By 1993, 4% of the city’s population were living with AIDS . The outbreak of the AIDS crisis challenged the illegal status of cannabis: now, law-abiding AIDS patients had to take illegal actions that were previously unthinkable, i.e., to purchase an illicit drug on the black market to ease pain and restore appetite . The cause seemed greater than harm, and it raised sympathy and support for AIDS patients among the population. AIDS patients first tried the path that Robert Randall has opened for them: they applied to the Compassionate Investigational New Drug Program to obtain government-supplied cannabis, but the number of applications was so large that the government stopped accepting new applicants in the early 1990s . Unable to get cannabis through legal channels, AIDS patients were pushed to the illegal market where medical cannabis activists developed informal institutions that delivered illegal products to legitimate consumers . In 1991, Dennis Peron, an illegal cannabis dealer and gay rights activist, drafted and organized the passage of the San Francisco medical cannabis initiative , which recommended the State of California and the California Medical Association to include cannabis in the list of available medicines and not penalize doctors for prescribing it.The proposition did not have the force of law but simply declared the city’s support of medical cannabis. The ballot passed with 79 percent of the vote. The backing of the city administration encouraged Peron to launch the San Francisco cannabis buyers’ club, whose main goal was to provide safe access to quality controlled medicine so that patients would no longer have to resort to the black market . Initially founded in a small apartment in the Castro district, the club was moved to a five-story warehouse near the San Francisco Civic Center in 1995 . To join the buyers’ club,vertical farming supplies one had to provide a photo ID and a doctor’s recommendation; senior citizens were granted automatic admission.
The social aspect of the buyers club was no less important than the medical one: it encouraged members to socialize and form support networks, which significantly improved the quality of their lives. The palliative conception of cannabis was integral to gaining public support for Proposition 215 in California in 1996 . By reinforcing the framing of cannabis as a remedy for the sick and dying, social movements gave legitimacy to the use of an illegal product and pushed local governments to recognize the medical qualities of a Schedule I drug.As Lashlly and Pollock point out, “tories […] were designed to challenge stereotypes about who smoked cannabis and to appeal to the societal values of compassion and the belief that individuals should have reasonable access to treatments that reduce their suffering” .48 The idea of medical cannabis incorporated positive elements from the healthcare category while simultaneously dissociated from stigmatizing labels of the black market: cannabis patients are not high, they are medicated . In 1995, the San Francisco cannabis buyers’ club hosted weekly meetings of grassroots activists who worked on a full-scale ballot campaign. The movement consisted of cannabis clubs’ owners, hospice organizers, lawyers, harm-reduction activists, doctors, leaders of pro-cannabis organizations, and other “seasoned activists in a grassroots reform movement” . In November 1996, California voted in favor of Proposition 215 , which ensured the right of patients to obtain cannabis for treating serious illnesses ; guaranteed protection to patients and doctors from criminal prosecution; and encouraged the federal and state government to provide safe and affordable distribution of cannabis.49 Several circumstances can explain why the medical cannabis movement succeeded in the passage of Proposition 215. First, many AIDS patients were politically active and integrated in communities receptive to the civil rights agenda. According to Veronica Terriquez , the recognition and activation of multiple identities by social movements may catalyze intersectional mobilization and facilitate participation and commitment among marginalized groups. The medical cannabis movement was a spillover of the gay rights movement, whose members strongly favored cannabis law reform. Both movements were guided by the same basic principle: people should not be punished for personal lifestyle matters .
Emerging in an era of increasing visibility and acceptance of the LGBTQ movement, the medical cannabis movement empowered its members to disclose not only their sexual orientation but also their use of stigmatized substances. Second, from the very beginning, the movement’s main goal was to win legal recognition of cannabis. Even though the pro-cannabis community occasionally staged boycotts, demonstrations, cannabis giveaways, smoking in public, and other forms of nonviolent civil disobedience,they were seeking reform through legal and bureaucratic processes. Their strategy was to decouple state law from federal law . Activists had a moderate agenda, which shaded away the recreational component of cannabis: Proposition 215 did not legalize cannabis and did not contradict the federal legislation; it merely allowed physicians to recommend cannabis and patients to use it . Tod Mikuriya, a pro-cannabis activist from the physicians’ camp, carefully drafted the language of the initiative. Third, although the AIDS crisis created political and discursive opportunities to shift public opinion about cannabis and cannabis users, the passage of Proposition 215 would not be possible without money. The opinion polls showed that the majority of the population were in favor of medical cannabis, but for the proposition to quality as a ballot measure, the organizers had to gather more than 400,000 valid signatures in 150 days. The medical cannabis initiative got the attention of George Soros, Lawrence Rockefeller, and other investors, who were ready to contribute large sums of money to the cause. Substantial funding professionalized the movement: Peron was replaced with a professional campaign manager, and the movement’s headquarters was moved from the Bay Area to Santa Monica . The broad language of Proposition 215 was both a blessing and a curse. On the one hand, it helped the initiative to pass because the narrative was not in direct conflict with the federal law; on the other hand, it did not guarantee real protection to cannabis patients. Proposition 215 created a medical necessity defense for people arrested for cannabis, but it did not prevent them from being arrested or prosecuted. It was the responsibility of an individual to claim that he has the right to use cannabis.
Another gap in Proposition 215 was that it had almost no details regarding how a medical cannabis system should operate and how patients should obtain their cannabis . Activists who drafted Proposition 215 were more concerned with legitimizing a state of affairs than ensuring that patients could avail themselves of cannabis in the future . Finally, most of the regulation was left to the county level and thus resembled a patchwork quilt, with disparate standards and rules. Such regulatory and enforcement loopholes made cannabis patients vulnerable to state and federal prosecution . The passage of Proposition 215 was met with strict resistance from the federal government . Barry McCaffrey, Clinton’s director of the office of National Drug Control Policy, threatened to revoke the license to any physician who prescribed cannabis to a patient due to its Schedule I status. Although the American Medical Association backed up a physician’s right to discuss cannabis therapy with a patient, many doctors shifted away from recommending cannabis to their patients .Local and federal authorities continued to raid medical cannabis dispensaries and private homes, seize cannabis, and arrest patients and caregivers. The backlash from law enforcement only intensified social mobilization. Founded in 2002, Americans for Safe Access became a nationwide support group for the emerging medical cannabis industry . ASA activists monitored the law enforcement activity, maintained a database of legal cases involving cannabis, and developed emergency response strategies for cannabis patients and providers . They also recorded police raids and held demonstrations at DEA offices. Moreover, ASA attorneys filed suits against California cities and counties that banned medical cannabis facilities and against the California Highway Patrol, forcing it to allow the intrastate transit of cannabis.In 2010, California passed Senate Bill 1449, which made the possession of no more than 28.5 grams of cannabis a misdemeanor that shall be punished by a fine of no more than $100.If Proposition 215 was mostly a symbolic gesture that manifested a cultural change, SB 1449 was instrumental in its function . Proposition 215 had quite an adverse effect on law enforcement agencies—after 1996, the number of cannabis arrests continued to grow, reaching its peak in 2008-2009 . SB 1449, on the contrary, influenced the behavior of state officials in a more instrumental manner and finally achieved what Proposition 215 failed to do. The number of arrests dropped significantly in just one year—arrests for cannabis indoor greenhouse possession dropped from 56,000 arrests in 2010 to 10,000 in 2011. Arrest rates for cannabis sales remained stable for a few more years until the passage of Proposition 64, which explicitly legalized cannabis sales—after that, they dropped from 7,600 in 2016 to 2,200 in 2017 .
For several years after the passage of Proposition 215, the situation with medical cannabis in California remained unsettled. Guidelines were provided only in 2003 when Senate Bill 420 finally clarified the scope of Proposition 215 . In particular, SB 420 established a state-regulated identification card program and allowed patients to form “collectives” to grow and distribute cannabis. The new adjustments created a space for the development of the legal cannabis industry. Collectives often worked as storefront dispensaries, and, even though they could only provide cannabis for suggested donations, these “donations” worked as retail prices . In 2015, California issued the Medical Marijuana Regulation and Safety Act , which imposed very specific rules on medical cannabis businesses, including regulations for cultivation, manufacturing, testing, distribution, transportation, and dispensing. According to Sam Kamin, “it was an indication […] that the state was finally getting serious about regulating the marijuana industry” . The symbolic meaning previously attached to cannabis was changing as the substance was placed in a context of increasing legitimacy . By 2016, the California medical marijuana market had grown to over 700,000 patients , and many people knew medical cannabis patients among their friends or neighbors. New cannabis dispensaries attracted a different type of cannabis users, which contrasted with the traditional “stoner” stereotypes . Cannabis providers employed medical symbols and terminology, gave detailed information on the chemical composition and potency of various cannabis strains, incorporated scientific knowledge, and deemphasized the negative effects of cannabis products. Oaksterdam University, a trade school for cannabis businesses, was founded in 2008 in Oakland; within three years of its launch, it had more than 13,000 students . In 2009, the California Board of Equalization imposed a state sales tax on dispensary operators, which signaled that cannabis companies should be treated on par with other legal businesses. These and other practical developments professionalized the field of medical cannabis and established an infrastructure that promoted the image of cannabis as a morally acceptable commodity. By 2016, 49% of Americans replied that both medical and recreational use of cannabis should be legal, and 35% thought that only medical use of cannabis should be legal.55 Although the primary goal of Proposition 215 was to provide safe access to cannabis for seriously ill people, de facto the majority of users consumed it recreationally . Gaining victory with medical cannabis, California activists jumped on the opportunity to fight a longer-term campaign aimed at full legalization. The first attempt to legalize cannabis for recreational use was under the Obama administration in 2010. Although California’s citizens rejected Proposition 19 , its 46% support indicated that the tide was turning .California’s Proposition 64 was considered in a more favorable context. Throughout the 2010s, the media became increasingly supportive of cannabis legalization : documentaries produced by CNBC, CNN, and Discovery Channel, as well as articles published in the mainstream magazines, called for an end of cannabis prohibition and helped to normalize it. Also, the spread of the Internet made it much easier to share information and educate citizens. From 2012 to 2014, three states and the District of Columbia had legalized the recreational use of cannabis, which provided a big morale boost to California’s activists. In 2013, the Obama administration gave the green light to the legal cannabis market by passing the Cole Memorandum, which constrained the federal government from enforcing federal cannabis laws in states that legalized cannabis for medical or/and recreational use.