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The Case for Legalizing Medical Cannabis in North Carolina: A State-by-State Comparison

Updated: Sep 27

Exploring, comparing, and contrasting cannabis policies and cannabis centered legislative history in California, Idaho, and North Carolina.


Written by Dustin Diaz - Political Journalist  and Edited by Jessica Diaz - Marketing Journalist

Tuesday, September 24, 2024

Turn tobacco fields into cannabis fields in North Carolina, United States of America.   Photo produced by Ai.

Turn tobacco fields into cannabis fields in North Carolina, United States of America.

Photo produced by Ai.

 

Data from the National Survey on Drug Use and Health estimates 61.9 million individuals 12 years or older used marijuana in the last year and 42.3 million reported using it in the last month (Congressional Research Service, 2024). The federal government considers these users to be criminals, while some states follow suit and many others have legalized it for medical or recreational use. A Gallup poll found last year that 70 percent of Americans favor legislation, the highest figure ever recorded (Zeke et al, 2024). Despite the drug still being a controlled, illegal substance by the federal government, more than 80 percent of states today permit medical cannabis, and the North Carolina General Assembly should be the next to legalize it for compassionate care.


Economic Impacts

Legalization has proven an economic boon in states like Colorado and California. According to the Colorado General Assembly, the state “collected $282.3 million from the marijuana industry in FY 2022-23 from … a 15 percent excise tax, a 15 percent special sales tax, and the state’s 2.9 percent general sales tax. … Sixteen state agencies, multiple local governments, and the state General Fund received marijuana tax revenue in FY 2022-23. K-12 schools received $108.3 million for school construction and school funding” (2023). The rest included $10 million for substance abuse prevention and other socially beneficial programs (Colorado General Assembly, 2023).


Healthcare Impacts

Marijuana has been shown to be effective in treating insomnia, indigestion, chronic pain, and post-traumatic stress disorder (PTSD), as well as relieving suffering for cancer and other patients. Scholars for JCO Oncology Practice wrote in 2022 that “Several studies support the efficacy of cannabis for various cancer and treatment-related symptoms, such as chemotherapy-induced nausea and cancer pain.” Additionally, for veterans and other PTSD sufferers, Rehman et al. write for AIMS Neuroscience that “Data from observational studies demonstrated significant reduction in overall PTSD symptoms [from cannabis use] and improvement in functional outcomes such as quality of life, social function, and family function” (2021).


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Prohibition Impacts

States began to outlaw marijuana use in the early 20th century because of its negative association with minorities and deviant population (Harris et al, 2021). Forty-eight states banned it by 1936, and Congress effectively prohibited cannabis use, sale, and possession nation-wide in all other states when it passed the Cannabis Tax Act in 1937, effectively beginning the criminalization of the substance in the United States. Further federal legislation to regulate the sale, possession, use, and cultivation of marijuana included the Boggs Act of 1952, Narcotics Control Act of 1956, Controller Substance Act of 1970, and Anti-Drug Abuse Act of 1986 (Yu, 2020).


Different states have different rules and laws concerning access to medical and recreational marijuana, so patients in non-legal states are on a different playing field, medically, than their counterparts in legal states. According to a study by the International Journal of Drug Policy, data suggest “cannabis and/or cannabinoids are effective for treatment of chronic pain in adults, as antiemetics in the treatment of chemotherapy-induced nausea and vomiting, for improving patient-reported multiple sclerosis spasticity, and for symptoms from severe seizure disorders” (Schauer, et al, 2021). States like Colorado and Virginia have given full legalization to marijuana, but North Carolina’s partisan legislature doesn’t have the political will to go forward with that approach, making medical cannabis a more immediate possibility.


Biden for President 2020 - Unsplash Images
Biden for President 2020 - Unsplash Images

President Biden recently approved a change to marijuana as a controlled substance from the most restrictive Schedule I to the less restrictive Schedule III (Zeke et al, 2024). California was the first state to legalize medical marijuana in 1996 when the voters passed Proposition 215, the Medical Marijuana Initiative, allowing for the sale and medical use of marijuana for patients with AIDS, cancer, and other serious painful diseases. This referendum was a direct ballot initiative voted on by California’s citizens. Today, 41 states and the District of Columbia have followed suit and allow their citizens to treat themselves with cannabis as appropriate (University of Georgia, 2024).



North Carolina and Cannabis

Patients in North Carolina cannot have treatment that is considered a right in other states. North Carolina, a state with a strong agricultural tradition, could enhance both public services and private commerce with the money legal cannabis would bring. Democratic North Carolina delegates previously proposed the legalization of prescription, possession, and use of medical cannabis (North Carolina General Assembly, 2023) and I believe that bill can pass today. Legislation is the best way establish this right for citizens of North Carolina.


 

"Democratic North Carolina delegates previously proposed the legalization of prescription, possession, and use of medical cannabis and I believe that bill can pass today."

 

Central North Carolina Farm Land - Corn Fields
Central North Carolina Farm Land - Corn Fields

According to the Centers for Disease Control and Prevention, “The cannabis plant contains more than 100 compounds, or cannabinoids. These compounds include tetrahydrocannabinol, or THC, which is impairing or mind-altering, as well as other active compounds, such as cannabidiol, or CBD. CBD is not impairing, meaning it does not cause a ‘high’” (CDC, 2021). Currently, the Food and Drug Administration has only approved Epidiolex, a purified form of CBD that can be used to treat epilepsy and other seizures; and Marinol and Cesamet to treat nausea in patients who have AIDS or are undergoing chemotherapy to help them eat (FDA, 2024). Cannabis in any form is fully illegal to use for medical or recreational purposes in North Carolina as of May 2024.


In prohibitive states, minorities are disproportionally targeted in drug enforcement and criminal convictions. The North Carolina General Assembly finds “the prohibition of cannabis has had an unfair, disparate impact on persons and communities of color. A 2020 report by the American Civil Liberties Union found black individuals are three and six-tenths times as likely as white individuals to be arrested for cannabis possession, despite nearly identical use rates” (2023, p.1). Writers for the Judges’ Journal elaborate on this: of more than 1.6 million drug arrests in 2018, 43 percent were marijuana-related, with 92 percent of these arrests for possession. They say Black people are 3.64 more likely to be arrested for possession, a disparity that increased in 31 states between 2010 and 2018. Having an arrest or conviction on one’s record can have serious consequences, including police knowing if a citizen had been arrested before, even if not convicted. Students can lose scholarships, parents can lose custody, or employees may fire someone for a drug arrest. Having an arrest or conviction can reasonably be expected to hurt a person of color more than a white person, too (Harris et al, 2021).


 

"... black individuals are 3.6x as likely as white individuals to be arrested for cannabis possession, despite nearly identical use rates"

 

North Carolina has not kept pace with its cross-country neighbors in adopting laws to promote the growth of a vibrant medicinal and/or personal-use marijuana industry. 2023 saw bills introduced in the House and Senate that touched on the legalization and regulation of hemp, medicinal and adult personal usage, but the legislature adjourned without passing any, leaving open the question of cannabis for most citizens in the Tar Heel State (Viebrock & Steineker, 2023). North Carolina’s cannabis bill states “cannabis prohibition before it, has been a wasteful and destructive failure. About half of Americans admit to having used cannabis despite more than eight decades of prohibition. … Legalization allows regulation and control to protect consumers, workers, communities, and the environment” (General Assembly of North Carolina, 2023).


Cannabis is legal in Cherokee, NC

Cherokee Smoking Peace Pipe - Image created with WIX Ai
Cherokee Smoking Peace Pipe - Image created with WIX Ai

Located in Cherokee, North Carolina, the Eastern Band of Cherokee Indians were once part of a much larger Cherokee Nation population, with the rest of the tribe located in Oklahoma today. Cherokee is a sovereign nation, meaning it has its own laws, elections, government, institutions, and the like. The Eastern Band is self-governed and autonomous, recognized by and maintaining relationships with the United States federal and North Carolina state governments. According to the Eastern Band of Cherokee Indians’ website, their chief executive is Michell Hicks, who “was recently reelected as Principal Chief of the Eastern Band of Cherokee Indians by an overwhelming majority. During his time in office, Michell led the 15,000-member tribe through a period of remarkable economic development and cultural advancement” (2024). The tribe also has a vice chief, a tribal council, and an independent judicial branch.


 

"North Carolina residents can apply for patient cards, although tribal officials said cards are being issued at first only to tribal members with qualifying medical conditions"

 

Dreamcatcher - Unsplash Images
Dreamcatcher - Unsplash Images

The Eastern Band of Cherokee Indians, a sovereign nation within North Carolina’s state boundaries, legalized medical cannabis on September 7 last year and began selling it at its dispensary, the Great Smoky Cannabis Company, this year. North Carolina residents can apply for patient cards, although tribal officials said cards are being issued at first only to tribal members with qualifying medical conditions (Marusak, 2024). This is the only place in North Carolina where patients can legally purchase medical cannabis today. The Cherokee are also considering legalizing recreational cannabis (Hofmann, 2024).


House Bill 626, which was sponsored by multiple North Carolina lawmakers last year (General Assembly, 2023), should be able to pass the legislature this year if the voters and the legislature have the will to push it through. California and other states have shown how it can work, and the Cherokee have done the same on the local level. No grants or local government authority will be necessary to implement the policy. Any market established by the state would pay for itself and farmers in North Carolina would have a new revenue source. It is obvious that 2024 is the year North Carolina should pull the trigger and join dozens of other states in legalizing medical cannabis.



Political Culture Comparisons

According to American Political Cultures, North Carolina has a traditionalistic political culture while Idaho and California are both moralistic in culture. Elazar states the moralistic culture conceives of the political order as a “commonwealth- a state in which the citizens cooperate in an effort to create and maintain the best government in order to implement certain shared moral principles” (Ellis, 1993, p. 175). Shally-Jensen et al. write in the American Political Culture Encyclopedia that the moralistic culture considers collective action through politics the highest calling and that the greater good is the objective of government (2015). Terms used to express Elazar’s conception of moralism include “communitarian” and “communalism.” In comparison to traditionalist culture, in which most citizens defer to the commonwealth, “the communitarian adheres to a participatory vision of the collective” (Ellis, 1993, p. 176). A moralistic culture would seem to me to trend toward legalizing cannabis, but that cannot be the explanation since Idaho and California are on the opposite ends of the medical cannabis issue. 


 

"A moralistic culture would seem to me to trend toward legalizing cannabis, but that cannot be the explanation since Idaho and California are on the opposite ends of the medical cannabis issue."

 

However, Shally-Jensen et al. also write moralistic states are more likely to engage in direct democracy, and both states have done that, with failure in Idaho and success in California (2015). Shally-Jensen et al. add that traditionalistic cultures like North Carolina’s generally have governments that benefit elites and preserve the status quo. That explains the lack of direct ballot initiatives in the state and why the status quo on medical cannabis has been resistant to change in the state. That doesn’t mean the status quo cannot change, as other states like California have shown.



North Carolina

Welcome to North Carolina Canva Image
Welcome to North Carolina Canva Image

North Carolina’s population (10,439,388 in 2020) is mostly rural with some large cities. According to Britannica, “North Carolina has long been dominated by the Democratic Party. Most state and local officeholders are Democrats, but candidates from the rival Republican Party have made major gains. Since 1970, the number of Republicans in the General Assembly has increased, and the state has usually voted Republican in presidential elections, including in 2020. North Carolina has also elected Republicans to the U.S. Senate and House of Representatives and, on occasion, to the governorship” (2024).


North Carolina’s political competition is high. While Britannica states North Carolina has been dominated by the Democratic Party, including current Gov. Roy Cooper, the state has a Republican-dominated legislature and is a swing state in presidential contests (Britannica, 2024). A bipartisan group of legislators put forth a bill to create a medical marijuana program in North Carolina, but it did not advance through the full legislature because North Carolina House Speaker Tim Moore stopped it on procedural grounds. Democratic lawmakers in North Carolina will try to pass it again this legislative year.


 

"A bipartisan group of legislators put forth a bill to create a medical marijuana program in North Carolina, but it did not advance through the full legislature because North Carolina House Speaker Tim Moore stopped it on procedural grounds."

 

Unlike California, which legalized medical marijuana through a ballot initiative, and Idaho, which rejected it through one, North Carolina is part of a minority of 24 states who do not provide any mechanism for citizen initiatives or referendums, so its citizens have not been able to bypass the legislature and implement any program here. This can partially be explained by its traditionalistic political culture, in which politics are considered the domain of the elite. Only nine states still prohibit medical cannabis (University of Georgia, 2024).


Medical Cannabis Prohibition Map USA - Graphic Created by Jessica Diaz, Diaz Media Marketing
Medical Cannabis Prohibition Map USA - Graphic Created by Jessica Diaz, Diaz Media Marketing

North Carolina’s chief executive is Gov. Roy Cooper, a term-limited governor serving his second and final term as governor, last elected in 2020, even though Donald Trump won the state in the presidential election. Cooper is a 66-year-old white Democrat. Only citizens of the United States that are residents of North Carolina and over the age of 30 are eligible to serve as Governor of North Carolina. Cooper is the Commander-in-Chief of the North Carolina National Guard, the state budget director, and the sole official managing communication between North Carolina, the federal government, and other states. Ten members of the executive branch are popularly elected. This includes the Governor, the Lieutenant Governor, the Secretary of State, the State Treasurer, and the State Auditor. The departments of the executive branch that have elected department heads are Agriculture, Insurance, Justice, Labor, and Public Instruction. The remaining department heads are appointed by the governor. Cooper can veto legislation, including the line-item veto, and when he does, a supermajority of three-fifths of the legislature is needed to override the veto. He issued his first veto of the 2024 legislative session on May 23. Cooper cannot select judges, as they win their seats through partisan elections in North Carolina (National Governors Association, 2024).


North Carolina has a bicameral hybrid legislature called the State General Assembly. The State House of Representatives is made up of 50 members and the State Senate is made up of 120 members, with all legislators being elected every two years. The state’s lieutenant government is elected by the voters and presides over the Senate, voting only to break ties. Prior to their election, NC House candidates must live in the district they represent for over one year and NC Senate candidates have similar residency requirements and must be at least 25 years old. As of 2020, of 120 total legislators, 43 are women (25.3%), 34 are African-American (20%) and two are Hispanic (1.2%) (Britannica, 2024) Both houses of the legislature are currently held by Republicans. They do not share the governor’s political agenda and in any case have not sent a bill authorizing medical cannabis to Cooper for his signature. This party division, as well as a lack of voter initiatives in North Carolina, is likely why cannabis legislation has stalled in the state.


 

"Both houses of the legislature are currently held by Republicans. They do not share the governor’s political agenda and in any case have not sent a bill authorizing medical cannabis to Cooper for his signature."

 

Atlantic Beach, North Carolina - Photo by Jessica Diaz
Atlantic Beach, North Carolina - Photo by Jessica Diaz

North Carolina’s local government is divided into its 100 counties, each with their own elected board of commissioners and seat of government. Counties and municipalities are the primary forms of local government in North Carolina. From there, local government flows to the city and town level. The North Carolina Constitution grants the General Assembly (legislature) the authority to create, abolish, and govern cities, counties, and other local governments as the Assembly sees fit (NC.gov, 2024). As an example of county executive authority in North Carolina, Carteret County’s Board of Commissioners consists of seven members elected for staggered, four-year terms. Each commissioner is elected countywide but must reside within the boundaries of one of six districts (two commissioners share one of the districts). The mission of the Carteret County Board of Commissioners is to enhance the future, health, safety, and quality of life in Carteret County by ensuring delivery of needed services to all citizens with courtesy and compassion. (Carteret County North Carolina, n.d.) The town of Beaufort has its own elected chief executive, Mayor Sharon Harker, elected in 2021 and re-elected in 2023 (Town of Beaufort, 2024). That’s where I live!


The North Carolina Constitution’s Article IV establishes the General Court of Justice, which "shall constitute a unified judicial system for purposes of jurisdiction, operation, and administration, and shall consist of an Appellate Division, a Superior Court Division, and a District Court Division." The Judicial Department Act of 1965 standardized procedures for the state’s judicial branch that went into effect in 1971, establishing the General Court of Justice as the highest judicial authority in the state. All judges are chosen through partisan election, serve eight-year terms and may serve until 76 years old in North Carolina (NC Legislature, 1965).


North Carolina’s superior and district court divisions empanel juries and hold trials to determine matters of fact. District courts handle civil cases between $10,000 - $25,000 and lower-level crimes, while superior courts hear cases involving appeals from district courts, felony crimes, and civil cases involving more than $25,000 or more. The state’s three-level system begins with superior and district courts, with 111 superior court judges and 282 district court judges. There are also civil magistrates for administrative functions (North Carolina Judicial Branch, 2023).


The Supreme Court and Court of Appeals make up the appellate division. The Court of Appeals is an intermediate appellate court that was created to help Supreme Court with its caseload. Most cases appealed from the Superior and District courts in civil and criminal cases are heard by a panel of three of the Court of Appeals’ 15 judges. A decision that is not unanimous can be appealed to the Supreme Court and capital murder cases are automatically appealed to the Supreme Court. Like the Supreme Court, the Court of Appeals decides only questions of law. The Court of Appeals’ role is to determine if the trial court correctly applied the law and whether there was prejudicial error in the conduct of the trial (North Carolina Judicial Branch, 2023). The North Carolina Supreme Court is the state’s highest court and decides cases appealed from lower courts. The Supreme Court considers questions of law only, “determining claims of errors in legal procedures or in judicial interpretation of the law during appeals from trials in lower courts,” and has six associate justices and a chief justice instead of a jury (NC Legislature, 1965).


North Carolina is more diverse than Idaho, but less than California, and that’s reflected in the high court, according to the Brennan Center for Justice. As of 2023, North Carolina’s population is 40% nonwhite, with 29% justices of color on the Supreme Court, 29% women justices and 14% women of color on the state’s highest bench.



Idaho

Welcome to Idaho - Canva Image
Welcome to Idaho - Canva Image

Idaho’s population (1,839,106 in 2020) mostly lives in the state’s urban areas, but 28% live among its abundant natural terrain, with 3,900 square miles of wilderness. More than nine-tenths of the population is of European descent (white), and over a third are Mormon thanks to the southeast’s proximity to Salt Lake City. Voting in Idaho has trended heavily Republican in presidential elections, the governorship is usually held by Republicans, and Republican congressional candidates also win office much of the time in Idaho (Britannica, 2024). Idaho’s citizens can file a citizen’s initiative or referendum with signatures from 20 qualified

electors with the Secretary of State, provided they have a plan to pay for implementing a positive result.


Idaho’s chief executive is Gov. Brad Little, in his second term and last elected in 2022. Idaho’s governors are not term limited. Little is a 70-year-old white Republican. Only citizens of the United States that are residents of Idaho and over the age of 30 are eligible to serve as Governor of Idaho. The governor appoints department heads and members of boards and commissions, issues executive orders which have the force and effect of law, drafts and recommends a budget to the Idaho Legislature, and is the state’s military commander-in-chief. On extraordinary occasions, the governor can convene special sessions of the Legislature. He must give final approval of legislation by signing bills passed by the Legislature. He has the power to veto bills but must list his objections. The Legislature can override a veto by a two-thirds vote of each chamber. (National Governors Association, 2024) He vetoed legislation concerning COVID vaccination mandates and the legislature did not override his veto. He signed another version of the bill the next year. (Dutton, 2022) Little cannot appoint judges; they win their seats in nonpartisan elections in Idaho.


Idaho has a bicameral part-time legislature. The State House of Representatives is made up of 35 members, while the State Senate is made up of 75 members, with all members being elected every two years.  The state’s lieutenant government is elected by the voters and presides over the Senate, voting only to break ties. Prior to their election, Idaho Senate and House candidates must live in the district they represent for over one year and be a U.S. citizen at least 21 years old. As of 2020, of 105 total legislators, 33 are women (31.4%), one is African-American (1%) and none are Hispanics (Britannica, 2024). It’s possible this lack of diversity, and lack of sympathy for people of color prosecuted for crimes involving marijuana, is a factor in the political situation around medical cannabis in Idaho. Both houses of the legislature are currently held by Republicans, a known factor in the political situation around marijuana in the state. A ballot initiative for medical cannabis was introduced and defeated in 2021, but the Republican legislature has not proposed or passed any and it is unlikely Little, also a Republican and conservative, would sign it if they did.


 

"A ballot initiative for medical cannabis was introduced and defeated in 2021, but the Republican legislature has not proposed or passed any and it is unlikely Little, also a Republican and conservative, would sign it if they did."

 


Yellowstone National Park - Wix Images
Yellowstone National Park - WIX Images

Idaho’s state constitution states “the judicial power of the state shall be vested in a court for the trial of impeachments, a Supreme Court, district courts, and such other courts inferior to the Supreme Court as established by the legislature. The courts shall constitute a unified and integrated judicial system for administration and supervision by the Supreme Court” (Idaho State Legislature, 2024). The executive head of the judicial system is the Chief Justice of the Court, who is elected by its members. Idaho’s unified judicial system consists of seven judicial districts, each with its own district court and a magistrate division. The magistrate division comprises 101 judges across the state who hear civil cases under $10,000 along with misdemeanor, traffic, divorce, custody, and child abuse cases. Forty-nine district court judges hear felony cases, civil cases over $10,000 and appeals from magistrate courts. Magistrate court rulings can be appealed to district court while district court rulings can be appealed to the Supreme Court. The Supreme Court assigns some cases to the Court of Appeals, Idaho’s intermediate appellate court. District and magistrate judges win four-year terms in non-partisan elections and retention elections. Appellate and Supreme Court justices run for six-year terms. The governor appoints judges to fill midterm vacancies, after which the judge must win retention in a nonpartisan election. Idaho also uses specialized treatment courts that provide treatment to Idahoans with both court cases and behavioral health issues (Idaho Supreme Court, 2024).


According to the state’s website, all nine of Idaho’s appellate judges are white; no people of color are represented on the bench. Three members of the Idaho Supreme Court are women and two are men, while two members of the Idaho Court of Appeals are men and two are women. This means the 21% nonwhite population of the state has no representation in the state’s highest courts (Bannon & Powers, 2023). Idaho’s representation and diversity is among the worst in the nation; it isn’t known if this would influence the state’s judicial branch’s decision-making if medical cannabis law made its way to the docket. What is known, according to USA Today, is that “nationally, state supreme courts have flipped from Democratic control in the 1980s, '90s and early 2000s to a Republican majority in recent years. The implications for abortion, LGBTQ+ rights and voting are in some places only beginning to be felt” (2023), and that could be unfriendly for litigation about medical cannabis as well, with conservatives and Republicans usually opposing any legal access to cannabis.


According to Encyclopedia Britannica, “Idaho has more than 1,000 units of local government, including counties, municipalities, school districts, and special- purpose districts, the last having limited taxing power. Most activities of local government are carried on by counties and cities. County commissioners, with a combination of legislative and executive functions, are very powerful. The state legislature for many years refused to pass home rule legislation, but in the late 1990s it granted charter authority to Idaho’s counties” (2024). The largest county in Idaho is Idaho County, with three elected county commissioners each representing one of three districts. Commissioners cover a large area in their role to manage and lead Idaho County while remaining aware of the unique issues and cultures that are present in this North Central Idaho region (Idaho County, 2024). Idaho also has a city named for itself, with an elected mayor named Ken Evers. The responsibility of the City of Idaho City Mayor is to serve all citizens and business owners fairly and openly (City of Idaho City, 2024). No local government in Idaho or North Carolina has authorized the use of medical cannabis.


 

"No local government in Idaho or North Carolina has authorized the use of medical cannabis."

 

California

Welcome to California Canva Image
Welcome to California Canva Image

California’s population (39,538,223 in 2020) is the most urban in the United States, concentrated mostly along the roughly 1,100-mile coastline with more than three-fourths of the state’s people living in the Los Angeles, San Francisco, and San Diego metropolitan areas in Southern California. As of February 2020, “All statewide elected officials are Democrats, including both United States senators and the governor. No Republican has been elected statewide since 2006. Democrats also hold supermajorities in both chambers of the legislature and represent all but 7 of the state’s 53 congressional districts” (Britannica, 2024). Many of the state’s Republican voters are spread in other areas of the state and concentrated on the coast. Political competition is low; California is known to be a moralistic and solidly Democratic state. Its citizens believe government should do the most amount of good for the most people (McGhee, 2020).


California long has been considered a liberal state in the extent of its health and welfare

statutes, with state benefits funding the University of California public education system and offering aid to families with dependent children, to those with disabilities, and to senior citizens. Moralistic states like California Party share this emphasis on education with traditionalistic states, even though they may diverge on issues like medical cannabis. The PPIC poll indicates most unregistered voters in California consider themselves Democratic (2020). Californians can file initiatives like Proposition 215 by filing petitions must be signed by registered voters in an amount equal to at least 5% of the votes cast for all candidates for Governor at the last gubernatorial election.


Medical Research- Unsplash Images
Medical Research- Unsplash Images

California’s medical research facilities lead the country in several branches of medicine, notably oncology, immunology, and gerontology. California’s culture is marked by widespread public involvement with and spending on the arts and cultural trappings, erecting galleries, museums, and concert halls (Britannica, 2024). California’s voters largely support immigrants, with 72 percent of respondents to a Public Policy Institute of California poll believing immigrants are a benefit to the state and only 26 percent supporting a new wall on the Mexican border (McGhee, 2020). The state’s moralistic political culture and the Democratic lean of California’s voters helped it become the first state to legalize medical marijuana.


 

"The state’s moralistic political culture and the Democratic lean of California’s voters helped it become the first state to legalize medical marijuana."

 

California’s chief executive is Gov. Gavin Newsom, a term-limited governor serving his second and final term as governor, last elected in 2022. Newsom is a 56-year-old white Democrat and a prominent national party figure. Only citizens of the United States that are residents of California and over the age of 18 are eligible to serve as Governor of California. Newsom is the Commander-in-Chief of the militia of the state and is the sole official of communication between the California, the federal government, and other states. Members of more than 30 boards and commissions are appointed by the governor (National Governors Association, 2024). An amendment to the state constitution in 1911 made the governor subject to popular recall vote, which was used to oust Gray Davis in 2003. Newsom can veto legislation, as well as possessing the line-item veto, and if he does so, a supermajority of two-thirds of the legislature is needed to override the veto. In 2021, Newsom 770 bills into law and vetoed 66, a rate of 7.89%. The legislature had the votes to override him for 10 of those bills, with one bill even passing both houses unanimously, but did not do so. No legislature has vetoed California’s governor in over 40 years (Myers, 2021). The governor appoints many judges, while others are elected and all stand for re-election.


California’s highest level of local government consists of its 58 counties. The state constitution says the County is the "largest political subdivision of the state having corporate powers" (Georgetown Law Library, 2024), and the two types of counties are called charter counties and general law counties. The constitution gives the state’s 13 charter counties the autonomy to create and enforce local ordinances, provided the ordinances do not conflict with the general laws of the state. One way in which California differs from North Carolina is the additional ways it administers government authority at the local level. Another form of local government authority is exercised by the 478 incorporated cities in the state of California. These cities have a higher level of autonomy than counties because they are voluntarily formed and perform many essential service functions. The fourth form of local government is the California Special District. There are approximately 4,763 Special Districts, state agencies created for the local performance of a specific governmental or proprietary function, unlike cities and counties that perform functions for citizens. Special districts provide services and facilities within a defined boundary and are governed by a board (Georgetown Law Library, 2024).


Los Angeles - Wix Images
Los Angeles - WIX Images

The role of county government, as a political subdivision of the state of California, is to deliver the services mandated by the state and federal governments. Each county is governed by a five-member Board of Supervisors that sets policy, enacts ordinances and regulations, and oversees activities of county departments (SanDiegoCounty.gov, 2024). San Diego is both an example of one of California’s cities and one of its counties (Georgetown Law Library, 2024). San Diego County has an elected board of supervisors, while the city’s chief executive is Mayor Todd Gloria, elected in 2020 and running for a second term this year (City of San Diego, 2024).


California has a bicameral full-time legislature. The State Assembly is made up of 80 members elected to two-year terms, while the State Senate is made up of 40 members elected to four-year terms with half of senators re-elected every two years (Britannica, 2024). Democrats currently hold a majority in both houses, giving Newsom more power than a governor with a divided legislature. Prior to their election, legislative candidates must be over the age of 19, United States citizens, have been residents of California for at least three years, and have lived in the district they represent for at least one year. Legislative dominance is held by populous southern California at the expense of rural areas. As of 2020, of 120 total legislators, 37 are women (30.8%), 11 are African-American (9.2%) and 23 are Hispanic (19.2%) (Britannica, 2024) Cannabis laws and regulations are particularly liberal, with access to medical marijuana first granted via popular initiative, and later expanded by the legislature and defended by governors and the courts.


According to the California Courts website, California’s court system serves about 12 percent of Americans and is the largest state court system in the United States. California’s three-level state court system comprises 58 superior courts, six Courts of Appeal, and the Supreme Court. California’s court system checks the legislative and executive branches by making sure those branches do not step outside the powers given to them in the state constitution. The courts are responsible for ensuring the just and equitable application of law. Voters elect superior court judges to six-year terms in non-partisan elections during even-numbered years. The governor appoints replacements for any vacancies that occur due to death, retirement, or other reasons. The governor also appoints appellate justices and the Commission on Judicial Appointments confirms them. Appellate justices serve 12-year terms, commencing in early January following their election. The 12-year term attaches to the seat, meaning that a vacancy does not change the election cycle for that seat (California Courts, 2024).


Most California court cases begin in one of the 58 superior, or trial, courts – one for each county in the state. Superior courts hear criminal and civil cases, along with traffic, juvenile, and mental health cases. The next level in California’s three-step court system is the Court of Appeal. According to the California Courts website, “Most cases before the Courts of Appeal involve the review of a superior court decision being contested by a party to the case. The state Supreme Court serves as the highest court in the state and has discretion to review decisions of the Courts of Appeal to settle important questions of law and to resolve conflicts among the Courts of Appeal. The court also must review the appeal in any case in which a trial court has imposed a judgment of death” (California Courts, 2024).


The California Supreme Court is composed of a Chief Justice and six Associate Justices. The governor appoints judges to fill vacancies on the Supreme Court, then the jurist appears on the ballot at the end of the 12-year term to win retention. When California Supreme Court or Court of Appeal justices choose not to seek reelection near the end of their 12-year terms, the Governor nominates individuals to appear on the ballot to replace them pending voter approval. The California Supreme Court is the final interpreter of the state’s laws, and its decisions may only be reversed by the United States Supreme Court if California law conflicts with the United States Constitution (California Courts, 2024). California’s population is majority (65%) nonwhite and so is the California Supreme Court, with 71% justices of color, 57% are women and 43% are women of color (Bannon & Powers, 2023). This high court, like Idaho’s and North Carolina’s, has not made any decisions about medical cannabis.



White House Photographer Bag with Canon DSLR - Photo by Jessica Diaz, Diaz Media Marketing
White House Photographer Bag with Canon DSLR - Photo by Jessica Diaz, Diaz Media Marketing

Federal Policy Advancements

The U.S. Supreme Court was forced to weigh in on medical cannabis in 2004 when a group of medical marijuana users filed a lawsuit in federal court following a Drug Enforcement Agency (DEA) raid on a patient’s home to seize their marijuana, which had been prescribed by a doctor. They argued in court that Congress did not have the authority to regulate the medical cannabis market, as it claimed to have through its constitutional power to regulate interstate commerce and the Controlled Substances Act (CSA). The case, called Gonzalez vs. Reich, saw the group go against the DEA and Attorney General, losing in district court, but succeeding on appeal. The Ninth Circuit Court of Appeals agreed with the group and found the CSA’s power exceeded that granted by the Constitution, ruling that “using medical marijuana did not substantially affect interstate commerce and therefore could not be regulated by Congress” (Oyez, 2024).


The Supreme Court reversed the Ninth Circuit Court of Appeals’ opinion in a 6-3 decision, effectively granting Congress authority to prohibit marijuana, even in states that allow medical cannabis by law. Justice John Paul Stevens said Court precedent "firmly established Congress' commerce clause power to regulate purely local activities that are part of a class of activities with a substantial effect on interstate commerce.” The majority argued that Congress could ban local marijuana use because “regulating intrastate use was essential to regulating the drug's national market” (Oyez, 2024). Some federalists believe the opinion makes a weak constitutional argument and instead consider the decision an unconstitutional power grab of authority over an issue that the states have already decided for themselves.


According to the Marijuana Policy Project, “The federal government has never alleged in court that federal laws preempt state medical marijuana or legalization and regulation laws” (2024). Supreme Court Justice Clarence Thomas used language friendly to the cause in 2021, opining a federal marijuana ban “may not be necessary” (Pierson, 2021), but no Supreme Court, federal court or even state court decisions since then have made things better for patients. Polls show more than 70 percent of Americans believe interfering with state-legal marijuana business is the wrong way to use federal government resources (Marijuana Policy Project, 2024).


 

"If California can make grants work, why couldn’t the federal government or North Carolina?"

 

Texas Senator Ted Cruz and Political Journalist Dustin Diaz
US Senator from Texas Ted Cruz and Political Journalist Dustin Diaz

According to the U.S. House of Representatives, a federal mandate “means any provision in statute or regulation or any Federal court ruling that imposes an enforceable duty upon State, local, or tribal governments including a condition of Federal assistance or a duty arising from participation in a voluntary Federal program” (1995). No current federal law, regulation or court decision acts as a federal mandate concerning cannabis, and federal lawmakers have backed off as a matter of policy in one regard. According to the Congressional Research Service, “In each fiscal year since FY-2015, Congress has included provisions in appropriations acts that prohibit DOJ from using appropriated funds to prevent certain states, territories, and DC from implementing their own laws that authorize the use, distribution, possession, or cultivation of medical marijuana. The appropriations rider bars DOJ from taking legal action against the states directly to prevent them from promulgating or enforcing medical marijuana laws, though it poses no bar to federal prosecution of activities involving recreational marijuana. Federal courts have also interpreted the rider to prohibit certain federal prosecutions of private individuals or organizations that produce, distribute, or possess marijuana in accordance with state medical marijuana laws” (2024).


There are no federal grant programs available for medical cannabis use or research; however, California’s Department of Cannabis Control (DCC) does have grant programs. DCC provides at least $10 million in annual grants to California public universities to study the effects of adult-use cannabis legalization. The Department also provides funding to establish local retail licensing programs and to support people who were negatively affected by cannabis legislation in the past in operating their cannabis businesses today (State of California, 2024). These programs demonstrate how grants could work at the federal level or in other states. If California can make grants work, why couldn’t the federal government or North Carolina?


 
Jessica Diaz - Diaz Media Marketing - Marketing Journalist

Dustin Q Diaz - Political Journalist

Dustin hails from Massapequa, New York, and recently relocated to the area after meeting Jessica at a half marathon in Virginia Beach. A disabled Combat Camera Veteran with the U.S. Navy, Dustin brings decades of experience in camera operation, news production, and editing to his work. As a recognized military journalist and editor, he has a knack for storytelling and a way with words. With his deep, smooth baritone voice, Dustin’s narration enhances any video project. His brilliant interview skills create a comfortable atmosphere, allowing authentic voices to shine on camera. Dustin is currently studying Political Science with a minor in Economics at SNHU.

 

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