Running head: MEDICAL MARIJUANA- AN EXPEDITION FROM PROBLEM TO POLICY 1

Medical Marijuana- An Expedition from Problem to Policy

Luminus Afrin
Southeast Missouri State University












MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 2

Abstract
In 1972, the US Congress cited marijuana in Schedule I of the Controlled Substances Act
because they considered marijuana use product. Since then, 21 of 50 US states and DC have
legalized the medical use of marijuana. And in 1996b California became the fist ever state to
legalize marijuana for medical use.
Supporter of medical marijuana argue that it is medically effaceable for cancer, AIDS,
multiple sclerosis, pain, glaucoma, epilepsy, and other conditions. They cite dozens of peer-
reviewed studies, prominent medical organizations, major government reports, and the use of
marijuana as medicine for the sick people all over the world.
Opponent of medical marijuana argue that it is too dangerous to use, lacks FDA-
approval, and that various legal drugs make marijuana use unnecessary. They say marijuana is
addictive, leads to harder drug use, interferes with fertility, impairs driving ability, and injures
the lungs, immune system, and brain. According to the opponent party it could lead to
recreational use and become addiction.

Key words: public problem, public policy, marijuana, medical marijuana, stakeholder,
policy stream, policy analysis method.



MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 3

Introduction
Medical marijuana is one of the tenacious issues now a day. The question is still
escalating about whether to legalize marijuana for medical purpose or not. Though is a kind of
drug but for many critically conditioned patients, marijuana is the only medicine that relieves
their pain and suffering without any side effects.
Over the years marijuana is become the most wanted medical product in the world. Here
in this particular paper for the course public policy analysis I will discuss how the problem made
its journey towards a policy but for the discussion we need to know the public problem about
medical marijuana, how does it become value conflict among parties, stakeholders map analysis,
king dons policy stream, and at last but not the least we will use the policy cycle model.
I think the triggering issue about medical marijuana is whether or not it should be
legalized. Other than that many stakeholder raised question about whether this is good for future
of the young people.
The initial part of this paper will identify the main public problem and the value conflict
concerning medical marijuana. Then the discussion turn towards stakeholder map analysis. The
third part will portray king dons policy stream from three point of views. The fourth portion will
discuss how it becomes a policy through policy cycle model. The final part will include
conclusion with recommendations. And major work will be cited with helpful appendix.


MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 4

Discussion
Prior to major discussion of the paper we should have apparent idea about what
marijuana is and why it is considered medical marijuana, as marijuana is the basis of paper.
Basically Marijuana is a type of plant. According to www.drugs.com Marijuana is a green,
brown or gray mixture of dried, shredded leaves, stems, seeds and flowers of the hemp
plant Cannabis sativa. Marijuana is used as a psychoactive (i.e. mind altering) recreational drug,
for certain medical ailments and for religious and spiritual purposes. Sinsemilla, hash/hashish
(resinous form) and hash oil (sticky black liquid) are stronger forms of marijuana.
Marijuana is considered as medical use because it provides therapeutic benefit to the
patients of several diseases. Its also can be used as medicinal ways because it treat
chemotherapy patients who have nausea, vomiting and loss of appetite. Sometime its also helps
patients who are struggling with cancer and even AIDS. According to www.drugs.com mainly
there are eight types of medical use of marijuana. They are: Cancer, Glaucoma, HIV/AIDS ,
Muscle spasms, Seizures ,Severe pain, Severe nausea , Cachexia or dramatic weight loss and
muscle atrophy (wasting syndrome).
MEDI CAL MARI J UANA - Public problem and value conflict
A proverb goes around the world that a problem turns out to be a policy. Each and every
policy is made from a popular public problem. Now we need to know what a public problem is.
Every policy analyst deals with this question. To have concrete thought what is or is not a
problem is an extremely vital job for a policy analyst. For this paper the public problem is to
whether marijuana should be legalized for medical use or not. There are several communities in a
society who are for and against the medical marijuana policy. As we can assume they conflict
MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 5

views portray issues in a dualistic manner. This kind of situation creates value conflict. One
group of the citizens does not want marijuana to be medically legal because they think their
children will be affected and ultimately it will affect the social vale and norms. The other group
of citizen thinks to get rid of any sickness is most important. People should have proper medicine
to survive the disease. For that they dont care about what other group think. They just shore up
to legalize the marijuana medically.
Over the time conflicting values create policy problem. According to Anderson (85), a
policy problem is defined as a condition or situation that produces or dissatisfaction among
people and for which relief or redress by governmental action is sought. And in most of the
cases this kind of policy problem triggers to implement the policy for the related problem. And
for this paper there policy problem was the dissatisfaction of the citizens who never want the
marijuana to be medically legalized. And this is a good way to discover about the expedition of
problem to policy about medical marijuana.







MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 6

MEDI CAL MARI J UANA - Stakeholder analysis
Throughout the process from problem to policy several stakeholders becomes a part of
that process. When it comes to a question of policy to legalize marijuana there is lot of stake.
During that policy making process of legalizing medical marijuana many individual or groups
may gain or lose something. The stakeholders of legalizing medical marijuana are: citizens,
medical community, law enforcement, interest groups, and government. To better understand the
stakeholders situation and position we need to conduct the stakeholder analysis. According to
Mcbeth and Clemons (27), stakeholder analysis or mapping is in one sense recognition that the
policy process is political. It is recognition that there are actors whose cooperation, or at least
willingness no to obstruct is necessary for policy success. It is recognition that differences in
values, roles, perceptions and interest are probable.
Following is table for the stakeholder analysis which will help us to understand why
individual, organization or several group take interest in issues or programs to expedite the
problems to a popular public policy.





MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 7

Table 1 stakeholder map
Stakeholders Stakeholders attitude Stakeholders power
Internal and/or
external
Cooperation(+)
/opposition (-)
Value
and
objective
Importance
H/M/L
Adoption
power
yes(y) no
(n)
Implementation
power yes(y)
no (n)
Who they
influence
Who
influence
them
Medical
Community
+ Social
value
H Y Y Community,
government
,citizens
Interest
group,
government
Interest group
-(Americans for
Safe Access
(ASA)
- California
Conference of
Local Health
Officers
(CCLHO)
- California
Narcotic
Officers'
Association
(CNOA)
- Social
and
economic
value
H Y N Citizens and
government
Government,
citizen
Citizens +/- Social
and
Economic
value
H Y N Every
stakeholder
Interest
group, the
media
Government - Social
and
economic
vale
H Y Y Every one citizens
Law
Enforcement
- Social
value
H Y Y medical
community,
government
Interest
group,
citizens

Though the stakeholder analysis take quite a bit of time and effort, its useful to have a
clear idea about the projected policy from the problem of whether marijuana should be legal or
not.
MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 8

MEDI CAL MARI J UANA- Kingdons policy stream model
Kingdons policy stream model is a great way to understand about how popular problems
like medical marijuana become a strong policy in some of the states. I will use these three
streams to analyze the journey of the problem to policy of medical marijuana.
Kingdon proposed three diverse streams of policy proposal. They are: the Problem
Stream, the Policy Stream, and the Politics Stream. When at any point at least two of the streams
cross, a policy window are opened for action.

The problem stream

Among the three streams The Problem Stream describes how different problems will take
place on the agenda of a decision-maker. This is done in a few different ways. Basically the
problems arise from a triggering event. And policy maker also get attention about a problem
from feedback from differs sources. When the public has something on its mind or an issue it
wants addressed, it will make decision-makers aware of their concerns through its feedback
(Kingdon 2003).
In this medical marijuana case the focusing event for the policy maker medical marijuana
is the California proposition 215. The stakeholders want this issue to be addressed. The
Californias Proposition 215 was the first statewide medical marijuana voter initiative adopted in
the USA. 56% voter support to male policy to legalize marijuana as medicine for only critical
conditioned patients. And I think this a great triggering event for medical marijuana.



MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 9

The Policy Stream

The second stream is the policy stream. In this stream policies are made and interest
groups and other organizations and groups get along with government. Kingdon talked about
primeval soup, where policies basically originate. According to kingdom in this stream policy
maker check the technical feasibility, related cost, dominant social paradigm and the amount and
strength of political opposition they set in motion. Their main target was to make the proposition
215 clear of ambiguity, which could help the whole nation to implement the medical marijuana
policy.

Before originating the medical marijuana policy the decision maker need to take into
account the amount of possession of marijuana by any individual at a time. Some of the law
enforcement tried to be more liberal in case medical marijuana possession. But some other
stakeholders like the medical community and the interest groups they are opposed to the amount
of possession, they argued that the amount is too much indulgent. Some of the legislators
proposed to have ID card system for the patients. Id card is for to let the law enforcement know
who the original patients are. And all of these programs should work effectively and efficiently
because according to kingdom, it would be embarrassing to have some stupid fatal flaw
(kingdom 2003, 131)




MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 10


The Politics Stream

The third and final stream is the politics stream. In this stream the problem gets noticed
and placed on agenda of the policy makers. To be more specific this is the stream where problem
becomes the policy by the decision makers. Here the problem is the triggering event discussed in
the problem stream. In this stream the political groups support policy proposition for the ultimate
gain.
Politics stream is the best way to know about the view point of the public about the issue
in hand. Because for any policy to be made and implemented public opinion is a very easy
approach to gauge. For this medical marijuana case, about 56% of the voters (public opinion)
voted to legalize marijuana under proposition 215. I think this was very strong pointer towards
the policy makers to place the issue on the policy making agenda. Though public opinion is
considered to be important sometime the perceptions are modified as consequence of election
results, perceived changes in the political ambiance, interest group activity. Kingdom considered
political factors as electoral, partisan, and pressure group factors (1995, 150-153)

And analyzing the streams I can say that the triggering event in the problem stream helps
out to get through the journey towards the implementation of policy. According to kingdon this
is considered as policy window, giving an issue to move the policy proposition forward.




MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 11

MEDI CAL MARI J UANA- Policy Cycle Model
The journey of legalizing medical marijuana can be better understood by breaking down
into the components that occurs within the political system. For this I am using the policy cycle
model formulated by Jones (1984), Dye (2008), Anderson (2006), and others. The policy cycle
model entails of four interrelated steps. The steps are as follows:



Figure 1 policy cycle model

In the first step an issue is identified as public problem. When the problem gets noticed
by the policy maker and can no longer be ignored, then the problem become the triggering event
to consider and placed in to the agenda. In case of legalizing marijuana as medical use the
triggering event was the proposition 215.
In this policy formulation stage, many available alternatives are being considered. Here
policy goals and means are analyzed. For the medical marijuana they were being searching for
Problem Identification / Gaining Agenda Status
Policy Formulation And Adoption (Including Funding)
Policy Implementation
Policy Evaluation/ Adjustment/ Termination
MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 12

any other alternatives to legalize it. When public voted 56% for the medical marijuana, the
policy makers were considering several alternatives like ID card system, amount of possession,
licensing etc.
According to Mcbeth and Clemons (79), policy implementation refers to organizational
activities directed towards the carrying out of an adopted policy by administrative bureaucracies
at the national, state, and local level. After getting the public opinion from around 56 percent of
voters to legalize medical marijuana policy makers started to implement the policy. But there
were not enough funds to meet the policy objective. The interest groups opposed to implement
the policy.
The final step is the evaluation. Policy evaluation is needed to know about the outcome of
the policy. For the medical marijuana proposition 215 we have seen many supporters and
opposition. All of their advice takes into account in this step. Some of them want the policy to be
lenient and some of them tough.
Basically the policy cycle model is a continuous process. That is why continuous
feedback is inevitable. If one policy does not play properly, the decision makers try to fix it
through program justification.







MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 13

Conclusion

The expedition from problem to policy of medical marijuana was pretty much nerve-
racking for all the stakeholders. Throughout the paper I discussed how the medical marijuana
becomes the triggering event for the policy makers and results as a popular policy in United
States.
I think the win-win policy for the entire stake holder would be to have strict marijuana
possession policy. Though the legislators suggested having ID card system and specified amount
of marijuana possession for medical use, I think this has flaws. And any program with flaws
cannot be a successful one. Because in this tech savvy world anyone can try to falsify the
information and can make fake ID.
By analyzing the problem to policy expedition my suggestion would be to introduce
electronic fingerprint and eye scanner system for the patients. The patients will have a database
for their fingerprint and eye scan. And every time they need marijuana they will have to come to
licensed store to get that. And the licensed store would be under strict monitoring system so that
that cannot sell marijuana for pleasure seeking people.







MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 14

References
Americans for Safe Access. 2011 About Us. Americans for Safe Access.
California State Legislature. 2003. SB 420 The Medical Marijuana Program Act.
Hamilton, Shawn. 2009. To legalize or to not legalize: Should marijuana be legalized? Helium.
Kingdon, John. 2003. Agendas, Alternatives, and Public Policy. 2
nd
ed. Addison-Wesley
Educational Publishers.
Newport, Frank. 2011. Record-High 50% of Americans Favor Legalizing Marijuana Use.
Gallup.
Vasconcellos, John, & Mark Leno. 2003. A Letter to All Parties Interested in Medical
Marijuana and SB 420. Safe Access Now.
Hoffman DE, Weber E. Medical Marijuana and the Law. 2010. New England Journal of
Medicine 362(16): 1453-1456.
Cohen P. Medical marijuana 2010: Its Time to Fix the Regulatory Vacuum. 2010. Journal of
Law, Medicine & Ethics 38(3): 654-666.
http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881#summary
Annas GJ. Reefer MadnessThe Federal Response to Californias Medical-Marijuana Law.
1997. Legal Issues in Medicine 337(6): 435-439.
Mark Mcbeth, Randy Clemons. Public Policy Praxis. New York: Pearson, 2009.
Karen O'Keefe, State Medical Marijuana Implementation and Federal Policy, 16 J.
Health Care L. & Pol'y 39 (2013)

MEDICAL MARIJUANA-AN EXPEDITION FROM PROBLEM TO POLICY 15

Legalization of Marijuana for Medical Treatment Amendment Act, Council of the District of
Columbia, Bill 18-622 (2010). Retrieved September 28, 2011 from
http://medicalmarijuana.procon.org/sourcefiles/DCMJLawMay2010.pdf

Delaware Medical Marijuana Act, Title 16, Del. Health and Safety Food and Drugs, Chapter 46A
(2011 May 13). Retrieved September 28, 2011 from
http://delcode.delaware.gov/title16/c049a/index.shtml










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Appendix








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