they assurance a aggregate agronomics agreement. They accredit all the added patients in the aggregate to abound medical cannabis on their behalf. That sets up a 100% closed-loop administration arrangement that isolates my patients from any acquaintance with the adulterous market.”

But that doesn’t beggarly that every affiliate of the aggregate absolutely knows what a hoe looks like. “For a arrangement of actual accurate reasons,” DeAngelo continues, “most patients are clumsy to abound their own medicine. We act as a clearinghouse amid patients who are able to abound and patients who aren’t able to grow.”

Harborside now has 30,000 patients registered in its database, and their purchases of anesthetic accompany in about $20 actor annually in revenue, according to DeAngelo. “I’d rather not altercate my specific salary,” he says. “I can acquaint you if I was alive in any added industry and showed the affectionate of banking allotment that this business has shown, I’d be paid three or four times as abundant as I’m authoritative at Harborside.”

First-time patients, aloft dispatch through the metal detector at Harborside, anon abide a absolute paperwork check. The accommodating produces his doctor recommendation, the berth verifies its actuality with the doctor, and again the berth additionally verifies the doctor’s accreditation with the accompaniment medical board.

About 600 patients appear to Harborside anniversary day, according to DeAngelo, best to buy marijuana, a few to accumulation it. Suppliers can accompany in as abundant as three pounds at a time. (Bay Breadth badge about acquiesce patients to carriage this much, DeAngelo says.) The patient-grown marijuana is inspected for quality, advised for molds and fungi, and activated with a gas chromatograph accumulation spectrometer to actuate its THC content.

At Harborside, there are eight affairs stations forth a connected counter, anniversary a a bottle case announcement the advanced arrangement of medicines available, labeled as to ache and THC content. “Our best accepted strains are our amethyst strains,” says DeAngelo, “like Amethyst Urkle or Granddaddy Purple. The purples tend to be abundant indicas” — one of the two basic varieties of consciousness-expanding cannabis — “with a actual strong, adequate effect. They accept a artlessly sweet, about candy-like flavor.

“Another accepted ancestors of strains is the Kush family,” he continues. “That would accommodate OG Kush, Baba Kush, and Authentic Kush. The Kushes tend to be added sativa-dominant,” apropos to the added basic arrangement of cannabis, which is said to aftermath a added cerebral, “daytime appropriate” high, with beneath anatomy impact. “They accept a acid acidity as adjoin to a candied flavor.”

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At Harborside, I accomplished a balmy claimed epiphany: I accomplished that I never absolutely knew afore what beginning marijuana smelled like. Admitting I had calmly recognized, from East Coast academy canicule 30 years back, the aroma of smoked marijuana central Rosenfeld’s SUV, I had never afore smelled the sweet, herbal aroma suffusing Harborside. At aboriginal I afield affected it was some arrangement of aroma actuality artificially alien to affectation the odor I was accustomed with.

As I added inspected Harborside’s medicines, I additionally accomplished that I had never absolutely accustomed afore what fresh, high-quality marijuana looked like. I remembered baggies half-filled with ashamed amber twigs, leaves, stems, and alike seeds. But the dispensaries advertise abandoned beginning “bud,” which looks like cute, plump, down-covered caterpillars coiled in a ball.

After my apprenticeship at Harborside I went on to analyze some of the added approaches that marijuana entrepreneurs and activists are experimenting with as they try to acceleration to the proof-of-concept challenge.

Pioneering canna-businessman Richard Lee, additionally in Oakland, has opened his Blue Sky Caf berth as a coffee shop, demography his cue from Amsterdam. Lee acknowledges that he runs the Blue Sky as a for-profit business, a bearings that the Burghal of Oakland authorities accept at atomic tacitly endorsed, admitting SB 420’s credible prohibition of “for profit” distribution.

In 2004 the city, gluttonous to abstain actuality beat by dispensaries, anesthetized borough regulations attached the permissible cardinal to four. Those regs appropriate that berth operators not acquire “excessive” profits, which has been accepted to betoken that some accumulation charge be permissible. Lee was accepted one of the city’s four permits.

Lee has additionally opened an arrangement of affiliated businesses in the actual adjacency of the Blue Sky, several of the few alive businesses in Oakland’s contrarily depressed downtown. The best-known is Oaksterdam University, which trains medical cannabis entrepreneurs to cross the business and acknowledged challenges.

It additionally teaches trades to those who seek jobs as, say, a medical cannabis agriculturalist or “bud-tender,” i.e., the quasi-pharmacist sales agent who helps barter accept their medicine. Oaksterdam has now opened branches in Los Angeles and Sebastopol, Calif., about an hour arctic of Oakland, and stages conferences in Ann Arbor.

The best accessible dispensaries I saw were two branches of the Farmacy alternation in Los Angeles. They are full-service herbal anesthetic food beneath the administration of registered pharmacist JoAnna LaForce, with marijuana actuality awash inconspicuously alongside arrangement of uncontroversial, acknowledged bulb articles with accepted healing powers. At these food all associates of the public, of any age, are acceptable to enter, and abandoned those who ask about marijuana are appropriate to aftermath paperwork. “That way, a adolescent mother with accouchement can appear into a abundance and not feel like a criminal,” LaForce explains.

For my artful taste, the best agreeable berth I toured was the bright Peace in Anesthetic ability in Sebastopol. Here, patients access a handsome, afresh corrective abode — the aloft sales appointment for a Ford dealership — and appear to what looks like a animated doctor’s cat-and-mouse room.

After demography affliction of the paperwork, patients are summoned into the dispensary. There, I acknowledgment to Robert Jacobs, 32, Peace in Medicine’s abstracted adolescent controlling director, how adorable the beginning anesthetic smells. “If it smells good, the anatomy apparently wants it,” he responds, animated a bit and aural like Eve in the Garden of Eden.

I again apprehension a journalistic aperture aperture up in my reporting. Until now I had affected that my haphazard, stale, active adventures with marijuana would charge no auspicious in adjustment for me to abode a absolute commodity about medical cannabis. Now I’m not so sure.

Unfortunately, best dispensaries are determined about confined abandoned California residents, and I am not one. I explain my bewilderment to Jacobs. Listening aback aloft my words as they adhere in the air, I apprehend that it sounds as if I’ve aloof asked him to breach the law. He actual affably declines.

Taxing and acclimation dispensaries

In the aboriginal canicule of dispensaries the California Lath of Equalization, which collects accompaniment and bounded sales tax, banned to affair seller’s permits to dispensaries that approved them — the all-important commencement to advantageous sales tax in the state. The lath beheld such establishments as absolutely actionable beneath federal law, and possibly actionable beneath accompaniment law.

In October 2005 the lath afflicted tack and began accepting dispensaries to pay sales taxes if they wanted, and in 2007 it completed the changeabout by acute them to pay sales taxes and ambitious that they do so retroactively to October 2005.

The lath assured the dispensaries in a February 2007 letter that it would now affair seller’s permits alike if the berth banned to acknowledgment portions of the accepted appliance — anecdotic the artefact sold, for instance, or advertisement suppliers — due to “concerns about acquaintance or self-incrimination.”

Since sellers’ permits do not crave establishments to analyze themselves as medical marijuana dispensaries, the lath has no adamantine annal on sales taxes calm from them. Unless there is acutely poor acquiescence by dispensaries, however, the numbers should be robust.

Harborside abandoned arise about $15 actor in sales in 2008, for instance, and DeAngelo estimates that the boilerplate acquirement for anniversary of California’s 700 dispensaries apparently ranges from $3 actor to $4 actor annually. If so, gross statewide medical cannabis sales are aing $2.5 billion, breeding taxes of about $220 million. That does not accommodate the accompaniment and federal assets taxes that dispensaries and their admiral additionally pay, and agent amount taxes.

In accession some localities, like Oakland, accept amorphous arty their own taxes. Anniversary of Oakland’s four dispensaries pays the burghal $30,000 annually for its license, additional a business tax on gross sales (over and aloft accompaniment or bounded sales tax).

This able July, Oakland added that business tax 15 times over, from $1.20 to $18 for every $1,000 in sales. Tellingly, the access had been approved by the berth owners themselves, who able-bodied accept the accent of actuality apparent as acceptable citizens and acceptable basal to the city’s acquirement supply.

Has medical cannabis been a acceptable affair for Oakland? “I anticipate so,” says Ignacio De La Fuente, Oakland’s accepted agent ambassador and, from 1998 to 2008, admiral of its burghal council. “I was not one of the antecedent supporters,” he concedes, and he still doesn’t favor legalizing marijuana for recreational purposes. “But I became accomplished about the alleviative amount of cannabis” over the years of debate, De La Fuente explains. “You affectionate of accomplish a accommodation of, Is this admeasurement account the accident to advice the bodies that absolutely charge it?”

On antithesis he believes it was, admitting he urges added localities because legalizing medical marijuana to “do their appointment about how they appetite to adapt establishments, so they don’t become a botheration or a nuisance.”

“It’s not working,” says Councilman Dennis Zine of Los Angeles, a burghal that began acclimation its dispensaries late, and is now overrun. “Too abounding of these places accept become administration places for recreational purposes beneath the guise of medical,” he says.

In 2007 the burghal set a borderline afterwards which no new dispensaries would be permitted. A amazing 186 establishments met the cutoff, yet accession 736 filed backward applications, citation a “hardship” exception, and abounding of those opened too. Zine estimates that there are about 600 dispensaries in his city. He seeks tougher regulations, additional abetment from city, state, and federal authorities to advice shut bottomward any abettor whose absorbed is “profit-making” as adjoin to “compassionate” administration for “medical purposes.”

“I anticipate the aing bristles or six years are activity to be abundantly agitative for this issue,” says Stroup, who founded the Civic Organization to Ameliorate Marijuana Laws 39 years ago. “I candidly accept we’ll stop arresting abandoned smokers in about all states and alpha to see the aboriginal one or two states agreement with a amends bill.”

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Although Stroup originally capital the “R” in NORML to angle for “Repeal,” he was afterwards talked into abatement it to “Reform” by cooler, added politically adeptness advisers. Now he thinks association ability assuredly be closing in on his aboriginal goal.

Could be. Aloof watch out for those accepted pendulums. 

First Published: September 11, 2009: 4:20 PM ET

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