It is often said, “As California goes, so goes the nation,” because changes in cultural norms and behavior frequently begin in the Golden State. As we approach a ballot initiative to legalize recreational marijuana in California, many states could benefit from taking notes on how the battle to place the initiative on the ballot unfolded there.
After a yearlong process of competing initiatives, closed-door meetings, and much wrangling, marijuana interests have coalesced around a single initiative for the November 2016 ballot in California. The Control, Regulate and Tax Adult Use of Marijuana Initiative (#15-0103), or AUMA, was filed on Dec. 7, 2015, starting the time clock for the signature-gathering process and campaign. The measure is financially backed by Silicon Valley billionaire Sean Parker of Napster and Facebook fame, and has been blessed by California Lt. Gov. Gavin Newsom. Fearing failure on election day if competing measures were placed on the ballot, those supporting more than one dozen alternative initiatives have reluctantly capitulated to the dominance that the backers of AUMA represent in the state.
Alcohol and drug treatment advocates, led by the California Consortium of Addiction Programs and Professionals (CCAPP), were successful in obtaining funding mechanisms in the initiative to provide more than $600 million annually for treatment in the state, making it the most treatment-focused measure on marijuana to reach the ballot in the U.S.
“We understood the importance of having a voice early in this process, and did our level best to make sure, regardless of our own like or dislike of the legalization movement, that Californians would see an improvement in their addiction treatment services should it pass,” says CCAPP President Lori Newman.
“Providing leadership on this issue took forward thinking and courage,” says Newman.
She adds, “Our membership has diverse opinions on legalization, which could have stalled action on our part so that we could fight over our position as an organization. Instead, we took an 'if, then' approach. If it is going to pass, then we better see dramatic increases in funding.”
The leadership at CCAPP made a strategic decision to become involved early and often, for several reasons. Former CCAPP President and current Legislative Committee Chair Warren Daniels was instrumental in shaping the argument about CCAPP's role. At CCAPP's board meeting in May 2015, Daniels cut through the divisiveness of the issue and proposed a more objective bearing.
“This isn't about our personal beliefs or professional opinions,” said Daniels. “This is about public health and that's the way we should be looking at it.”
Daniels proposed that CCAPP develop a position paper recommending that 45% of revenues from regulated marijuana be allotted for treatment, and an additional 14% of the revenue be earmarked for workforce development, research, and quality-improvement activities. Daniels, who has a reputation for innovating solutions far before his colleagues catch up to his vision, was to be taken seriously from the get-go. With little hesitation, CCAPP embarked on a journey to change the course of the initiative.
At the beginning of the process, the California office of the Drug Policy Alliance (DPA) was key in developing the policy side of the initiative. In addition, Newsom assembled a Blue Ribbon Commission to consider public policy regarding a possible initiative. CCAPP had a strong relationship with the DPA from past co-sponsorship of Proposition 36 (the landmark Substance Abuse and Crime Prevention Act), which voters passed in 2000. The California Society of Addiction Medicine (CSAM) was pivotal at the Blue Ribbon Commission, where CSAM Past President Timmen Cermak co-chaired the Youth Education & Prevention Working Group. Bold policy recommendations, supported with substantial evidence, set the stage for influencing the direction of the initiative.
When all was said and done, California's marijuana initiative stands in stark contrast to its predecessors. Following are key revenue distributions prescribed by the measure.
Research on impact: $10 million to a public university or universities in California annually, beginning with fiscal year 2018-2019 until fiscal year 2028-2029. Research must include: the impact of treatment for maladaptive marijuana use and the effectiveness of different treatment programs; and marijuana use rates, maladaptive use rates for adults and youth, and diagnosis rates of marijuana-related substance use disorders.
Community treatment: $10 million beginning with fiscal year 2018-2019 and increasing by $10 million each fiscal year thereafter until fiscal year 2022-2023, at which time the disbursement shall be $50 million each year, of which 50% must be allocated to qualified community-based nonprofit organizations to support job placement, mental health treatment, substance use disorder treatment, system navigation services, legal services to address barriers to reentry, and linkages to medical care for communities disproportionately affected by past federal and state drug policies.
Youth treatment: Funds remaining after costs of implementation and earmarks are distributed at 60% (an estimated $600 million per year) to the Youth Education, Prevention, Early Intervention, and Treatment Account, which proposes to fund the following:
Construction of community-based youth treatment facilities;
Prevention and early intervention services: grants to programs for outreach, education and treatment for homeless youth and out-of-school youth with substance use disorders;