Pod 1: The History of Medical Cannabis in the US with Dr. Amanda Reiman

Tea and Other Drugs

In this episode, Amanda and Soren explore the events that brought marijuana back from the prohibitionist graveyard and into a medical model.

Transcript:

**Intro:** Hello and thank you for tuning in to Tea and Other Drugs. I'm your host Soren Shade, and today we have a great conversation with Amanda Reiman. Amanda has been involved in the cannabis activist space for many years. She's been involved with Drug Policy Alliance as well as many other anti-prohibitionist organizations. She's the co-founder of My Personal Plants. She also hosts a podcast called The Truth About the Plant. I recommend you check both out. In this conversation, we trace the path that cannabis took to go from a prohibited plant to a medical and recreationally available substance. Without further ado, Amanda Reiman.

**Soren:** Thank you very much for joining me today. If I understand your biography correctly, you came up in social work. That's where you got your doctorate in that field. You were once involved in the Drug Policy Alliance in California. But your specialty really lies in cannabis. And today I'm really interested in exploring the history of medical cannabis with you. Just jumping right into it, my first question is if you could kind of just walk me through some of the history of the important grassroots work that went into and up to Prop 215 in California. Were there organized petitions, rallies, campaigns, PR events? And then a sub-question to this: am I right in situating the beginning of the medical marijuana movement in Prop 215, California, or should we look back further to like the Schaeffer Commission, and then Oregon decriminalizing, and then California and a number of other states decriminalizing in the early stage? Or is it wise to look back even further? Or maybe 2000 years in China? Like, where should we start with the medical marijuana movement?

**Amanda:** Absolutely. You know, cannabis has been used as a medicine across the world for thousands of years. One of the things I like to talk about is when we think about the history, the modern history of medical cannabis, its role as a dangerous illicit narcotic is a very small span of time compared to its medical use. So, we're basically talking about 1937 when the Marijuana Tax Act was passed, which really limited the ability of access to cannabis. Prior to that, cannabis was available in a lot of medications, including ones made by Eli Lilly, Bristol Myers Squibb, and Pfizer, and some of the very well-known pharmaceutical companies. But there was a move to start labeling the ingredients that were in these medicines. There were cough syrups for kids that had opium and alcohol. It quieted them down, but really trying to better understand what was going into these medicines and that combined with the fact that cannabis was being used by populations like Mexican populations, Black populations that were really desired to be controlled by the federal government. Making cannabis illegal, making there be a criminality around the use of cannabis was a very convenient way to control these populations. And so, once that strategy was put in play, it really continued until the 90s until we saw laws start to change, really starting with Proposition P in San Francisco, which we'll get to.

But thinking about the time period of 1937 to 1996 compared to thousands of years of medical and therapeutic use around the globe because we were all raised in that short period of prohibition that we were born into it. A lot of times we think about that as the way it's always been when in fact that's really the exception to the rule and was really more of a modern-day classification of cannabis really having more to do with who was using it. Like I said, the desire to control those populations. So, after the 30s and 40s, we really saw the height of Reefer Madness, right? The propaganda out both in movies like Reefer Madness but also in the messaging that cannabis was highly addictive, that using cannabis once was going to lead to heroin. A lot of those images from those early propaganda films were showing white women especially being lured into cannabis use by people with dark skin. That was a very common theme. And let's face it, it scared the shit out of suburban moms. I mean nobody wanted to see their kid in the den of iniquity with the opium and the cannabis.

So, it really framed it as this very dangerous substance. It completely downplayed the medical benefits of cannabis. And so, it fell out of favor a little bit in the 1940s and was really revived in the 1950s through the beatnik movement. And we started to see artists and others who were questioning the system who were looking for alternatives to kind of the 1950s version of society of the white picket fence and the nuclear family. Cannabis was very much a part of this scene. And so, we started to see it reemerge and there really wasn't that much concern or thought given to it until it got co-opted by college students. And in the 1960s when we started to see the anti-war movement and the anti-establishment movement, cannabis was very much a part of that. And now all of a sudden, it wasn't just your beatniks and the coffee houses in New York. It was college students on the campus of UCLA who were using cannabis and also getting in trouble for cannabis. So, I think that really spurred the conversation about, should it be legal? Which really came to a head in the 1970s. Now today we see about 70 percent support nationwide for full legalization of cannabis. Even in the 1970s at the height of permissiveness at that time, approval was really only down in 20 percent of people that thought cannabis should be legal. So even though we saw it being used more, being used more openly, being associated with kind of this anti-establishment, anti-government movement that was happening among young people, there still wasn't this idea that it should then be legal, right? The idea was that they just shouldn't use it, that they should just get in line and listen to their parents. So, even though we were starting to see it being used more prolifically, it really didn't move the legalization conversation even though that was when NORML was founded, the National Organization for the Reform of Marijuana Laws, in response to the Controlled Substances Act.

**Soren:** Yeah, I mean that is like right when the Schaeffer Commission, their findings following, you know, Nixon passing the Controlled Substance Act, and it had the stipulations in there that there be congressional review of some of the substances included in that list, specifically cannabis with the Schaeffer Commission, which was, you know, with the findings of that came out Nixon summarily just ignored it and increased the penalties associated with possession and consumption and distribution of cannabis. But there were a number of states that took that finding, disregarded what Nixon was saying, and enacted decriminalization on a state level. I think 10 or 11 states, I can't remember the exact number, from like 73 to 80 and then everything stopped until 2000 again. And then interestingly enough in that same period, Carter, who had sort of a rocky relationship with NORML, part hot, part cold, especially with his drug czar, recommended to Congress that it be decriminalized. So how does that kind of, and I certainly want to keep, you know, hear more about the history past the seventies, but while we're in the seventies, how does the fact that some states were decriminalizing it square with the notion that there is 20 percent approval ratio, people were saying just fall in line and listen to your parents and don't consume it, don't be associated with these hippies? Was there any movement as well that came from these states that decriminalized it towards medicalization, or was it just to reduce policing associated with cannabis but then put it on ice until Prop P in San Francisco came and kind of reignited the whole thing again?

**Amanda:** Well, decriminalization was really a recognition that the criminal penalties for cannabis did not match the potential harms that it provided. And it was police resources. It takes money to arrest someone, to prosecute someone. And I think states were feeling it just isn't worth it. You know, it's not something we want to spend, unsurprisingly, a lot of these were hotbeds of liberalization anyway. So we're talking about places like California, Ann Arbor, Michigan, the state of Oregon. So these were already places where you had a lot of folks that looked at overarching criminal justice issues and whether or not they were really feeding into public health and safety. Carter's statement that he felt marijuana should be decriminalized, which of course did not come to fruition because of his issue with the drug czar doing cocaine at a NORML party, it really kind of stands behind what I think is kind of one of the most BS messages around this, which is it sends the wrong message.

**Soren:** Mm.

**Amanda:** So, you know, the states may have thought, well, we don't want to spend money prosecuting someone for using cannabis, but they stopped short of legalization because there was this idea that, yeah, we don't want someone to go to jail, but we don't want to encourage them to use it, right? And if you create legalization, if you create a system of access, you're encouraging use. And for a long time, there really was no talk about medical cannabis. And so, the idea that you're encouraging use meant young people, right? It wasn't the cancer patient. It wasn't the person with MS. It wasn't the person with chronic pain. It was the college student. It was the hippie. And there was kind of this unified idea that, you know, we don't think that person should go to jail, but we don't want to encourage them to use it either. Now, interestingly, parallel to all of this, at the same time was the investigational

new drug program at the federal level for cannabis. So, they did have a program at the federal level where patients could petition to be a part of it if their doctor said, you know, this is a medicine that they absolutely need, it's really helping them. They can't get relief from anything else. And, you know, it wasn't very popular. It wasn't very publicized. So, there were just a handful of patients, but this did exist in the 1970s, right? So, people were getting cannabis from the federal government. They were getting it for medical purposes, but at the same time, there was kind of this belief among society that we should not encourage use among the general population, but we also don't necessarily think they should go to jail for it.

Now, of course, all of this changed in the eighties with Reagan. You know, Reagan's stance was just say no. It was Nancy Reagan's pet project, right? This idea of a drug-free America. Criminal penalties for drug use in general increased. And then under Bush in the nineties really became militarized. So, we had this swing, and I talk about policy as being a pendulum, right? It swings towards liberalization, and then it gets to a point where society says, whoa, hold on. You know, that's too much. Or we get some in power that says, that's too much. And it swings back the other direction. And that's really what we saw in the 1980s and nineties. Now, something else that was happening in the 1980s was HIV, and this is a very, very important part of the story because a couple things happened when HIV really hit the LGBTQ communities, especially in places like San Francisco, where you had a very high population there. One was that the investigational new drug program got flooded with applications, and all of a sudden, everyone wanted to get into this program. It actually caused it to be shut down in the 1990s under Clinton, interestingly, because they could not handle or did not want to bring all of these new people into the program. However, people that were already part of the program were grandfathered in, and that's why you have people like Irv Rosenfeld to this day who get a container of joints sent to them from the federal government every month because they were part of the investigational new drug program back in the 70s. Most of the people in that program have since passed away. So, you had this flood of people trying to get in because recognizing that cannabis was very useful for symptoms of HIV. When you look at some of the main symptoms, wasting syndrome, lack of appetite, nausea, trouble sleeping, chills, depression, anxiety, because you had a disease that there was no cure for that was terminal. And then you also have the social aspect of it. And I think this is really, really important because the federal government did not care about HIV because of who it was affecting. And because of that, you had a population of people that were just kind of left to die. I mean, there was no research on how it was spread or what the safety protocols were. People who were in the hospital with HIV, you know, it was kind of like COVID. They were kept behind a door. Family members and friends couldn't visit them. Anybody that came in to care for them was in full hazmat gear. I mean, the social isolation that came from being someone with HIV also knowing that your government really didn't have an interest in getting to the bottom of this and in helping this population because of who it was affecting and all of the stigma and discrimination that went along with that diagnosis. These communities were largely left to fend for themselves and out of this community came the sharing of information, the sharing of knowledge. What's working for you? How are you managing your appetite? How are you managing your sleep? And coming out of this was the report that cannabis helped. And LGBT activists, people like Harvey Milk and Dennis Peron, were fighting very hard for HIV help, right? They wanted better care. They wanted these communities to be listened to. They wanted them to be taken seriously. They also wanted them to feel okay, right? They kind of took matters into their own hands. And that's really where cannabis kind of reemerged as a medicine. Now, not to say it wasn't being used as a medicine in the fifties, sixties, seventies, and eighties. It absolutely was, but it was very sporadic. So, there wasn't kind of a group of people that were willing to get together and say, we demand rights to accessing this medicine. It was more people using it in quiet. It was cancer doctors saying to people at end of life, look, I probably shouldn't tell you this, but cannabis is going to help you feel better in these last moments of your life. It was happening in a very underground way. HIV, these folks had nothing to lose. And so, they were coming out in force saying this is something we need access to and I don't really care if it's illegal or not. I'm going to provide this to my community. And that's really where we started to see the modern medical cannabis movement take hold.

**Soren:** And so what year is this? This is like late 80s, early?

**Amanda:** Late 80s, early 90s. And in 1992, Dennis Peron, whose partner had HIV and he was basically running the first dispensary out of his home in the Castro neighborhood of San Francisco, put Proposition P on the ballot in San Francisco. And it was a lowest enforcement priority law, which we've seen other states and cities pass since then, which basically said medical cannabis is the lowest enforcement priority for police. So, if you solve all other crimes, if you're sitting around, there's not one thing for police to do, then consider cannabis. But other than that, just leave us alone. I mean, that was really the message. Like, just leave us alone. You know, we're dying. Our friends are dying. Our community is dying. This is giving us relief. This is giving us community. This is helping our mental health. You know, getting together and using cannabis and feeling better and relieving anxiety. You know, this is something that we need. And you know, one last thing I'll add is something else really important happened right at this time, which was Brownie Mary. So, Brownie Mary was a great little old lady who lived in San Francisco. She would make pot brownies, and she would deliver them to HIV patients in the ward at San Francisco General to make them feel better. And right around the time that Proposition P was going to be considered, she got arrested. And so, you had this PR of this like little white-haired old lady with an amazing voice on her. Look up some of her speeches. She is a pistol, as my grandma would say. She really fought back. She was not going to go gently into that good night. You know, she was going to speak out about why it was wrong that she was arrested. And here are these optics of this little old lady who's trying to make dying people feel better by giving them baked goods, you know, getting arrested. And so, it really, and we'll talk more about this, but I think what really kind of made medical cannabis the pathway to legalization was that all of a sudden, it wasn't about college students and hippies and beatniks having access to cannabis. It was about people who are dying, people who are suffering, having access to cannabis. And that completely changed the conversation.

**Soren:** Yeah, that's... Was that planned? Because it almost seems like a brilliant...

**Amanda:** By the universe.

**Soren:** Yeah, yes. Yeah, that's so fascinating. And it's such a shame. At the same time, it's a wonderful step in the right direction, but it's also such a shame that we have to put trauma in a spotlight, put suffering in a spotlight, and really just kind of turn the screws on people who already have been cast a horrible lot in life in order to advance what should be very common sense, you know, freedom to consume something that makes you feel better, that doesn't harm anyone else. So, you know, it's both this wonderful point in the history of cannabis legality in the United States, and at the same time, it's like, damn. I can't believe we had to be this grotesque. It's almost like the children marches of the civil rights period where you had to see children getting attacked by police dogs and hosed by firefighters during protests against segregation in order for white America to open their eyes and be like, oh, maybe this is bad. We should do something about it rather than just understanding that it's bad and getting rid of it in the first place.

**Amanda:** Well, I mean, our approach to drugs and the cognitive liberty argument has always been there, right? I have the right to put anything in my body that I choose. But because we've had such a paternalistic structure around drugs in America, where it's like the people in power know better and so they're going to make our decisions for us, that was just so accepted because it was driven by fear. I mean, fear is so powerful, and propaganda is so powerful, that once you started making people feel a certain way about drugs, right? Whether they had used them or not, they felt a certain way. People don't change their minds with their heads. They change their minds with their hearts. And once you have that fear in their heart that this is bad, even if they can't really vocalize why it's bad, they just know it's bad because they've been taught it's bad, and propaganda is really the act of instilling emotion without critical thinking. It's really hard to change that. It was going to take a change of heart in order to change their mind. And the thing that was going tochange their heart were sick and suffering people who needed access to make them feel better. That was the thing, but that wasn't even enough in a lot of cases. I'll just lend this quick little anecdote. One of the first jobs I had in cannabis was working for Marijuana Policy Project in 2003, and my job was to go to some of these more conservative communities in the Bay Area of California to their 4th of July parades and kind of community gatherings and hand out these little flyers that said, "Do you think AIDS and cancer patients should go to jail?" And it was really challenging this notion that, you know, if somebody's sick, if somebody's suffering, is this the right thing for them to have to do? And this was in 2003. And I would get responses from people that said, "Well, if they're smoking pot, they should." So again, it's this feeling inside that this is a bad thing and that in order to protect society from this bad thing, we need to involve the police. That's really the only way we're going to do it. And that was so entrenched in people, especially people that grew up during those Reefer Madness times, that it was really difficult to undo.

**Soren:** Yeah. Oh, that's such a tough mentality to combat, but I guess a question on the other end of the spectrum of mentalities, and we're seeing it today in the psychedelic medicalization debate, we're seeing it within niche corners of the kratom regulation debate, is the fracture between the idealists and sort of the medical pragmatists, those that are saying LSD, MDMA, psilocybin, etc., have been illegal for 50 plus years now. No one has access to it. Everyone is at risk of going to prison, put into a cage if they consume it. Large multi-million dollar publicly traded corporations advancing these substances through clinical trials in order to reduce their scheduling classification from 1 to 2 to 3 to 4 to whatever will result in fewer people going to jail, will allow access and allow some treatment for people to use it. And then there are others, you know, the idealists in the psychedelic space, are saying, "How dare you patent psilocybin? How dare you patent LSD combined with MDMA? That's candy flipping. I've been doing that forever. That's prior art. You can't patent that." And so there's this cognitive liberty, complete freedom people who should be, you know, allies with the medical side of people who are combating it because of the bad taste for the quasi corporatization of some things. And we see that in the cannabis space today as well. These giant publicly traded cannabis companies that are at times lobbying against drug reforms in other areas because they want to maintain a monopoly, but that's another conversation. So within this ideological division between people who in theory should be on the same side, did we see maybe like a beatnik counter protest against the intention to medicalize cannabis going up to Prop 215 in California? Were there people who were saying, "No, we can't, you can't legislate access to cannabis only through physician prescriptions? This is a freedom issue. It should be available to all healthy individuals or unhealthy individuals." Was there this division that we're kind of seeing today in other spheres back in '96?

**Amanda:** Not really because there wasn't an industry yet, right? So, you didn't have businesses. You absolutely had folks that said, you know, like what you alluded to, that cannabis should be available to everyone, whether your doctor recommends it or not. And I think that belief was definitely there. But I also want to remind folks that Prop 215 was half a page long and all it did was say if you get caught with cannabis and you have a doctor's note, the law doesn't apply to you. That was it. You could use it as a defense in court. There was no, "This is how you get a license. We're going to give out this many licenses and there's vertical integration and not vertical integration." Like none of that was there. Drug companies for the most part were not interested in cannabis. It was a schedule one drug. The cost of developing into a medicine was huge. They had plenty of other drugs to work on that were a lot cheaper to bring to market. So Prop 215 was unique in that it didn't establish a regulatory system, and there was no regulatory system for cannabis in California until Prop 64. So for 20 years operating under Prop 215, the only thing that businesses could really get to legitimize themselves were local business licenses. And there were only a handful of cities that were giving those out. So cities like San Francisco, Oakland, Berkeley, Santa Cruz, they would issue business licenses for somebody to have a dispensary. They had rules about how far you had to be from a church and a school and other dispensaries. They had to pay local taxes, but they did not have a state license. And no cultivators had licenses, or manufacturers, or testing labs, or distributors or anything. None of those people were licensed. Cannabis was grown on a farm. There were some medical collective protections. So, at the very beginning of Prop 215, the idea was that people were growing it themselves collectively. So Wham in Santa Cruz run by Valerie Corral was really the first collective garden where the patients could sign up as a member of the collective. They could grow cannabis together in one place and every member of the collective could then share in that harvest. In 2002, Senate Bill 420, ironically, passed. And what that said was that you do not have to be actively engaged in the grow in order to be part of the collective in order to get cannabis from the collective. And that was really the birth of the storefront dispensaries. And when you went into a dispensary, you became a member of the collective, and the money you were giving the budtender wasn't for the cannabis. It was to reimburse the person who grew that cannabis for their cost and effort to grow that cannabis for you. So, you are part of the collective, you are reimbursing the cultivator for their role in producing it, and the dispensary was acting as the middleman as the place you could go pick it up. You know, not that different from a CSA, right? You become a member of a CSA, the farmer's growing it somewhere. There's somebody's garage that you go pick up your box in. You don't have to grow that food in order to access it. You're basically paying to reimburse the farmer for their cost of growing that food for you, and then you're picking it up in a neighborhood drop-off point. That was really how the first dispensaries in California were supposed to operate.

So going back to your question, we didn't have large MSOs and corporate cannabis that was going to fight it or try to insert their own desires to stifle home grow or to require vertical integration or, you know, any of the things that we see now when a medical cannabis or adult use is up for grabs in a state. Like I said, you definitely had folks that said, "Hey, I don't think it's fair that you have to have a medical card in order to access it." But at the same time, anyone could get a medical card. So, you know, we have always had an open list of conditions in California. You know, Prop 215 said any condition that your physician feels cannabis might benefit you for. And of course, there were doctors that absolutely believed that cannabis should be available to everyone, that it was safer than a lot of pharmaceuticals and over-the-counter medications. So, there wasn't a situation even at the beginning of Prop 215 where there was somebody saying, "I could really benefit from medical cannabis, but I can't get a medical cannabis card." That was something anyone could get. Anyone could take advantage of Prop 215, but you still had this huge underground sector of the industry, which was cultivation and manufacturing where there were no regulations, where there was still a huge risk. We still had federal intervention and interference, and they were also still interfering with the dispensaries. So, early dispensaries, without having any kind of state licensing, were subject to federal raid. You know, we used to have raid trainings at early dispensaries in the Bay Area where we taught patients what to do if they came and knocked the door down, and you know, how to not get shot and not get arrested. You know, this was still very much a part of the early cannabis culture for medical even after Prop 215 came along because the federal government was still wanting to interfere. They still wanted to enforce federal law and there was no state regulatory system to protect anyone from them doing that.

**Soren:** Right. Yeah. And those raids were going on even up through the Obama era.

**Amanda:** They were, but differently. So, just like arresting Brownie Mary, the federal government found out pretty quickly that, you know, arresting someone in a wheelchair or with an oxygen tank was not a good look. So, what you saw pretty quickly after the nineties as we got into the 2000s was that raids looked differently. They were going after landlords. So, landlords that had buildings that were housing dispensaries. They were trying to get them on charges for housing a federally illegal kind of drug trafficking operation. The IRS was going after dispensaries because the laws and the rules on taxes were very, very unclear. And so, you had a lot of dispensaries that may be paying their local tax, but they weren't paying any state and certainly not federal tax. So, they really were going in the back door after a while because they understood that support for medical cannabis was growing and that going through the front door and arresting a bunch of people, it wasn't the same as going in and arresting a bunch of hippies or beatniks. Now, you're arresting grandma and grandpa

. And the public certainly didn't like that look.

**Soren:** Right. And so that kind of brings us up to the Rohrabacher–Farr amendment. So that's passed in 2014. Is that around the same time that we started seeing the proliferation of big cannabis or?

**Amanda:** I think they were always kind of looking for opportunity and they were looking to minimize risk. And so having the federal government say, "We're not going to use any money to go after state legal dispensaries and state legal operators throughout the supply chain," you know, seeing the kind of a Cole memo that came out under Obama, which was like, "Here are the 10 commandments you cannot break." And as long as you don't break these 10 commandments, we're not going to come in and disrupt your state program. That definitely emboldened a lot of bigger companies. And also as more states started passing laws. So, you know, if you're a company and your only opportunity is to open in Michigan, you know, it's not as, the risk is still too high. But now all of a sudden, if you can have operations in 10 states, 15 states, 20 states, even with all the restrictions on banking and interstate commerce and other things that still plague the industry, it's a much better proposition. And it was at this time that these companies started to say, "Hey, maybe we can even affect the law. So maybe we can even lobby the legislature to have things in there that are going to benefit us." And I think that is when we really started to see things take off. And, you know, to be honest, there's a lot of talk about Prop 64 in California back in 2016. And yes, there were a lot of issues with it. It was a very early law. We still were fighting against a lot of stigma and a lot of desire to keep cannabis illegal. But it was still too early for those large companies to come and affect things. So when we were drafting Prop 64, yes, we had constraints put on us by the League of Cities and the Narcotics Officers Associations and some of these other more conservative state groups. But we did not have large cannabis MSOs coming in and telling us not to put in home grow. And so, I think that came later. If we had waited until 2020 or, you know, to be one of the more recent, I think you would have had a lot of involvement. There's also a big difference between states that pass by initiative and states that pass by legislature. So, you know, not every state allows the initiative process. So, when you're passing something by initiative, it's really more what are the voters going to care about? Less than what the companies are going to care about. So, with Prop 64, you know, we did a lot of discussion with voters, like what is too far? And of course, what's too far for the average person is not too far for the activist. So, I think that's more the line we had to balance was what are people willing to vote for versus the kind of idealistic idea of what it should be. I think now when you see states trying to pass medical cannabis legislation through their legislatures, it's less about the public and more about what do the activists and the grassroots folks say versus what the large corporations say. And how does the legislature strike a balance that's going to be okay enough with both of them to prevent any kind of serious lobbying?

**Soren:** So, when we look at the marijuana landscape today, the legalization attempts, and we look at grassroots activists and initiative ballots, ballot referendums and House bills, Senate bills that are introduced through lobbying efforts, where do we see the most conflict? Is it like homegrown stuff or is it something else? And do we see symbiosis between it? Are there instances in which we should be grateful that there was this big business funding and lobbying efforts that we could fall back on that were pushing the cannabis legalization either rec or medical the right direction? Because for example, in 2022, they put eight psychedelics on the federal register to be made illegal. DOI, DOC, DIPT, Moxy, a number of tryptamines and eths, and the psychedelic pharmaceutical startup space, which was still very early in its inception at that time, put together funds for lawyers and filed lawsuits against the DEA in order to stop it. And that's an instance in which I can think, oh, thank God there were investors with a lot of funds and had reasons, monetary reasons to prevent criminalization and scheduling and prohibition. And I'm wondering if we see good instances of big business interfering in government or is it always just conflict? And if maybe you could give an example of both instances if you have any in mind.

**Amanda:** Yeah, absolutely. So, you know, I often say that capitalism is the bitter pill we have to swallow for access and keeping people out of jail. You know, we live in a capitalist society. That's the way America runs. So, to think that that would hold true for everything else that's available in commerce except for these intoxicating substances, I just don't think that's realistic. As soon as businesses see an opportunity to make money, they're going to come in and they're going to push that money around to benefit them. Now, sometimes it benefits all of us. So, an example I'll give is Florida. You know, Florida has a medical cannabis law. They are looking for adult use this November. Trulieve, which is an MSO that controls a lot of the medical cannabis market in Florida, has put a ton of money into getting this on the ballot. And it costs a lot of money to get something on the ballot, especially in a highly populous state. I mean, a lot of money and all of your activists with all of their petitions and their door knocking and their fundraisers is not going to be able to raise the money to put something like this on the ballot. So, in Florida, if it had not been for Trulieve, we would likely not have the opportunity to legalize cannabis for adult use. Now, do they want some things for their money? Absolutely. So, going back to your question about kind of what are the things that the corporate folks ask for when they are supporting or lobbying? You know, home grow is weird to me. We see pushback against home grow a lot of times that is led by large corporations. I feel like that's misplaced. We don't see Whole Foods lobbying against farmers markets or being able to grow tomatoes in your backyard. And our research at New Frontier Data on our consumer survey show that, you know, a little less than 3 percent of cannabis consumers rely on home grow for their primary source. So, allowing home grow, we have no evidence that that cuts into retail benefits, that that cuts into revenue. But that's, you know, just them wanting to control the market, right? They want to get every last bit of that revenue. So, I think home grow is one area where they fought against it. I don't feel like that really benefits them, but it's something they're doing anyway. Other areas are whether or not vertical integration is allowed, right? So, Washington state, for example, does not allow vertical integration. You cannot have a license to cultivate and distribute and manufacture and be a retailer. You have to be just one thing. Other states require vertical integration. New York is a really interesting example because their medical law required vertical integration. And as a result, you basically have five companies that run the medical cannabis program in New York. Their adult use law prohibits vertical integration with some exceptions. So, you know, a lot of times large corporations, they like vertical integration because they can afford to have a cultivation facility and a distribution network and a manufacturing facility and a dispensary. And that allows them to really cut the price. It allows them to improve their margins and it makes it very hard for independent operators to compete. So, states like Illinois have a very high presence of vertically integrated MSOs. Like I mentioned, the New York medical program is all vertically integrated MSOs. California allows for vertical integration, but the large corporations haven't had as much luck here in California, mostly because it's such a big state and the consumers are a bit dubious of vertically integrated MSOs in California because of the culture and history we have with cannabis. But I think vertical integration is another piece that they really lobby in favor of. And then it's like the licensing process, right? So, they don't want equity programs to be able to go first. They don't want small operators to be able to go first. They want everybody to be able to go first because they have the means and the lawyers and the money to get those applications in quickly. So, there's definitely business-friendly aspects that they lobby for. But again, you know, I'm a pragmatist. So, even though I'm part of the cannabis culture, I believe in the whole plant as an amazing medicine. I do think people should continue to have access to the whole plant. They should be able to grow it themselves. They should be able to make their own brownies. They should be able to do all of that. I do not want people to go to jail. And I want everyone who could benefit from cannabis to have access to it. So, if there's a person out there that says, "You know what? Cannabis would really help me medicinally, but I'm not going to take it unless it's available through a pharmacy from my doctor because that's just what I believe medicine is." I want that person to have access to cannabis too. I don't want them to be on opiates. I don't want them to be on Ambien. I don't want them to be popping, you know, a ton of ibuprofen every day. But we have to meet them where they're at. So, I personally believe in access for all. I do not think we're going to change capitalism just

because we have a culture that favors this kind of more grassroots approach to consumption, which really came out because we had criminalization. I mean, if cannabis had remained a medicine and Bristol Myers Squibb and Eli Lilly and all of these companies hadn't had to stop production of cannabis-based medicines, it would just be another opiate or Ambien or, you know, I don't even know if we'd have access to the raw plant. So, I do think it was the fact that we had to go underground for such a long time that we developed this culture where we had to do for ourselves, which we couldn't make medicines ourselves. We could grow the plant. We could consume the plant as it had been for a very long time. But it kind of prevented this medicalization unless and until there was an opportunity. And now that opportunity has come to fruition.

**Soren:** Oh, that's a brilliant deep take there. I really like that. I've never thought of it that way before. Yeah, I'll just add that to another one of those perverse goods that came out of prohibition. Like, there's this wonderful little aside in PiHKAL by Alexander Shulgin where he talks about how the Controlled Substance Act is the reason why we have so many psychedelics in existence today because psilocybin was made illegal. All right, well, let's try 4-AcO-DMT. Let's try 4-HO-MET. You know, you ban it. How about DPT? How about DiPT? How about MET? And without the economic incentive that prohibition creates, there would be no reason to create these drugs that are maybe a little bit better, maybe a little bit worse, maybe about the same, but for the average consumer, you know, they want the psychedelic experience and the enjoyment that they get out of that and maybe the therapeutic effects that they get out of that. And if it wasn't for the incentive of prohibition, the pages and pages of novel psychoactive compounds wouldn't exist. And I, you know, with cannabis, you know, there's the interesting synthetic cannabinoids.

**Amanda:** I was going to say Delta-8, anyone? I mean, why do we have Delta-8, you know, being sold in dispensaries in places like Indiana and North Carolina? It's because they do not have access to the natural plant. And there's going to be a smart-minded chemist that's going to come along and is going to say, you know, we could take CBD and apply this process to it and have THC and this is not being regulated. I mean, none of that would happen if it wasn't for prohibition. Now, of course, there's all kinds of issues with safety and testing and all of that that comes with something that's unregulated. But, you know, we've got hemp-derived THC drinks in Minnesota being sold at the wine store. And, you know, that's not something that would have happened unless there had been a reason to go outside of the legal framework of cannabis.

**Soren:** Yeah, yeah. And so, you are saying you believe that there might not even be a recreational space or culture around cannabis consumption had there not been the Marijuana Tax Act or a stamp act?

**Amanda:** It's possible. I mean, we have opiates. We don't have opium.

**Soren:** Right.

**Amanda:** I mean, opium is legal when it becomes an opiate, you know, in the pharmaceutical production, but it's not legal to score my own pods of my poppies and collect the milk and turn that into opium and consume it. That's manufacturing a Schedule 1 drug. So, I think there would have been movements over time, likely to protect the pharmaceutical industry, that would have outlawed the use of the raw plant in favor of the medical side. And I think a lot of pharmaceutical companies would have lobbied for that because why do you want someone to grow their own product when you want to provide it for them? Similarly, in the way that MSOs fight against home grow, you want to corner the market. So, you know, the fact that there was such a big market for the raw plant under prohibition. And I think this kind of feeds into the rescheduling of cannabis because there's a big question mark about what will happen if and when cannabis becomes Schedule 3 because by federal law, Schedule 3 drugs are FDA approved and they're provided through pharmacies. It's very unlikely that we will see the raw plant being provided through a pharmacy. So, what does that do for the entire industry that is based around the raw plant? Now, if this had happened, let's say, in 1996, if cannabis had been rescheduled, I think you probably wouldn't have even seen recreational cannabis laws be as popular as they were because everyone would say, "You just get it through your pharmacy. Like, why do you need to grow the plant? Just go get the pill from your doctor the way we get all medicines." But it had time to grow and now it's like the genie's out of the bottle and, you know, if I'm Governor Newsom or the governors of the other states that have legalized for recreational and medical use, do I really want to give up all that tax revenue that's coming in from my recreational cannabis market because now the feds say everything has to be FDA approved and sold through a pharmacy? So, I do think this is something that we're going to have to deal with. But if this had all happened prior to those markets growing, prior to that tax revenue rolling in, I think it would have been a different conversation.

**Soren:** That's fascinating. That's a really interesting take. And I would love to spend some more time on sort of how prohibition is an incubator for cultural attitudes, for demarcating between recreational and medical use. But instead of spending all day on that, I'd like to kind of move on to the role that scientists had in crafting legislation. Did they have a role? Were there a lot of scientific voices in the debate in the 90s in California? Do we see it today? Are they advocating pretty much strictly for medical consumption? Do we see some scientists, and this is not just like physicians with ideologically in-charge motives, but researchers who claim expertise in, you know, specific cannabinoids or the whole plant which has, I guess, sort of been quarantined to Mississippi and the NIDA?

**Amanda:** Well, I think you're answering your own question. So, you know, the U.S. funds about 80 percent of the world's drug research. So, they really control what questions we ask because it's what gets funded. Scientists by and large rely on soft money, meaning they move from grant to grant. They apply for a grant from NIDA or NIH. They get that money. They do the study. They apply for another grant. That's how they support themselves. And that could be through a university. It could be through a research institute. And until very recently, I'm talking the last couple years, the government was not funding research on the benefits of cannabis. They just weren't. And the fact that it's a Schedule 1 drug meant even studies that looked at therapeutic value were doing it in preclinical models. So, rats and petri dishes, not in human beings. And so, that was a really big issue and scientists were very frustrated by that because they could not have a livelihood that depended on looking at medical benefits for cannabis. Now, one of the early scientists to kind of try to get around this was Dr. Tashkin at UCLA. And he wrote a grant to the federal government saying he was going to find the link between cannabis and lung cancer. No one had been able to find it. There was always this assumption that because you smoked cannabis, it caused lung cancer. He did not believe that it did, but he knew that if he framed his study as "Why cannabis doesn't cause lung cancer," he would never get funded. So, the way he framed it was, "We're going to find the link. You want this, right? Government, you want to be able to say that research has found the link." So, he got funded. He did the study. Lo and behold, he did not find a link. He couldn't really understand as much why he had some theories about the antioxidant properties of cannabis, the intensity of consumption versus the consumption cigarettes. But, you know, it was kind of this roundabout way of being able to do that research. I did my doctoral dissertation in 2005 on how medical cannabis dispensaries were operating as health service providers. And I was funded by the federal government through a pre-doctoral fellowship with the Public Health Institute at UC Berkeley. You know, they got through Berkeley's internal review board. It was a survey study. After I finished the study, I spoke at an event put on by Americans for Safe Access in San Diego to deliver my results. The next week there was an article in the San Diego paper about that event. My boss at Alcohol Research Group, where I was housed at this time as a post-doc, got a call from the federal government complaining that someone who was funded by the feds was saying positive things about cannabis. And that just cannot happen. They wanted her to reprimand me. And she basically told them to go F themselves because she's amazing. And said, "Look, she's a scientist. She's going to report the results." But even back then, you know, they really did not want anything from the federal government to be associated with benefits of cannabis. And I think this largely goes back to the schedule. I mean, how can the government say out of one side of their mouth that cannabis is a Schedule 1 drug with no medical benefit, highly addictive, highly dangerous? And on the other hand, being funding research that contradicts that but not making any move to change the schedule. And so because of that, because they had to have the public believe that they knew what they were doing and that cannabis was in Schedule

1 for a reason, they really didn't allow scientists to study the benefits of cannabis. So, I think also because of that, scientists were very scared to come out and talk about their belief in the benefits of cannabis because they were under federal grants that were to study the opposite. So, it was very hard for the scientific community. There were definitely conferences and things where we kind of gathered in a room and kind of woe is me and how are we going to fix this? But it really didn't lead to anything. I remember being at one such conference back in the early 2000s and there was someone from NIDA there and they were giving a talk and one of the researchers stood up and said, "This is all silly because all that's going to happen is we as scientists are trying to develop synthetic analogs to THC so that we can actually study them. Where do you think spice and K2 came from? They ended up getting leaked to the public. And then we have to come up with something all over again." There was kind of this tongue-in-cheek discussion around how even if we found benefits in apes or mice or petri dishes to cannabinoids, we would never get funding to do these studies in human beings. So, it really wasn't going to go anywhere, even if they had really important clinical implications. So, I think by and large, scientists felt that they really couldn't speak out about the benefits of cannabis because who they were getting their money from. And like I said, it's only in the last couple of years that NIDA has rescinded its monopoly on the production of cannabis for research purposes outside of the University of Mississippi. And only in the last year that they've actually put out grants to really study the medical benefits of cannabis, to develop a medical cannabis patient registry. Johns Hopkins recently announced that they're doing a very large study of medical cannabis users to better understand these mechanisms.

**Soren:** Were scientists, and you of course are among that group, ever consulted by representatives of any state reaching out and saying, "Hey, we're thinking about putting a medical marijuana bill on the books or a recreational bill on the books. What do you know about it? How can we interject science into our legislation?"

**Amanda:** I think that's where the doctors you mentioned came into play. You know, they were the ones that were seeing the patients. And again, it all ties back to the patient. What really made medical cannabis work as a policy issue wasn't the science. It wasn't, "Oh, we've discovered this thing about medical cannabis and now we need to make it available." It was the emotional appeal, right? It was doctors who are treating cancer patients like Dr. Abrams here in California, getting up and saying, "I'm seeing patients who weren't able to eat and were wasting away and couldn't sleep. And they've had these miraculous impacts." It was kids, you know, such an interesting twist that, you know, so much of prohibition was about keeping cannabis out of the hands of kids. And now you had pediatric oncologists and doctors who were treating kids with epilepsy and other diseases coming up and saying, you know, "We need this because these kids, nothing else is working for them. This is giving them quality of life." And I mean, you know, when you think about who are the most sympathetic characters for the public to rally around, it's children and it's people who are dying. So, I think it was the fact that doctors were coming forward and that patients were coming forward and parents, right? So, you had parents coming forward. They have been one of the most powerful lobbying group for the advancement of medical cannabis, I think way more so than the scientists ever were. And when you talk to a legislator, I'm going to talk about Dianne Feinstein in retrospect, you know, she was against medical cannabis for such a long time. And towards the end of her life, she started to come around. And the reason she gave was that she met patients. And when you talk to a legislator who has been against medical cannabis, when they tell you what brought them around, it's never, "Well, someone showed me this research study," or, "They showed me all this data." It's, "I met so and so and their daughter who is five and needs cannabis in order to function." And I thought, you know, this could be my child. This could be my granddaughter. And that has always been the thing that has pulled legislators around.

**Soren:** Ah, well, if our legislators don't have minds, they at least have hearts. So, that's a good...

**Amanda:** And that's how they make their decisions. I mean, quite honestly, like I delivered personally thousands of petitions and data points and literature to Dianne Feinstein's office over the years and it never made a dent. And it really wasn't until that personal interaction that really makes people think, "Is this somebody I want to suffer?" And their answer is no. And that is what changes them. That's what changes them.

**Soren:** Yeah, I think that's a really important lesson. I think that's, if we're gonna distill anything out of the history of medical marijuana up to cannabis legalization on a recreational level, it's that successful lobbying efforts are often done through emotional pathos-filled pleas and not the logos, not the science. And that's something that's very important to me and very current because there are currently federal bills being proposed for the regulation of kratom, and there's a lot of state bills that are being proposed for the regulation of kratom on the state level in order to prevent and preempt any sort of bans on those ends. And they're so infatuated with the idea of getting people who have researched kratom, the scientists on board to create these, you know, 0.5 percent alkaloid concentration differences. And what is safe? What isn't safe? This is what we have the science to know. This is not what we have the science to know. If we say that a leaf can have 4 percent total alkaloid content instead of 3.5 percent total alkaloid content, maybe the senators will say that's too high. And I just keep thinking like, that's never been something that they're concerned about. They're concerned about who's testifying in front of them. Is it, you know, someone had their life turned around, someone who was previously involved in a socially stigmatized drug use is now consuming something that is not socially stigmatized. And therefore, it's a good drug compared to a bad drug. And all these sort of emotional pleas are what's effective. And it's not just maybe they're going to be effective. It's we have evidence in the cannabis space for their effectiveness.

**Amanda:** One which is that legalization and regulation are not the same thing. So, legalization is really about getting the public to decide this is a product that should be available. It should not be criminalized. People should not go to jail for using it. And if they're not going to go to jail for using it, we should have standards in place to make sure it's safe, to make sure that the people that are selling it have someone to answer to, that they have some kind of regulatory framework around them. That's really about public opinion. And then after that, you're like, all right, so what does that look like? And that's where the science comes in, right? That's when you're saying, all right, what's the safest product? What's the best testing method? But there is one big difference between cannabis and kratom, which is public awareness. So even if you're not a cannabis consumer, you've heard of it. You probably know someone that uses it. You've seen it in the movies. You have a kind of a good sense of what happens when people use it. A lot of people are very, very unaware of kratom. You know, maybe they've heard about it. They think about it as the green powder that you see in the head shop. They don't really understand. They don't understand how, why people use it. And so one of the jobs of the kratom movement that the cannabis movement didn't have as much work to do is educating the public about what it even is. And I think that is, you know, the science can come into that, but you have to be able to translate it to the public. Like, what is the public concerned about? They're concerned about the effect on kids. They're concerned about the addictive potential. They're concerned about the intoxication and what that means for public safety, being on the job, driving. You know, that's what they're concerned about. They're concerned about it being a gateway to other things. So, you can take the science that talks about those issues, and you have to translate it to the average person and what they're going to understand. And then once you get them on board that this is not something that rises to the level of criminalization, this is something that actually may have benefits, and they're on board with you, then you have to decide what are the regulations going to look like? And that's where you really have to start talking about, you know, is there a difference in intoxication between certain percentages that increases risk of public safety? I mean, that's a conversation we're having around cannabis right now. As we see THC levels getting into the 30 percent in flower, we see an increased use of vape pens which is very high concentrations of THC. And so, we're having the conversation of, you know, banning something doesn't make it go away. It just drives it underground and makes it more unsafe. But at the same time, we should be aware that very high amounts of THC, especially when being consumed by young people, do have health and safety consequences that we can't ignore. Like the tobacco company ignored the consequences of smoking cigarettes. So, unfortunately, it's hard to have those conversations because the minute you say, "Maybe we shouldn't have 70 percent THC products being consumed by 16-year-olds all day in school," the prohibitionists

say, "Let's go back to making it illegal." And that's not the answer. But we do a horrible job in this country about moderation. We do a horrible job not taking a yes or no approach, but taking a moderate, healthy consumption approach with things that make us feel good. And so, it's a very difficult conversation to have because of our history of "just say no" and "drug-free America" and this idea that you're either not doing it, or you're doing it to...

**Soren:** That's so right. That's so on the nose. That's so on the nose. And I think once we can crack that code, if that can be cracked, I think that we will be in a much better place to be able to finally start proposing alternatives to the Controlled Substances Act and the way that we have integrated psychoactive substances into our culture for the past 50, 60 years. On a final note, we have the current event of HHS recommending the DEA reschedule cannabis into Schedule 3, which in and of itself has its problems. It has greater potential for abuse than Schedule 4, Schedule 5. How is that determined? That's kind of a rhetorical question. I don't expect anyone to have that answer because in my mind, the Controlled Substance Act scheduling criteria is all kind of absurd. But in your perspective, are you in favor of dropping the scheduling from Schedule 1 to Schedule 3? A lot of the issues that I've heard about the possible drop from 1 to 3 would be interference with states that have already legalized medical or recreational. Will it reduce their ability to maintain the status quo that they have enacted and are utilizing? And are there benefits to being dropped from Schedule 1 to Schedule 3?

**Amanda:** So, again, I'm a pragmatist. I'm a scientist. So, I mean, let's face it. Cannabis shouldn't be in the CSA. I mean, if we go back, it should not be in the CSA. It does not meet the criteria. But that it is, right? I mean, we can't change that. And it's a Schedule 1. And we have to remember that as much as we who love cannabis and think it should be available to everyone, there's just as many people out there that say, "No, it should be absolutely controlled." I do think the rescheduling is a political move. I think 3 is in the middle of 1 and 6. I think that's why they chose it. I think they thought, you know what? To the average person, they're going to say, "All right, the government is admitting there's medical value to cannabis. Go Biden." You know, "I'm going to support him now." I mean, I really feel like that's what this is all about. But one of the benefits of Schedule 3 is insurance reimbursement. So, we go back to the medical discussion. Right now, there's no ability for a medical patient to get reimbursed for their medical cannabis save for some networks out there like Benebis that kind of created relationships with dispensaries that are in a network that are willing to offer discounts. You know, you get a tax break on medical cannabis in most states, but it doesn't compare to being able to get opiates for a dollar, you know, where your cannabis is 50 a quarter or an eighth depending on where you live. So, I think, you know, if we're able to get insurance reimbursement for an FDA-approved version of cannabis, and if that comes in a pill, again, I'm willing to say okay because there's somebody out there right now who could benefit from cannabis, who could use it to replace opiates but isn't because either they don't want to use it in the form that it's currently available, they don't believe that's medicine, or they can't afford to. And I want everyone to have access. So, I really favor a dual-track approach. I say, look, let's develop an FDA version of cannabis. Let's have it available at Walgreens. Let's have it prescribed by every doctor who would prescribe opiates. Let's have it reimbursed by Blue Cross and UnitedHealthcare and all the other systems so that people can access it. And let's have a pathway for the natural plant medicine. And maybe we stick a label on that that says, "This has not been approved by the FDA," like we do other nutraceuticals and other herbal supplements. And let's let states pass their own laws about what that regulation system looks like. Maybe with the stipulation that it's 21 and up for everyone because the federal government likes to control the age like they do with alcohol. So, like, I do think there's a dual pathway. And like I said earlier, I do not think governments are going to give up this tax revenue. I mean, I just read that California is borrowing from the cannabis tax fund in order to pay for a budget shortfall at the state level. So, they're making a lot of money off of this. And I don't think they're going to all of a sudden shut down the programs and have that revenue stop coming in and make thousands of people unemployed in their state because now it's Schedule 3. I do think they'll strike a deal with the federal government, and I think they'll allow these programs to continue. We may not be able to call it medical cannabis anymore. I was thinking about this the other day. That term may be reserved for an FDA-approved product. So, we may have to call it doctor-recommended cannabis or therapeutic cannabis or something else. But I do think it's too late to put the toothpaste back in the tube. I do think there will be a carve-out for state programs. I do think cannabis can be completely rescheduled in the future. I think we can keep moving it down that ladder. But to me, moving from Schedule 1 with no medical value to something that at least admits medical value to the point where we allow it into our medical system is a win for patients.

**Soren:** I agree completely. Yeah. I think that's a really good take. And I just hope that it's the tip of the iceberg. I hope it sets the precedent for descheduling, for dropping down scheduling, perhaps removing things from the Controlled Substances Act completely.

**Amanda:** Revisiting the whole Controlled Substances Act. I mean, we already know that those drugs are not where they are because of science. Those drugs are where they are because of society. And that's why in Schedule 1, you see the psychedelics, you see the mind-expanding substances like cannabis and psilocybin because of the threat that they play to systems, right, that we're employing. And the people that were using them and the ideas that they were getting after they used them. And then there's a desire to control that. I think one thing we have to our advantage is that that population is aging out. You know, the folks that made up those laws, that used them for social control, you know, they're moving out of power. The people that are moving in power are people that grew up around medical cannabis. They grew up in the age when psychedelics were being considered medicines. They will bring the question to the table, why is it like this? We just have to wait for them to get a little bit older so that they have that power in order to change those laws.

**Soren:** Yeah. I think that's a really great place to end this. Belief that the mechanisms of a Kuhnian paradigm shift are at play now that the generation of prohibitionists is aging out, they're disappearing, and the new generation has completely different perspectives on drugs, on psychoactive substances. They have a lot less blind faith in the correctness of our administrators, and change will come, and hopefully this is the first step in a very long path to correcting things. Thank you so much, Amanda. I really appreciate it. Do you have anything you want to plug?

**Amanda:** Yeah, so I actually have a podcast, well it's webisodes more than a podcast, on YouTube called The Truth About the Plant in 15 Minutes or Less. So every week we post a question. These are very basic questions. Is marijuana addictive? Can you overdose? Is it safe to drive? And we give you the science fact answer in 15 minutes or less. This is a way for people to get quick evidence-informed information about cannabis. There's so much conflicting information on the internet. So, this is really to help people use cannabis safely. And then I also have a platform called Personal Plants at mypersonalplants.com that focuses on how to integrate psychoactive substances into your life in a healthy, balanced way.

**Soren:** That's great. Thank you so much, Amanda. I really appreciate it. I learned so much talking to you today.

**Amanda:** Anytime.

**Soren:** Alrighty.

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The transcript was automatically generated and edited lightly for clarity and those pesky AI mistakes. Please excuse anything that I missed.