Adithya Sambamurthy/The Bay Citizen

The dispensary at Harborside Health Center on Tuesday, Dec. 21, 2010

San Francisco is among the most active cities in California in easing access to medical marijuana, having issued more than one-third of the 47,828 cannabis cards in the state. But unlike surrounding counties, San Francisco has a long-standing practice of handing back the paper applications for cards and not recording the names of patients or the doctors who gave them the required recommendations.

The policy dates back to 2000, when then-Supervisor Mark Leno met with medical cannabis activists, who expressed fears that the federal government could seize the records and arrest patients. 

Accurate data about the use of medical marijuana and its health effects in California could inform the debate about efforts to liberalize laws against the drug, health researchers say. But even as marijuana activists push for broader legalization — including Proposition 19, the state measure to legalize pot for recreational use, which failed at the ballot box on Nov. 2 — counties are wildly inconsistent in how much data they collect.

Senate Bill 420, sponsored by now-retired state Sen. John Vasconcellos, established guidelines in 2003 for a statewide medical cannabis program. The bill clarified and expanded the medical marijuana act approved by voters in 1996, requiring “uniform and consistent application of the act among the counties within the state.”

But application of the act has been anything but uniform. Colusa and Sutter counties have resisted issuing any cards, while others keep much of the data to themselves.

The Santa Clara County Public Health Department keeps all application data. The Alameda County Department of Public Health said it keeps only data on ethnicity.

Data from Marin demonstrates one of the issues the medical card program has faced in recent years. Of about 1,000 cannabis cards handed out by Marin County, 57 percent were underwritten by just two doctors, according to Timmen Cermak, president of the California Society of Addiction Medicine.

Cermak said his main concern with inconsistent record-keeping is that it could hide unscrupulous practices of problem physicians. “There's a wide range of non-life-threatening illnesses being treated,” Cermak said. “Some physicians are not truly treating, but providing access.”

San Francisco’s medical cannabis card program became a model for the 2003 legislation that required all counties to set up similar programs.

The state law cites the value of studying the health effects of the drug: “More information is needed to assess the number of individuals across the state who are suffering from serious medical conditions that are not being adequately alleviated through the use of conventional medications.”

Ronald Owens, a spokesman for the California Department of Public Health, said that the counties do not share any demographic information about medical marijuana users with the state. He said the only time the state gets information about patients is when the person applying for the card is a Medi-Cal recipient, because they can get a 50 percent discount on the card.

Proponents of legalization say the science is in, arguing that marijuana is safer than legal, addictive drugs such as alcohol and tobacco. But there have been far fewer studies about marijuana than other substances — a lack of clarity that clouds the public debate.

Stanton Glantz, a tobacco researcher at the University of California, San Francisco, said gathering consistent statewide medical marijuana data could be invaluable for researchers. But he noted that even with perfect records and access to them, a lack of funding for research is a big impediment, because it’s hard to convince federal grant-makers to back studies of the effects of marijuana.

“I do know people who have tried to work in this area,” Glantz said. “It’s tough to get money for research.”

New Jersey recently passed its own medical marijuana law and attempted to have Rutgers University grow cannabis to be sold at teaching hospitals, the Newark Star-Ledger reported in June. Rutgers refused, because it feared losing more than $500 million in federal funding.

Eileen Shields, a spokeswoman for the San Francisco Department of Public Health, confirmed that medical cannabis activists told city officials at the launch of the program that privacy was a priority. They did not want the city to keep card data because they feared federal prosecution of patients.

At the same time, some retention of records was required to help local law enforcement identify legitimate card-holders. When legislators approved SB 420, they explicitly required the retention of records to protect patients from “unnecessary arrest.” The law set up a hotline through which local law enforcement officers could avoid arresting patients by verifying a nine-digit code and patient photo on the front of the cards.

Because the cards bear only a number and photograph, and not the name of the card-holder, law enforcement agencies have no easy way of determining the correct owner of an ID card. That could open the doors to fraudulent sale or use of cards.

San Francisco issued 2,817 cards during the fiscal year ending in June, including yearly renewals. The California Department of Public Health's Medical Marijuana Program says the total for all counties was 12,859.