The voters approved medical cannabis in California over 15 years ago yet there are still many people without safe access to this medicine. Advocates and patients have been working to establish laws and regulations that provide access through storefront dispensaries and home delivery services. Public polls show 80% support for access to medical cannabis, yet more California localities ban medical cannabis facilities than allow them. After the recent state Supreme Court decision declaring that cities and counties may ban dispensaries, even more localities followed suit. Why would leaders deny access to medical cannabis when public support is so overwhelmingly in favor and what can patients do about it?

Local politicians ban dispensaries for a variety of reasons, none of which make any sense to patients. Nimbyism, fear, and prejudice are all present when local leaders consider the idea of dispensaries. Even successful efforts can be thwarted by a single parent or teacher who shows up at the final council vote to ask, “What about the children?” As though a collective haze settles in, the politicians all reply, “Yes, what about the children?” While a complete answer to that question is a topic for a different article, politicians need to understand that banning dispensaries does not take cannabis out of their town. Cannabis always has been and always will be. Prohibiting safe access for patients does not change this. Nor does it relieve parents of the responsibility to protect and educate their own children about drugs, alcohol, sex and other life risks that go along with being human. Yet the bans continue.

This problem is not limited to local cities and counties. The state legislature has also refused to act and implement regulations for access to medical cannabis. The only regulation they have managed to implement since the passage of SB 420 in 2003 is a 600 ft buffer zone between mobile or storefront dispensaries and schools. SB 420 established the system we currently know today, but it left open many questions the least of which is how many feet to buffer from schools. For years, bills have been introduced only to stall in committee and barely get heard. Yet local politicians use the lack of state guidelines as an excuse not to act. “We want the state to do something,” they say, shifting responsibility to Sacramento. This may be an easy way for local leaders to get patients off their back, but it leaves those patients without any effective political representation.

Politicians have failed patients at both the local and state level. Patients have therefore turned to the voters. Local ballot measures have been introduced throughout the state. After 6 years of back and forth with the city council, activists and patients introduced not one but three ballot measures in Los Angeles. In May, voters approved one of those measures establishing the first dispensary regulations in the state’s largest city. This was a successful effort, but it is a daunting challenge to go city by city trying to get safe access. Many patients and activists are yearning for a statewide ballot initiative. There are several ballot initiatives in the works, but these address legalization of recreational cannabis use and not medical regulations.

One may ask, “What about the dispensary operators and the medical cannabis industry? Where are they in all of this?” Few dispensary operators engage in political efforts and many who do are bogged down in local fights. Others have chosen to focus on recreational legalization. Some operators have hired lobbyists to go to Sacramento. Unfortunately these lobbyists usually do more harm than good as politicians are not looking to hear from hired hands on this issue. Most efforts to organize operators have failed in California as factions form, divisions arise, and hidden agendas lead to sabotage. Industry advocacy groups have all but abandoned their efforts in California as Colorado and other states take the lead in industry development.

All of this leads to the conundrum that is medical cannabis in California today. Politicians won’t act, the industry cannot organize, and activists are divided. Until something changes, patients without safe access to medical cannabis are on their own. Fortunately these patients have what may be the most powerful tool for reform, their own voices. The few politicians who do act are moved by personal stories told by patients themselves. Patients can use their voices during the Sacramento lobby summits organized by Americans for Safe Access. All patients are urged to join the next summit this August. By bringing your voice to Sacramento, you can do more than all the lobbyists, dispensary operators, and industry advocates combined. But you should not quiet your voice once you return home. Local visits with state representatives can have a tremendous impact. The more they hear from patients, the more likely they are to support the latest bill to establish safe access. Following local politics and voicing support for medical cannabis can bring change in your town. Speaking out at a local council meeting can help other patients find their voices and as you join together politicians will have no choice but to listen. Advocates, industry representatives, and dispensary operators would be wise to support these efforts with more coordinated lobby days, in-district visits, and even sit-ins for politicians who refuse to act. There is hope for medical cannabis in California yet.