Colleen Costello

Colleen C 

The image features Dennis Peron and Mary Jane Rathbun (aka Brownie Mary) advocating for medical cannabis in California. Centered on the image in large, bold text is the phrase: "NO TAX ON MEDICINE". The overall composition conveys a strong advocacy message about fair treatment for medical cannabis patients.







Patient Equity: No Tax on Medicine

At Meadow, we’re committed to standing up for what matters—fair access to medicine, compassion for patients, and equity in cannabis policy. Yesterday, we took action by delivering the __Patient Equity in Medical Cannabis letter __to Governor Newsom, Senator Wiener, and Assemblymember Haney, advocating for tax relief for medical cannabis patients.

This issue strikes at the heart of what the medical cannabis movement was built on: ensuring patients have safe, affordable access to medicine. Yet today, patients face unnecessary barriers that undermine this promise.

Unlike any other medication prescribed by a doctor, medical cannabis is subject to sales tax unless patients endure the long, expensive, and intrusive process of obtaining a state-issued Medical Marijuana Identification Card (MMIC).

This is not only inequitable—it’s causing California’s once-thriving medical cannabis ecosystem to die.

## The Issue: Tax Inequity is Harming Patients

For any other medication, a doctor’s prescription is enough to exempt it from sales tax. But for cannabis patients, a valid doctor’s recommendation is not sufficient. Instead, they are required to:

- Obtain a Medical Marijuana Identification Card (MMIC) through their local Department of Public Health.
- Pay costly application fees.
- Undergo a time-consuming process that many find burdensome and inaccessible.

The result? Fewer patients are obtaining MMICs every year. In 2023, there were just 3,196 cardholders statewide. This year, that number has dropped to 2,800. California’s current policy not only adds unnecessary barriers for patients, it undermines the original spirit of Prop 215 and Prop 64—protecting medical access and patient rights. 

Patients who forego the MMIC process either end up paying a premium for their medicine with sales tax compounded on top of excise and local taxes, or they turn to the unregulated market. 

## Why This Matters

1. __Patients Deserve Fair Treatment__: A doctor’s recommendation should be treated the same as any other prescription—without requiring an extra layer of bureaucracy and cost. California’s tax policies discriminate against patients who cannot or choose not to obtain an MMIC.

2. __The Medical Market is Dying__: The medical cannabis market in California has shrunk dramatically since adult-use legalization. High taxes and regulatory burdens have pushed patients to the unregulated market, where products are untested and potentially dangerous but much less expensive.

3. __Compassion is Lacking__: Compassion programs, which exempt patients from sales tax, are voluntary and largely non-existent. Most dispensaries simply cannot afford to run these programs due to high operating costs, leaving patients without viable options for tax relief.

4. __Public Health is at Risk__: When taxes make regulated medical cannabis unaffordable, patients turn to the illicit market. This creates serious health risks for vulnerable populations relying on cannabis for conditions like chronic pain, PTSD, insomnia, epilepsy, and cancer.

## The Solution: Treat Cannabis Like Medicine

Our campaign aims to eliminate the MMIC requirement for sales tax exemption and allow patients with a valid doctor’s recommendation to receive fair tax treatment—just like they would for any other medicine. This small, common-sense change would:

- Restore affordability for medical cannabis patients.
- Encourage patients to return to the regulated market.
- Increase public safety by reducing reliance on untested products.
- Uphold the voter-backed protections of Prop 215 and Prop 64.

## Taking Action

At Meadow, we believe this issue is a matter of fairness, compassion, and public health. California started with medical cannabis, and it’s time to honor those roots by ensuring equitable access to medicine for all patients.

We are working alongside California’s leading trade organizations, advocates, and patient groups to push for this critical change in the next legislative session. Together, we’ve drafted a letter to Governor Newsom, Senator Wiener, and Assemblymember Haney calling for action.

But we can’t do it alone. We need the community’s voice to make this change a reality.

## How You Can Help

- [Sign Your Support for our “No Tax on Medicine” Campaign](https://docs.google.com/forms/d/e/1FAIpQLSeDZQbfXyrcJOSSEuq4dO6lU6t3O2YCmleHltg4EZAXRW4SvA/viewform). Every voice matters in showing lawmakers that this change is needed now.
- Share This Post with your community. Spread the word to patients, operators, and advocates who care about access to affordable, regulated medical cannabis.
- Engage with Lawmakers. Reach out to your state representatives to share why this issue is important to you.

## Standing Together for Medical Patients

California’s medical cannabis market was built on compassion. It’s time to return to those roots. By removing unnecessary barriers like the MMIC, we can ensure patients have safe, affordable access to the medicine they rely on—just as Prop 215 intended.

Fairness. Compassion. Access. Let’s make it happen.

<callout> [Stand with us for patient equity—sign our letter to Governor Newsom, Senator Wiener, and Assemblymember Haneyto end the tax on medicine](https://docs.google.com/forms/d/e/1FAIpQLSeDZQbfXyrcJOSSEuq4dO6lU6t3O2YCmleHltg4EZAXRW4SvA/viewform) </callout>

## Full Letter to Governor Newsom, Senator Wiener, and Assemblymember Haney

Dear Governor Newsom, Senator Wiener, and Assemblymember Haney,

On behalf of California's leading cannabis trade, labor, advocacy, veterans, and patient organizations, as well as individual stakeholders throughout the industry, we write to seek your help in addressing California's inconsistent tax policies as it relates to medical cannabis patients.

Our position is that cannabis patients should not be subject to California Sales Tax if they possess a valid doctor's recommendation for the therapeutic use of cannabis. This position is supported by California law. In all other cases, save individual taxation, including untaxed cannabis disbursement to a patient pursuant to a Compassion Program, a doctor’s recommendation is considered sufficient to exempt one from payment of sales taxes. We are hopeful that you will work with us to correct the one remaining inconsistency: State sales taxes imposed on medical cannabis patients who are not part of Compassion Programs.

Prop. 215 still exists. The definition of “Qualified Patient” still includes any Californian who uses cannabis for medical purposes with a valid physician’s recommendation.1 Qualified patients have never been – and still are not required, by design – to register or obtain an identification card in order to qualify for the legal protections of Prop. 215. Indeed, the Adult Use of Marijuana Act (“Prop. 64”), which legalized commercial adult use of cannabis, includes the strongest language possible restricting changes to Prop. 215 – “nothing in this section shall be construed or interpreted to amend, repeal, affect, restrict, or preempt laws pertaining to the Compassionate Use Act of 1996.” However, California’s sales tax policy discriminates sharply between qualified patients with and without identification cards – one pays sales tax and the other does not. This policy has no legal or policy justification that is consistent with the voter-endorsed provisions of Prop. 215 and Prop. 64. Until voters say differently, all qualified patients should be afforded sales tax relief, not just those with the geography or resources to register for a county identification card. Why is California making medical cannabis more expensive for certain patients over others?

According to a February 2, 2022, email from Christina Dempsey, Acting Deputy Director of External
Affairs of the DCC, per the regulations, “either an ID card or a physician's recommendation is
acceptable for compassion care patients.”

Patients enrolled in a compassion program are exempt from sales tax. However, patients who cannot find a compassion program in their area or can’t qualify for such a program must pay State sales tax at the check-out counter, despite the fact that they are medical cannabis patients in possession of the very same document (a valid doctor’s recommendation) which qualifies a medical cannabis patient enrolled in a compassion program for a sales tax exemption.

It should be noted that compassion programs are voluntary programs underwritten by dispensaries or specific programs funded by donations. At a time when most cannabis businesses are facing extinction due to taxation, over-regulation, and a huge illicit market, few are able to offer compassion programs. Proof of this rests in the annual report on Tax Exemptions for Medicinal Cannabis published by the Legislative Analyst’s Office (see https://lao.ca.gov/Publications/Report/4608) which shows a shockingly low number of compassion program tax exemptions.

As demonstrated by the LAO Report referred to above, compassion programs in California are largely non-existent. Given this, the only way to ensure that patients, particularly those who are poor, are treated equally under the Tax and Revenue Code is to allow all patients possessing a valid doctor’s recommendation relief from California’s Sales Tax.

Currently, compassion program patients need only a doctor’s recommendation for tax relief. Patients who are not attached to a compassion program must acquire a state-issued Medical Marijuana Identification Card (MMIC) in addition to their doctor’s recommendations to qualify for tax relief. Excluding a patient from the tax exemption based solely upon registering for a state-issued card is arguably discriminatory, in that it excludes tax relief for those without the ability to pay for the card, regardless of their medical need.

The intention of Prop 64 was not only to expand legal access to adult-use cannabis but also to preserve a well-established medical cannabis market. However, in California today, we have a contracting medical market, dropping from 3,196 MMIC card holders in 2023 to just 2,800 card holders in 2024. Offering sales tax relief to cannabis patients would still require them to pay the excise tax, which when combined with local taxation, brings the total tax burden down to an affordable level, mirroring what patients paid in taxes prior to legalization.

Prior to legalization, there were millions of California patients with doctor’s recommendations, achieving over $2.5B in medical sales in 2017. Post legalization, due to unbearably high taxes, medical cannabis patients have been forced to seek their medicine in the unregulated market, where untested products have already been a proven danger to their health. The State has lost millions in excise taxes as well.

Medicine is not subject to California sales tax (see CDTFA Regulation 1591). In the interests of fairness, equity, and compassion this should apply to medical cannabis patients as well.

Our organizations view exempting all cannabis patients from California Sales Tax as critical in providing an affordable pathway for patients. Medical cannabis patients who are relieved of California Sales Taxes will be disincentivized from illicit market purchases. Their return to the regulated market will increase the excise tax and local tax revenue.

We are hopeful that this change can be included in legislation contemplated by the Governor in the next year’s legislative season. Our representative, David Hua, will be contacting your offices shortly to ascertain whether virtual meetings to discuss the above might be possible. Should you have any questions or concerns David Hua can be reached at: David@getmeadow.com 

Sincerely,

David Hua, CEO, Meadow

Kenny Morrison, President, California Cannabis Manufacturers Association

Lauren Coté, Co-Board Chair, Cannabis Distribution Association

Johnny Delaplane, President, San Francisco Cannabis Retailers Alliance

Jonatan Cvetko, Executive Director, UCBA

David Goldman, President, San Francisco Chapter, Brownie Mary Democratic Club

Kandice Hawes-Lopez, Founder and Executive Director, Orange County NORML

Sarah Armstrong, JD, Outreach Chair Los Angeles and Ventura Counties, Americans for Safe Access

Keith Cich, President, Sunderstorm Inc.

Erin Gore, Founder & CEO, Garden Society

Bobby Vecchio, Co-Founder & CEO, Herb Delivery

Vincent Ning, Co-Founder & CEO, Nabis

Stacey Hronowski, Co-Founder & CEO, Canix

Ted Lichtenberger, Co-Founder & CEO, Flower Co

Steve Albarran, Co-Founder & CEO, Confident Cannabis

Bert Vick, Co-Founder & CEO, Rev Genomics

Nohtal Partansky, Co-Founder & CEO, Sorting Robotics

Steven Jung, COO, PAX

Ryan Miller, Founder, Operation EVAC

Aaron Newsom, COO & Co-Founder, Santa Cruz Veterans Alliance

Eric Goepel, Founder & CEO, Veterans Cannabis Coalition

Hirsh Jain, Founder, Ananda Strategy

Shabnam Malek, Partner, Brand and Branch

David Belsky, CEO, FlowerHire

Amber Morelli, Regional Sales Manager, Pure Vape

Aaron Flynn, CEO & Co-Founder, Gold Seal

Gretchen Miller, CEO & Co-Founder, Kiskanu

Lara L DeCaro, Partner, Leland, Parachini, Steinberg, Matzger & Melnick LLP

Sara Payan, Public Education Officer, Apothecarium

Andrea Greenberg, Founder, Society Jane

Joyce Cenali, COO, Big Rock Partners & Sonoma Hills Farm

Justin Pressfield, Associate Vice President, Weedmaps

Darren Story, CFO, Coastal Sun

Jordan Kuhl, General Manager, Dr. Greenthumbs LAX

Wesley Hein, Head of Global Expansion, Mammoth Heavy Hitters

Andrew DeAngelo, Founder, Andrew DeAngelo Consulting LLC

Ezra Malmuth, CEO, Atlas Edibles

Benjamin Larson, CEO & Co-Founder, Vertosa

Josef Airone, Founder and Director, The Sweetleaf Collective

Whitney Beatty, CEO and Founder, Josephine & Billies and Apothecarry Brands

Tiffany Devitt, Chief Compliance Officer, CannaCraft

Ron Gershoni, CEO & Co-Founder, Jetty Extracts

Judy Yee, CEO & Co-Founder, K-Zen Beverages

Jamie Feaster, CEO and CoFounder, Country

Tuan Le, Business Development, Brite

Nate Landau, COO, Snowtill

Jason Horst, Managing Partner, Horst Legal Counsel

Colleen King, VP Growth, Ciclo

David Kaufmann, Partner, Slap Consulting

Dylan Ferman, CEO, Genius Pipe

Neil Dellacava, Business Development, HERBL

Tegan Thompson, VP Marketing, Petalfast

Dustin Gibbens, Co-Founder/COO, 965 Solutions

Alexa Goldberg, Sales Director, Psychedelics Today

Terryn Buxton, CEO, Oakland Extracts

Elissa Hambrecht, Managing Member, Napa Valley Fume

Leah Cerri, Manager, Select

Frances Villaneuve, CEO, Clarified

Nicole Howell & Ariel Clark,	Partners, Clark Howell LLP

Manndie Tingler, CMO, CannaGram Delivery & Head of Brand Relations, Conception Nurseries, CRO and 
Co-Founder, Khemia Manufacturing

Amanda Reiman, Founder, Personal Plants

Jimmy Levi, VP Business Operations, Chemistry

Morris Kelly, CEO & Founder, SF Roots CA

Omar Figueroa, Founder, Law Offices of Omar Figueroa

Chelsea Sutula, Owner & CEO, Sespe Creek Collective

Michael Kraft,  Compliance Officer, Papa & Barkley

Dana Leigh Cisneros, Esq., Managing Attorney, The Cisneros Firm dba Cannabis Corporate Law Firm

Jesus Sahagun Jr., CEO, Phog Center

Konstantine Kostas, Consultant, Synchronicity Holistic

Randy Cruzado, CEO, The Growcery

Mike Mekk, CEO, Mission Organic

Sean Kali-rai, Founder, Silicon Valley Cannabis Alliance

Hilary O'Brien, Director of Operations, Ivy Hill Cannabis & Green Remedy Collective

Michael Kay, Owner GE Granada Hills, DBA Green Earth Co

Jessica Bray, Director of Inventory and Purchasing, Green Cross of Torrance

Zachary Pitts, CEO, Ganja Goddess

Carly Ekenstam, Director of Operations & Security, Cruz Verde Inc. dba Original Green Cross

Mina Mishrikey, Partner and Head of Investments, Merida Capital Holdings

Cristina Arantes, Operations Manager, IncrediMeds

Anthony Jenkins, CEO & Co-Founder, Next Level

Stephanie Pangelinan, Regional Manager, Foggy Daze

Julie Germenis, General Manager, Eagle Eye

Mary Aigner, General Manager, Love In It Inc dba Sol de Mendocino

Gillian Levy, Co-Founder, Humboldt Apothecary

Dawn Bazurto, CEO/Founder, Lady Gemini

Jakki Hernandez and Dana Cisneros, Board Members, Orange County NORML

Tiffany Wright, COO, La Brea Collective Compliance

Kip Clifton, Board Director, Purextracts

Kevin Watts, CEO, TFA, Inc

Micah Anderson, CEO, Leef Holdings

Zachary Selvin, President, LitCo

Nikita Baranovskiy, Management, Infinity Medical Alliance INC

Brooke Rosel, General Manager, The Sweetleaf Collective

Cristina De Sousa, IncrediMeds

Mario Barajas, GreenLift

Kevin Reed, Owner, The Green Cross

Nancy Do, CEO and Founder, Endo Industries

Aaron Justis, President, Buds & Roses

Kimberly Cargile, CEO, A Therapeutic Alternative

Amir Gresham, Board Member, Social Equity Owners & Workers Association

Colleen Costello, Director of Communications, Meadow

Robert Lee, Founder, Evolved Microdoses

Brendan Kelly, CEO, CEAS

Laura Bell, Director of Manufacturing & Lead Hash Maker, Heritage Hash Co.

Chris Romaine, Owner, Pacific Coast Photo DBA Kandid Kush

Matthew Ingram, President & Co-Founder, Proof

Nicole Daryanani, Sr. Sourcing Manager, Kiva Confections

Anthony Alegrete, COO & Founder, 40 Tons

Shannon DeGrooms, Executive Director, This is Jane Project

Jake Kuczeruk, Director of Sales, New Frontier Data

Tommy Ramos, Board of Directors (MCBA)

Madison Mullis, Publicist, Trailblaze

Pamela Epstein, Chief Legal & Regulatory Officer, Terpene Belt Inc.

Greg Kouvaras, CEO & Founder, Greenline

Dina Nagib, Principal Consultant, Grass Goddess Consulting

Jerred Kiloh, CEO & Founder, The Higher Path

Kerri Accardi, Media Producer, 420MEDIA + Cannected TV

Lauren Mendelsohn, Junior Partner, Law Offices of Omar Figueroa

Brian Holler, Chief Revenue Officer, Beard Bros. Pharms & Media

Vien Trinh, Product Marketing Manager, Flourish Software

Jeff Pehrson, Producer, Planted with Sara Payan

Eric Rosete, Owner, Farcaster Creative

Sean McDermott, owner, The Grove La Mesa

Mitch Kulick, Partner and Co-Founder, Feuerstein Kulick LLp

Jesse Duncan

Brett Yader,  CEO & Co-Founder, Flower Supply

Brian Applegarth, Founder Cannabis Travel Authority 

Steph Sherer, Founder & Executive Director, Americans for Safe Access

Megan Prusynski, Marketing Director, Applegarth Strategies

Chiah Rodriques, co-owner, Operations Director, Arcanna Flowers

James M Beatty, Co-Founder Arcanna Flowers

Jesse Stout, Esq. 

Alex Shamil

JohnPaul Williams II, Founder, J Williams Designs

Omar Figueroa, Founder & Managing Partner, The Law Offices of Omar Figueroa, Inc.

Bridget  May, CEO and Founder

Vincent Patterson Owner Founder The Flowershop llc

Shoshana Patterson The Flower Shop LLC Manger

Victoria Schanzle, President Cherry Valley Farms LLC

Crystin Johnson, Director of Sales, Pure Beauty

Mike Rosati

Maureen Dube-Savage MS RD, Founder of More Canna Care.llc

![Patient Equity Support Logos ](//images.ctfassets.net/6kwu1u6s8j23/hI9f20rJrONmwzBWCEoVB/2a0da38d64138eab5df6a105e41c52ab/Untitled_design_-_2024-12-17T221148.146.png)

<callout> [Add your signature and logo; sign our letter to Governor Newsom to end tax on medical cannabis](https://docs.google.com/forms/d/e/1FAIpQLSeDZQbfXyrcJOSSEuq4dO6lU6t3O2YCmleHltg4EZAXRW4SvA/viewform) </callout>

The image features Dennis Peron and Mary Jane Rathbun (aka Brownie Mary) advocating for medical cannabis in California. Centered on the image in large, bold text is the phrase: "NO TAX ON MEDICINE". The overall composition conveys a strong advocacy message about fair treatment for medical cannabis patients.


Learn how we can protect California’s medical cannabis patients and ensure medicine remains accessible for all.

No Tax on Medicine: Tax Relief for California Medical Cannabis Patients

Aria Biswas

Aria Biswas is head of marketing and cannabis events at Meadow, a cannabis retail software system for dispensaries.

How medical marijuana can help Crohn's disease

Medical Marijuana and Crohn's Disease

This article was originally published by Daniel Towns on the Meadow blog in November, 2014.

---

I had been using cannabis to alleviate my symptoms for nearly two years by the time a doctor diagnosed me with Crohn's Disease. It was the fall of 2010. I was a college sophomore at the time, with homecoming right around the corner. It was difficult to accept the fact that I suffered from a chronic condition, but I stayed in school thanks to prescription drugs and, as I've learned, thanks to cannabis.

Since 2010 I've experienced just one other flare-up of symptoms, the worst of which include ulcers, deficiencies caused by the malabsorbtion of nutrients, and the resultant fatigue that debilitates so many Crohn's patients.

I count myself lucky in the relative severity of my disease, which is itself extremely rare, because I have not yet undergone surgery for any life-threatening complications. Most patients with my condition will - and I may yet end up under the knife - but I argue that cannabis products significantly reduce that danger.

Many people have died at younger ages from aggressive, often untreatable Crohn's symptoms, so I feel more grateful for each healthy day at the age of twenty-four.

As a medical marijuana patient living in California, I have access to excellent medicine. Now that my home state of Oregon has followed its northern neighbor in legalization, I feel even more empowered to access treatment up and down this beautiful side of the country.

My patient journey was not always so easy, though. I arrived in the San Francisco Bay Area in the fall of 2009, without a medical marijuana recommendation, but I had already begun experiencing serious symptoms.
One year later, I reached my breaking point because of two legal drugs that are now completely off-limits for me. I did just about the worst thing any Crohn's patient could do: fighting a hangover with Advil.
Now I abstain from both alcohol and Ibuprofen because they can cause ulcers in a fragile gastrointestinal tract like mine. Before my diagnosis, however, I knew none of this.

I did know that one of the only ways I could eat in my condition was by smoking cannabis to achieve the increased appetite known colloquially as "the munchies."

In fact, I had eaten my most satisfying meals while medicated for years by that time, but flare-ups can exacerbate the suppressed appetite that afflicts many patients with inflammatory bowel disease.

My second and most recent flare-up occurred in the winter of 2013, and I was again prescribed a notorious little steroid known as Prednisone. This drug has a range of nasty effects including weight gain, difficulty sleeping, mood swings, and other harmful imbalances, and it can cause serious side effects if used in the long term.

After two regimens on Prednisone, I must admit that I felt much worse than I had at the height of any flare-up. Once again, cannabinoids helped me with pain while my intestines healed - this time, however, I was mostly suffering because I was weaning off of the steroids I had been prescribed.
My experience with cannabis as a treatment for Crohn's Disease is one of the biggest reasons that I'm excited to write for Meadow.

Cannabis was popular in ancient medicine as a cure for ailments of the stomach and digestion, but now we are truly living in a new age: medical researchers have finally begun to expose these hidden links with relation to Crohn's Disease.

Even with such high tradition in natural medicine, doctors and scientists explained the phenomenon very recently - the term 'endocannabinoid' was coined in the mid-1990s after a series of breakthroughs pinpointed THC-sensitive receptors in the brain.

These receptors were found to relate to a range of psychological and physiological responses that include the functioning of the gastrointestinal system. With the discovery of the endocannabinoid system, it became apparent that cannabis might achieve the transition from an ancient to a modern medicine.

What does this mean for patients with inflammatory bowel disease? Put simply, it explains how cannabis helps Crohn's patients to suppress symptoms like nausea, a cause of weight loss.

Increased appetite was a noticeable effect, but the evidence suggested calming and antispasmodic properties as well; people with IBD likely used cannabis to relieve pain, stress, and to help them sleep long before the discovery of the endocannabinoid system.

Following these implications, researchers began seriously investigating cannabis as a medication for Crohn's Disease in 2011, with promising initial results.

Here at Meadow, we strive to provide patients with accurate and objective posts on peer-reviewed research, which is why we've created this Cannabis Patient's Guide to Crohn's Disease.

Firstly, we do not recommend immediately adopting cannabis as a replacement for Crohn's medication prescribed by physicians.

Medical marijuana has been proven to reduce the need for medication in other diseases, and the same may be true for Crohn's Disease - however, we should wait for further research before moving in this direction.

In my experience, the best approach to controlling Crohn's Disease involves a combination of prescription drugs, cannabis, regular exercise, and a healthy diet.

On a side note, I do prefer certain pharmaceuticals over others, but some people suffering from a more aggressive case of Crohn's Disease may not benefit from my prescriptions.

With that said, medical researchers made impressive progress toward classifying cannabis as an approved treatment for Crohn's Disease in recent years.

The best scientific evidence for the effectiveness of cannabis as a Crohn's medication came in a series of three studies conducted between 2011 and 2013. Beyond the fact that each study included actual Crohn's patients using cannabis, each of the three publications is unique in terms of sample size, methodology, and reliability.

<figure>
![Cannabis as Crohn's Medication 2011-2013](//images.contentful.com/6kwu1u6s8j23/6nVfAes99ZQSP4DXnw4LTQ/b7b9de9f6440df6b4896acd8b6d2b570/Cannabis_as_Crohn-s_Medication_2011-2013.png)
  <figcaption>A graph showing the dates, sample sizes, and clinical response rates for three major studies of cannabis as a medication for Crohn's Disease</figcaption>
</figure>

In the first study, conducted by an Israeli team in August 2011, 30 participants rated their diseases on a scale called the Harvey Bradshaw index (also known as the Crohn's Disease Activity Index or CDAI).

After treatment with cannabis, 21 of the 30 "improved significantly," with the need for other medication also reduced. Remarkably, "15 of the patients had 19 surgeries during an average period of nine years before cannabis use, but only two required surgery during an average period of three years of cannabis use."

One of the most important benefits may be a reduction in the the number of surgeries undergone by Crohn's patients; the National Institutes of Health report that between 70% and 90% of these patients will require operations, of whom 39% require repeat operations.

While its results were promising, however, skepticism persisted in 2011 because this study was a first foray without the use of a placebo-controlled group. To their credit, the researchers did achieve impressive results as measured by the CDAI, which depends on both self-reported and observed criteria.

Later in 2011, a team of enteric scientists published a study of cannabis as a treatment for Crohn's Disease and Ulcerative Colitis (UC), two common varieties of inflammatory bowel disease.

The Crohn's group consisted of 191 patients, of whom 91 reported lifetime cannabis use - a rate of 48%. Of lifetime users, an impressive 50% used marijuana to relieve symptoms. The numbers compare similarly between UC and Crohn's patients in the study because cannabis treats similar problems caused by the two diseases.

To achieve these measures, the team employed a questionnaire "regarding current and previous cannabis use, socioeconomic factors, disease history and medication use, including complementary alternative medicines."
For disease activity they used the Short Inflammatory Bowel Disease Questionnaire, another systematic index measuring the health-related quality of life for Crohn's patients. As a survey of nearly 200 people, this study provided further evidence for the reclassification of medical marijuana as a Crohn's treatment.

It was not until 2013, however, that the journal Clinical Gastroenterology and Hepatology published the most definitive results yet achieved on the subject. In a placebo-controlled study of 21 Crohn's patients conducted over a period of ten weeks, 10 of the 11 subjects in the cannabis group induced a clinical response by smoking marijuana, with five even achieving complete remission.

The placebo group showed much lower rates in each category, providing a much-needed control for mounting evidence surrounding cannabis as a treatment for inflammatory bowel conditions.

With luck, these trials can provide the groundwork for a new series of experiments to prove the link between cannabis and Crohn's Disease beyond a reasonable doubt.

A review of medical literature published early in 2014 by the journal Pharmacology sought to do just that, highlighting the locations of cannabinoid receptors (classified as either CB1 or CB2) throughout the gastrointestinal tract and their potential clinical effects:

<figure>
![Crohns Disease IBD](//images.contentful.com/6kwu1u6s8j23/3afLmCLs6M4ouhAmekLP1z/3166e1ab4c2d992b64ea020bea1c7ab7/Crohns_Disease_IBD.png)
  <figcaption>Potential targets and mechanisms of CBs involved in the improvement of IBD. Natural and synthetic CBs act via intestinal CB1 and CB2 receptors to regulate epithelial permeability, motility, secretion (via the enteric nervous system), as well as leukocyte migration, recruitment and apoptosis. As the site with the highest CB1 expression (but also some CB2 expression), the brain may modulate motility, the sensation of pain and unpleasantness, thus positively influencing the inflammatory process. Source: Karger.</figcaption>
</figure>

Importantly, they emphasize that the brain is the principal site for CB1 expression and that CB2 has been detected in the brainstem. This means that the cannabis may reduce inflammation by acting on the central nervous system directly, perhaps influencing the sensation of pain, suppressing nausea, or relieving stress.

These conjectures make sense to me as a Crohn's patient, and researchers have long postulated that stress might cause symptoms to present. Paying respect to both ancient and modern wisdom, the review finds conclusively that cannabis has great potential as a treatment for Crohn's Disease. In their words, this "elegant translation" from natural to scientific medicine should set the stage for major discoveries in the near future.
Crohn's patients today may have the best chance at living normal lives seen thus far in the short history of this disease, and I believe that cannabis legalization could present another inflection point.

The research indicates that access to affordable cannabidiol and cannabis products could mitigate the pain and expense associated with Crohn's Disease, and public health officials, politicians, and dispensaries alike have taken notice.

If you suffer from inflammatory bowel disease and have not tried cannabis as a treatment for your symptoms, why not conduct your own clinical trials and report the results on one of the indices used in the studies?

No matter your background or condition, please recognize the mounting evidence for cannabis as a treatment for a range of conditions including Crohn's Disease - legalization may be able to prevent surgeries and even save lives.

---

Meadow builds software for the cannabis industry in California.

To learn more about Meadow, check us out on [Facebook](https://www.facebook.com/getmeadow), [Instagram](https://instagram.com/meadow.sf) and [Twitter](https://twitter.com/meadow).

Cannabis for Crohn's Disease

Read one patient's report about using cannabis as medicine for Crohn's Disease

Posts tagged “Cannabis Wellness”

No Tax on Medicine: Tax Relief for California Medical Cannabis Patients

A Cannabis Patient's Guide to Crohn's Disease

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