Cannabis Grow

Cultivation of marijuana and the associated use of toxicants have been recently documented in occupied fisher habitat. In addition to the four fisher mortalities attributed to anticoagulant rodenticides by Gabriel et al. , we documented nine additional pesticide toxicosis cases in the present study. The average incidence of toxicosis cases per year for the five year Gabriel et al. study spanning 2007–2011 was 5.6% . However, in the final three years of our study, we detected an increase in incidence per year to 18.7% . Exposure also increased from 79% to 85% for the same two time periods. This increase in cases and exposure could signify either an increase in the number of cultivation sites or area impacted or that cultivators are increasing the level of toxicants being dispersed within occupied fisher home ranges. In either case, this anthropogenic threat is of increasing concern. Previous reports of cholecalciferol poisonings have not been reported in a remote forest dwelling carnivore. This type of toxicant has been promoted as an alternative to anticoagulant rodenticides due to the minimized risk for secondary poisonings. Nevertheless, plant and animal based food flavorizers are often incorporated into rodenticides to enhance palatability to omnivorous rodents. Because fishers are omnivorous, they could be susceptible to primary poisoning if they are attracted to these compounds when they are impregnated with flavorizers. In addition, the massive amount of rodenticide dispersed at some cultivation sites e.g>40 kg in some sites, rolling grow table which have cultivation footprints of typically less than 0.2ha likely pose a secondary risk of poisoning to fishers. Fishers may consume numerous prey that may have recently ingested these rodenticides, with the likely exception of cholecalciferol.

As was noted previously for a subset of cases, toxicosis deaths occurred primarily in the spring. Additionally, males were more likely than females to die of poisoning relative to predation and other causes. This finding may be due to fewer predation events involving males than females or the higher prevalence of poison-related mortality in males. These trends could also be due to behavioral factors. Female fishers in California increase their crepuscular and diurnal activity in spring to saThisfy the additional energy requirements of lactation and care of weaned kits but typically within the confines of their established home-ranges. Male fishers may make extensive forays outside their normal home ranges in spring to search out females for mating opportunities. Marijuana cultivation coincides with the increased activity of fishers in early spring and frequently involves dispersal of large amounts of toxicants near occupied fisher home ranges. Furthermore, survival of female fishers in one population was found to be influenced by the number of marijuana cultivation sites in the 95% fixed kernel home range. The relationship between the number of ARs to which a fisher has been exposed and the increasing probability of death due to poisoning suggests that these pesticides may be acting additively or synergistically. However, little experimental data are available demonstrating exposure to multiple ARs increasing the risk of coagulopathy. Our data suggest that coagulopathy risk increases significantly with each additional new AR compound exposure, though it’s possible this pattern is reflecting an additive relationship between AR number and cumulative level of exposure. However, potential synergistic mechanisms need to be addressed due to the significant amount of other pesticides, herbicides, molluscicides and fungicides documented at marijuana cultivation sites. Because fishers are exposed to > 1.7 different ARs on average, our concerns on the potential unknown mechanisms of deleterious effects of multiple ARs warrants further investigation.

Human-related mortalities were relatively rare, and although a small number were associated with research activities, such mortalities represented < 1% of the captured fishers. This figure is comparable to other studies. Vehicle-related mortalities were also relatively rare with only three marked fishers suffering vehicle strikes, which represented < 2% of all mortalities. The higher number of uncollared fishers found killed in roadways suggests that roadkill may be a more local concern, associated with individual high-traffic corridors. Field biologists did not always accurately identify general causes of disease. We found only a moderate correspondence between biologist-determined and necropsy-confirmed causes of death except for the detection of disease-related mortalities, which were significantly underestimated by initial field assessments. For example, the three fisher deaths attributed to CDV and many of the toxicosis cases were preliminarily attributed to other causes in the field. The underestimation of disease has been observed in other wildlife studies because gross observations in the field are inadequate to detect subtle signs of disease. These findings fortify the need for full necropsies when studying causes of mortality, especially when knowledge of the frequencies of cause-specific mortality is required in managing or reducing the most significant limiting factors for fishers. Although predation was often correctly identified by both field biologists and the pathologists, the incorporation of molecular forensic approaches coupled with traditional pathology allowed us to more definitively identify both predation events and predator species. Predation is often implicated as the cause of mortality when field evidence such as tracks near or adjacent to the carcass, bite wounds, wound patterns or feces and/or hair near the carcass are found. However in our study, field observations misclassified 5 fishers as predation due to circumstantial predator evidence found near the carcass .

Field observations can be misleading, for example, bite wounds in soft Thissue often change shape and size due to environmental factors and visual artifacts that resemble ante-mortem hemorrhaging can occur due to autolysis, scavengers consuming Thissue and releasing non-clotted blood, or freezing and defrosting of a carcass. Finally, we present mainly the proximate causes of mortality for fishers though there were a few cases where ultimate causes could be ascertained e.g. anesthesia related death but clinically infected with CDV. However, it would be difficult, if not impossible, to determine whether some of the predation mortalities were ultimately going to result in toxicosis. Many of the predation cases exhibited ante-mortem hemorrhaging that could have been due directly to predation or alternatively, AR exposure. Anticoagulant rodenticides have previously been shown to cause lethargy and weakness in exposed animals, but teasing these two causes of death apart was not possible. This study presents the first large assessment of cause-specific mortality frequencies in California fishers. We have identified predation and natural disease as the top two mortality factors. In addition, mortality from and exposure to toxicants appears to be on the rise and we have found exposure to multiple ARs increases probability of death from these compounds. Increases of additive mortality of only 10% can prevent fisher population expansion even in the presence of suitable habitat with no dispersal barriers. Therefore, the high proportion of fisher mortality consisting of predation and disease may help explain the lack of growth and expansion of these populations to nearby suitable habitat. However, the growing number of toxicosis cases in fishers and the correlation of contributing mechanisms such as marijuana cultivation within fisher habitat suggest an emerging threat. Beyond direct poisoning, rodenticides have the potential to limit fitness through prey depletion and heightened competition between fishers and other carnivores. Future research should focus on the relationship between marijuana cultivation and associated rodenticide use and prey population cycles because carnivore population dynamics are often heavily influenced by fluctuations in prey base. Managing these threats should focus not only on the impacts on current fisher populations but also the reduction of threats that may be limiting expansion for future population growth. One recommendation is the complete removal of toxicants left at current and historicaltrespass marijuana grow sites. Most sites are not remediated, indoor plant table thus toxicants associated with these sites are a continuing threat. Furthermore, as female adult survival is notably important for population size and persistence in the southern Sierra Nevada population, forest managers should consider managing against habitat features that are conducive to interactions between fishers and their predators. Investigating these and other mechanisms for reducing mortality in California fishers within West coast DPS can be of assistance in effectively implementing policy or management options to potentially curb mortality rates in order to promote population recovery within California in addition to other fisher populations throughout the West Coast DPS.We would like to acknowledge the contributions of the following people and organizations. University of California at Davis Veterinary Medical Teaching Hospital, the graduate group of Comparative Pathology, Drs. Jonna Mazet, the field biologists at all the projects sites. Integral Ecology Research Center, California Animal Health and Food Safety Laboratory System, Hoopa Valley Tribal Forestry, United States Forest Service, National Park Service, United States Fish and Wildlife Service, California Department of Water Resources, California Department of Fish and Wildlife, California Department of Forestry and Fire Protection, and the Sierra Nevada Conservancy, and the Bureau of Indian Affairs provided logistical support.

We would like to thank two anonymous reviewers for making notable suggestions that improved the manuscript. Most of all we would like to thank the late Dr. Linda Munson forinitially taking the fisher health project under her wing. Her mentorship and contributions to wildlife conservation will be remembered and appreciated.Cannabis is one of the most frequently used psychoactive substances in the world and is the subject of major debates between proponents of the gateway hypothesis and advocates of legalization. Proponents of the gateway hypothesis have argued that epidemiological studies indicate that the early use of cannabis is an important risk factor for initiating cocaine use, that cannabis dependence predicts cocaine dependence , that cannabis use may be associated with poor cognitive and psychiatric outcomes in adulthood , and that major changes in legalization of the possession, sale, and cultivation of cannabis in the United States may exacerbate these poor outcomes by increasing the level of cannabis use in adolescents and young adults. Currently, its use exceeds that of tobacco smoking among adolescents in the United States, in which 37.1% of high school seniors in 2017 reported using cannabis within the past year. Advocates of legalization and medicinal use argue that it is unclear whether the relationship between prior cannabis use and later cocaine use or cocaine use disorder is caused by cannabis use per se or other drug-associated factors, such as concomitant psychiatric disorders and socioeconomic status. However, epidemiological studies cannot establish causal relationships between the pharmacological effects of exposure to cannabis and the development of cocaine use. Preclinical studies provide a controlled way to study causal relationships between early-life cannabinoid exposure and cocaine use, including compulsive-like use, later in life. Previous studies reported that exposure to the cannabinoid receptor agonist WIN55,212-2 during adolescence decreased the reactivity of dopaminergic neurons to WIN , produced cross-tolerance to cocaine in adolescence, and produced cross-sensitization to the psychomotor effects of cocaine in adolescence but not in adulthood. This effect appears to be mediated by the modulation of eukaryotic initiation factors in the brain. Such modifications of key neural substrates may reprogram the adolescent brain and make it more susceptible to the later use of other illicit drugs, such as cocaine. However, other groups found that prior treatment with either the main psychoactive constituent of cannabis or WIN had no effect on behavioral responses to amphetamine in either adolescence or adulthood. However, in the study by Ellgren et al. , cannabinoid exposure lasted only 5 days, the doses of cannabinoid were low, and the animals were injected only once per day. A major limitation of these preclinical studies is the use of an animal model of cocaine exposure that reflects neither the direct acquisition of cocaine use nor the compulsive nature of cocaine use disorder . To address this issue, we tested the effect of adolescent exposure to the cannabinoid receptor agonist WIN on key addiction-related behaviors using a more complex animal model of drug addiction. The model included measures of irritability-like behavior, which has recently been used as a measure of the negative emotional state in animal models of addiction. We also assessed cocaine-induced locomotion in adolescence and adulthood and the acquisition of cocaine self-administration under conditions of short access and long access in adulthood. The long-access model represents a comprehensive model of human addiction because it produces the escalation of cocaine intake that is associated with the emergence of negative emotional states and compulsive-like responding despite adverse consequence.All behavioral testing was conducted during the dark phase.

Since AIDS patients are treated with anti-retroviral therapies, researchers explored the potential impact of cannabinoids on indinavir and nelfinavir and found no significant impact of marijuana on the efficacy of these drugs . The first written account of medicinal marijuana took place in China in the 5th century BC , and with ongoing research of cannabinoid receptors and endocannabinoids, the therapeutic actions of marijuana are becoming clearer. Medicinal marijuana has been a controversial topic for many years which is characterized by the petition in the 1970s to convert marijuana from a schedule I drug to a schedule II drug and the support of rescheduling and appeal by the Drug Enforcement agency in the 1980s . In 1996, California proposition 215, the Compassionate Use Act, passed and stated “Patients and caregivers may possess or cultivate medical marijuana for medical treatment” . This vague statement that legalized marijuana enraged the government and health care providers because of the new stereotypes regarding the safety of marijuana and the lack of regulation. As a result, the federal government attempted to eliminate medicinal marijuana indirectly by prohibiting physicians to discuss medicinal marijuana with the consequence of losing prescription writing privileges . In addition, the definition of pharmaceutical grade marijuana and its production has been an area of active debate. The heterogeneous population of medicinal marijuana fails to meet a consistent standard of composition and quality . Solving this problem would require pharmaceutical companies to successfully develop a synthetic cannabinoid derivative .

In the modern patient-centered health care system, cannabis growing system health care providers must acknowledge the current research and make evidence based decisions on the benefits of medicinal marijuana as a treatment for cancer and AIDS related weight loss. Fifteen years ago, the existence of cannabinoid receptors was unknown, but research has painted a clearer picture of the hypothalamic CB1 receptors’ role in appetite stimulation. Despite the controversy of medicinal marijuana, continued research in this field has opened new avenues for treatment and prevention of the nation’s biggest health care problem, obesity. Understanding the cannabinoid receptors’ role in appetite suppression and its link in the leptin pathway may allow future physicians to treat and prevent obesity . Obesity is a significant risk factor for deadly diseases such as atherosclerosis, hypertension, and diabetes, and further research in medicinal marijuana’s role in appetite stimulation may be the key to curing an obese nation. Although the amount of information regarding medicinal marijuana is vast, there are many areas that need further research for more effective use among patients. First, double blind randomized control trials in humans are needed to truly assess the effectiveness of marijuana in appetite stimulation. Many studies on rats and mice have produced a working scientific basis for medicinal marijuana, but human trials are necessary to assess potential benefits and adverse effects in patients. Further, a risk/benefit analysis of medicinal marijuana is needed. Medicinal marijuana is often disputed as a treatment based on its side effect profile, but terminally ill cancer and AIDS patients might be willing to increase their risk for lung cancer in the long term to achieve an immediate improvement in quality of life. With a target population of immuno compromised patients, research on alternative delivery methods need to be employed to decrease the risk of infection associated with marijuana smoking.

Finally, a logistical study on the most effective and safest mechanism for distribution of marijuana in the population must be conducted. With this information, marijuana can be utilized safely to allow sick patients to engage in one of the most essential actions in life, eating. With the passage of Proposition 64 , state voters elected to integrate cannabis into civil regulation. Prior to the possibility of state licensure for cultivators, however, counties can decide on other designations and implement strict limitations. In effect, local governments have become gatekeepers to whether and how cultivation of personal, medical or recreational cannabis can occur and the repercussions of noncompliance. When cannabis is denied a consistent status as agriculture, despite being a legal agricultural commodity according to the state, localities can determine who counts as a farmer and who is considered compliant, non-compliant and even criminal. In Siskiyou County’s unincorporated areas, the Sheriff’s Office now arbitrates between the effectively criminal and agricultural. Paradoxically for this libertarian county, the furor around cannabis has seen calls for government intervention, and has led to officials passing highly stringent cannabis cultivation regulations that have been enforced largely by law enforcement, muddying the line between noncompliance and criminality. These strict regulations produced a situation where “not one person” has been able to come into compliance, according to a knowledgeable government official. Nonetheless, at the sheriff’s urging, Siskiyou declared a “state of emergency” due to “nearly universal non-compliance” , branding cannabis cultivation an “out-of-control problem.” Such a strong reaction against cannabis can be understood in terms of cannabis’s potential to reorganize Siskiyou’s agricultural and economic landscape. According to some estimates, there are now approximately twice as many cannabis cultivators as non-cannabis farmers and ranchers in Siskiyou , a significant change from just a few years ago. Although cannabis has been cultivated in this mostly white county for decades, since 2015 it has become associated with an in-migration of Hmong-American cultivators. 

Made highly visible through enforcement practices, policy forums and media discourses, Hmong-Americans have become symbolically representative of the “problem.” This high visibility, however, obscures a deeper issue, what Doremus et al. see as a nostalgic, static conception of rural culture that requires defensive action as a bulwark against change. Such locally-defined conceptions need to be understood , especially in how they are defined and defended and what effects they have on parity among farmers growing different types of crops. Our goals in this study were to consider the consequences of an enforcement-first regulatory approach — a common regulatory strategy across California — and its differential effects across local populations. Using Siskiyou County as a case study, we paid attention to the public agencies, actors and discourses that guided the formation and enforcement of restrictive cannabis cultivation regulations as well as attempts to ameliorate perceptions of racialized enforcement. This study attends to novel post legalization apparatuses, their grounding in traditional definitions of culture and the ways these dynamics reactivate prohibition. We used qualitative ethnographic methods of research, including participant observation and interviews. In situations of criminalization, which we define not only as the leveling of criminal sanctions but being discursively labeled or responded to as criminal-like , quantitative data can be unreliable and opaque, which necessitates the use of qualitative ethnographic methods . In 2018–2019, we talked to a wide range of people — including cannabis growers from a diversity of ethnic backgrounds, government officials, business people, subdivision residents, farm service providers, medical cannabis advocates, realtors, lawyers, farmers and ranchers, and, with the assistance of a Hmong-American interpreter, members of the Hmong-American community. We also analyzed public records and county ordinances, Board of Supervisors meeting minutes and audio , Sheriff’s Office press releases and documents, related media articles and videos, flood table and websites of owners’ associations in the subdivisions where cannabis law enforcement efforts have focused. Some cannabis cultivators regarded us suspiciously and were hesitant to speak openly, an unsurprising phenomenon when researching hidden, illegal and stigmatized activities, like “drug” commerce . This circumspection was most intense among Hmong-American growers on subdivisions, who had been particularly highlighted through enforcement efforts and local, regional and national media accounts linking their relatively recent presence in Siskiyou to cannabis growing. Human subjects in this research are protected under the Committee for Protection of Human Subjects, protocol number 2018-04-1136 , of the Office for Protection of Human Subjects at UC Berkeley.Siskiyou is a large rural county located in the mid-Klamath River basin in Northern California . Since the mid-19th century, in migrants have historically engaged in agriculture, predominantly livestock grazing and hay production, and natural resource extraction, primarily timber and mining . Public records demonstrate that although the value of the county’s agricultural output and natural resource extraction is declining, these cultural livelihoods still shape the area’s dominant rural values of self-reliance, hard work and property rights .

For instance, one county document stated that Siskiyou’s cultural-economic stability depends on nonintervention from “outside groups and governments” and residents should be “subject only to the rule of nature and free markets” . Another document, a “Primer for living in Siskiyou County” from the county administrator, outlined “the Code of the West” for “newcomers,” asserting that locals are “rugged individuals” who live “outside city limits,” and that the “right to be rural” protects and prioritizes working agricultural land for “economic purpose[s]” . We heard a common refrain that localities will eventually succumb to the allure of a taxable, profitable cannabis industry. Indeed, interviewees in Siskiyou universally reported economic contributions from cannabis cultivation, especially apparent in rising property values and tax rolls and booming business at horticultural, farm supply, soil, generator, food and hardware stores . However, a belief in an inevitable free market economic rationality may underestimate the deep cultural logics that have historically superseded economic gains in regional resource conflicts . As one local store owner told us, “I’d give up this new profit in a heartbeat for the benefit of our society.” Many long-time farming and ranching families remain committed to agricultural livelihoods for cultural reasons , even as the economic viability of family farms is threatened by increasing farmland financialization , corporate consolidation and biophysical decline . Many interviewees felt that the recent rapid expansion of county cannabis cultivation and corresponding demographic changes were a visible marker of broader tensions of cultural continuity and endangerment. As the sheriff expressed, cannabis cultivation would “jeopardize our way of life … [and] the future of our children” . This sense of cultural jeopardy , echoed by numerous interviewees, materialized in a range of negative quality-of-life comments about cannabis cultivation: noisy generators, increased traffic, litter and blighted properties, and unsafe conditions for residents. Non-cannabis farmers also reported farm equipment and water theft, livestock killed by abandoned dogs, wildfire danger, illicit chemical use and poisoned wildlife. Some non-cannabis farmers expressed a sense of regulatory unfairness — that their farms were subject to onerous water and chemical use regulations while cannabis growers “don’t need to follow the government’s regulations.” Enabling cannabis cultivators to pursue state licensure would facilitate just such civil regulation, but some feared that regulating this crop as agriculture would threaten “the loss of prime agriculturally productive lands for traditional pursuits” . If nothing less than the county’s culture and agricultural order were considered at stake, it is no wonder that absolute, even prohibitionist, solutions emerged in Siskiyou, with the Sheriff’s Office having a central role in defending local culture.Siskiyou’s sparsely populated landscape has been home to illegalized cannabis cultivators at least since the late 1960s, largely in remote, forested, and public lands in the western part of the county. Medical cannabis’s decriminalization in 1996 inaugurated a modest expansion of cannabis gardens throughout the county . However, for the next 19 years, Siskiyou did not establish regulations for medical cannabis, in line with locally dominant ideologies of personal freedoms and property rights. Instead, the county relied on de facto management of cultivation by law enforcement and the court system’s strict interpretation of state law . In 2015, informed by public workshops held by the Siskiyou County Planning Division, supervisors passed the county’s first medical cannabis ordinance, which seemingly balanced concerns of medical cultivators and other county residents. Regulation would be overseen by the Planning Division, which placed conditions on cultivation , limited plant numbers to parcel size and would establish an administrative abatement and hearing process for complaints. The Planning Division, however, had been without code enforcement officers since 2008 budget cuts. Though the county authorized the hiring of one civil code officer in 2015, the Sheriff’s Office felt that the Planning Division “needed outside help” and moved to assist. Soon, the county’s limited abatement capacities were overwhelmed by vigorous enforcement and a wave of complainants. County supervisors, responding to the sheriff’s 2015 reports on the “proliferation” of cannabis gardens on private property, moved to heighten penalties for code violations, place numerous new restrictions on indoor growing and ban all outdoor growing .

By bringing actors from the black market to the taxed and licensed marketplace, the state can raise billions in annual tax revenue and create jobs for thousands of people. The economic justification of cannabis legalization was compelling: if people were going to use it anyway, why not tax it? Other important arguments favoring full legalization were: reducing law enforcement and incarceration costs; alleviation of the drug war in Mexico; breaking with racial disparity of the war on drugs; consumers’ protection through quality control and regulation; defense of individual rights and freedoms; and so forth. The legalization of recreational cannabis is a nascent field of study, which has more questions than answers. Today, it looks that the economic framework has been most influential in the recreational cannabis campaign. With this project, I intend to shed some light on how the legalization of recreational cannabis became possible in California and which frameworks contributed the most to legal change. To answer these questions, I interview people who have a direct bearing on the institutionalization of the idea of recreational cannabis at the local level, i.e., licensed and unlicensed cannabis growers and distributors, social activists, city officials, representative of licensing agencies, and law enforcers. Today, cannabis is the transitional period characterized by a search for a new legitimate meaning. According to Victor Turner, a liminal stage means being “at once no longer classified and not yet classified” . In the case of cannabis, it means that it is no longer illegal but not yet legal; no longer criminalized but not yet legalized; no longer intolerable but not yet entirely acceptable. As cannabis consumption slowly and tentatively gains legitimacy, it also shows some harbingers of its institutionalization.

The binary rhetoric on cannabis—i.e., the medical and recreational perspectives—reflects a lack of a dominant narrative about it . For example, weed trimming tray many physicians do not have a consolidated perspective on whether cannabis is a medicine or not. On the one hand, they want to abide by professional norms and exclude dubious substances from clinical practice; on the other hand, they want to help patients by relieving their pain and suffering . A similar ambivalence exists on the regulatory level. California’s cities have discretion over whether to permit recreational cannabis, and many are still debating what to do. Thus, even if recreational cannabis became legal in some parts of California, it remained illegal in others, as well as on federal property. The persistence of the black market is yet another marker of ambiguity: due to high taxation, many cannabis providers choose not to obtain a license and remain in a shadow area. The socially uncertain state of cannabis partly arises out of its lasting conceptualization as a criminal justice issue. The federal prohibition of cannabis continues to jeopardize the position of every person involved in its cultivation and distribution in California. On December 2, 2020, the United Nations Commission on Narcotics removed cannabis from the list of most dangerous drugs. Two days later, the US House of Representatives approved the MORE Act , which should decriminalize cannabis at the federal level and remove it from the list of controlled substances. Both legislations are important symbolic gestures, but the future of cannabis in the US remains unclear. The federal enforcement agencies are not yet ready to accept cannabis legalization, and sometimes one step forward leads to two steps back. Although the recognition of medical benefits of cannabis use is more widespread now than decades ago, cannabis abuse is rarely perceived as a public health issue . All psychoactive substances that alter physical and mental processes in the human body require a special system of control, and cannabis is not an exception.

The question is: Which social institutions should be responsible for regulating cannabis? In different countries, cannabis sale, use, and abuse is regulated by the healthcare system, welfare institutions, religion, law enforcement, or the market. In the current US context, it comes under the jurisdiction of law enforcement agencies and courts and is viewed from a bureaucratic rather than a professional logic. Federal prohibition of cannabis encourages social stereotypes and impedes ideational change, which is necessary for moving cannabis from criminal justice to the medical, commercial, or recreational discourse. Drug testing in workplaces, widespread anti-cannabis campaigns, the concentration of dispensaries in marginal zones, the stigmatization of cannabis users, the unavailability of banking and legal services, the prohibition of interstate trade, and, of course, the federal prosecution—all these points indicate the heavy symbolic load attached to cannabis use, which means that cannabis is far from being normalized and institutionalized in California. Based on this information, some people might question whether the passage of Proposition, which legalized cannabis for recreational use, was premature. In this project, I argue that the adoption of formal regulation is only one in an ongoing series of episodes contributing to a broader cultural transformation. Asking whether the legalization of cannabis was premature is not relevant if we understand legalization as a process of gradual, incremental change. Such an approach allows us to see how the idea of cannabis is historically constructed through social interactions, strategic political decisions, adaptations, innovations, or even unintended consequences. It also provides a perspective on particularities and paradoxes of public morality, or, better to say, a moral background of contemporary American society . The increased tolerance of cannabis use, which we observe in recent decades, is often referred to as “normalization.” Saying that cannabis is becoming normalized means that the substance is available and accessible, consumption rates are increasing, and that there is greater social and cultural accommodation of its use . Since the 1990s, cannabis had undergone a significant transformation in public perception.

The perceived risk of cannabis is decreasing, along with the cultural anxiety and negative labels attached to it, and its users are less inclined to guard information about their consumption . The tone of media coverage of cannabis-related issues also becomes more favorable . Opinion polls detect broader acceptance of cannabis use: according to Gallup, the support of cannabis legalization grew from 12% in 1969 to 68% in 2020 . Many Americans believe that smoking cannabis is morally acceptable . In 1969, only 4% of Americans said they had tried cannabis; in 2017, that figure grew to 45%. The rates of cannabis and tobacco consumption rose at a similar pace ; however, among young adults aged 18 to 29, cannabis is significantly more popular than tobacco . Availability and access to legal cannabis are also growing: as of December 2020, the recreational use of cannabis is permitted in 15 states and its medical use in 36 states. Yet, despite broader social tolerance, the cannabis issue remains controversial. First, its continuing federal illegality poses a threat of legal sanctions on those using or distributing cannabis under state law. As Sam Kamin points out, “legalized” cannabis continues to operate in an unstable gray area. When the commodity is prohibited at the federal level and legalized at the local level, there might be considerable confusion regarding how governmental, market, educational, cannabis grow setup and other institutions should treat it . In particular, what the true dangers of cannabis use are and how to effectively distribute institutional resources to address these dangers . People engaged in cannabis activity still risk losing their jobs, parental rights, and many federal benefits . For example, the Drug-Free Workplace Act of 1988 requires employers who are federal contractors to maintain a drug-free workplace and prohibits the use and possession of illegal substances. Because the federal government classifies cannabis as an illegal drug, employers in California feel incentivized to impose drug testing at the workplace to comply with the law, even though the Act neither directly demands nor authorizes it . As of now, the attempts to challenge the discriminatory policies against employees using cannabis for medical purposes have been unsuccessful.Second, cannabis users continue experiencing stigma and social disapproval. Many studies show that notwithstanding the normalizing trends, cannabis-related stigma is conspicuous and strongly affects cannabis users’ identity formation . That cannabis is no longer “deviant”—at least in some social circles—does not make it “normal” either . Cannabis users employ various strategies to distance themselves from labels and familiar stereotypes about cannabis use and its relation to crime, deviance, sickness, etc. . Since the 1960s, civil rights movements are fighting for the “normalization” of cannabis use under the banner of recognition of dignity and pride within difference . Despite widespread tolerance and the success of the legalization movement, cannabis use still challenges the dominant values and remains on the margins of the mainstream culture. In 2019, 86% of cannabis supporters believed that cannabis helps people who use it for medical reasons, and only 35% agreed that cannabis use is not harmful. Moreover, cannabis use has potential social consequences—from disapproval by family members to termination of a labor contract.

This project instead underscores the importance of organizationalstigma by bringing attention to actors who are involved in cannabis legalization at the level of practice. I argue that normalization happens not only through changes in public morality and consumption practices but also through establishing new institutions and new social relationships. For example, the legalization of recreational cannabis brought about a variety of new organizational forms, such as licensing agencies, recreational cannabis dispensaries, microbusinesses, testing labs, cannabis cafes and restaurants, cannabis law firms, and so on. These institutions gave rise to new relationships—between cannabis companies and licensing agencies, landlords, law enforcers, lawyers, local communities, or consumers. Like individuals, organizations, or whole markets can also experience stigma, which forces them to exist in the shadows. The passage of Proposition 64 did not put cannabis on a par with other legitimate and tolerated intoxicants . Instead, it placed the emerging legal cannabis market abreast of other markets of morally questionable goods, for which attaining legitimacy is a crucial and pressing issue . For example, while alcohol can be enjoyed at bars, restaurants, or sporting events, there is no public place to consume cannabis lawfully . Moreover, due to incompatibility between state and federal legislation, cannabis companies do not have access to professional services necessary for businesses to function. Banks, attorneys, insurance companies, potential investors, and others are concerned with breaking federal law. As a result, the cannabis market is a cash-based trade that needs enhanced security services . Similarly, landlords are reluctant to let their properties to cannabis operations due to the risk of federal seizures . Since the traditional professions are cautious about engaging with legal cannabis, a pool of “special” cannabis doctors, creditors, and attorneys has emerged. These specialists are often considered marginal within their professional groups. Cannabis dispensaries manage the effect of industry stigma by dismantling the harmful stereotypes and distancing from the “black” market. In particular, they incorporate the language, symbols, and values associated with the healthcare system ; promote themselves as responsible and caring providers ; craft their professional image as experts in pain and anxiety ; imitate normal businesses ; deemphasize potential dangers of cannabis use ; and so on. Despite these efforts, the cannabis industry is not yet fully destigmatized. How can we quantify the current stigma of the legal cannabis industry and understand the extent to which it has been removed? Different theoretical perspectives can give a clue on how to test the normalization hypothesis and measure the effect of organizational stigma. In The Rules of Sociological Method , Emile Durkheim makes a distinction between normal and pathological based on how often individuals encounter different kinds of events. In other words, the criterion of frequency determines whether we call a phenomenon “normal” or “pathological”: normal things are the ones more widespread and common to find. Currently, only one-third of California cities allow cannabis-related activities within their borders, and therefore we can infer that cannabis companies are still a pathology rather than a staThistical norm. Durkheim’s main vulnerability is his disinterest in the social agents’ perspective and the systematic neglect of power . There are many rare social facts, but some become pathological based due to their infrequency, and others do not. Why is that so? To tailor the Durkheimian theory and make it more suitable for my empirical analysis, I incorporate Mary Douglas’s idea of pollution and power.

A log-rank test was used to determine the significance of difference between two survival curves. All analyses were conducted using JMP staThistical softwar.Survivorship of adults reared from wild-caught larvae and pupae was examined in three different environments: indoor, plantation, and forest . Female mosquitoes placed indoors survived significantly longer than those in banana plantation and forest for both An. minimus and An. sinensis . The mean survival duration of female An. minimus mosquitoes were 21.6, 18.8 and 14.8 days in indoor, banana plantation and forest, respectively . A similar result was found in female An. sinensis mosquitoes in different land use and land cover settings. Male mosquitoes lived for a significantly shorter period of time than females for both An. minimus and An. sinensis, but the pattern of survivorship in indoor, banana plantation, and forest environment was the same as the females . The daily survival rate ranged from 0.88 to 0.91 for females and 0.84 to 0.89 for males .The present study identified a significant effect of land use and land cover on vector survivorship. Mosquitoes placed under indoor environment exhibited significantly higher survivorship and longevity than banana plantation and forested environment. When mosquitoes were placed indoors in two sites differing in elevation, cannabis grow setup mosquitoes exhibited higher survivorship in sites with lower elevation. The effects of land use and land cover on mosquito survivorship likely resulted from differing microclimatic conditions among the habitats where adult mosquitoes were placed.

Significantly higher mosquito survivorship was found in an indoor environment where mean daily temperature was 2°C higher than in the forested environment. This result on the impact of land use and land cover on mosquito survivorship was consistent with other studies on An. arabiensis and An. gambiae in African highlands , and An. darlingi in the Peruvian Amazon. The findings from this study have important implications for understanding malaria transmission and vector control in changing ecosystem. The developing world has been experiencing rapid land use and land cover changes. Deforestation is a major component of land use and land cover changes. Increased survivorship of adult mosquitoes in the indoor environment indeforested areas, as demonstrated in the present study, suggests that Indoor Residual Spraying and Insecticide-Treated Nets should be used for vector control to prevent indoor malaria transmission. In addition, deforestation could alter the microclimatic conditions of aquatic habitats and subsequently enhanced survival and development of larval mosquitoes as demonstrated in An. gambiae and An. arabiensis in Africa. Because vector survivorship and vector density are important components of vectorial capacity, deforested agricultural areas could exhibit dramatically higher vectorial capacity than forested areas. Therefore, deforested agricultural area can increase the risk of malaria transmission. There are several limitations in our study. First, although it is a conventional method, microcosm rearing of mosquitoes in cages for determination of vector survivorship was in a confined condition. In field conditions, mosquitoes could hide and rest in moisture and dry habitats with microclimate conditions that are different from our cage condition.

Because it is not feasible to track the mosquitoes under field conditions, determination of vector survivorship under field conditions has been indirect based on biomarkers such as ovarian structural evaluation, fluorescent pigment pteridine concentration, cuticular hydrocarbon, and gene expression. These methods have significant limitation in estimation reliability such as the age of mosquitoes beyond certain period cannot be identified, and sensitive to blood feeding and other physiological changes. Our microcosm rearing of mosquitoes is the most direct measurement of mosquito survivorship. Second, we fed mouse blood and sucrose sugar in our experiments. The food source to adult mosquitoes may affect survivorship as An. minimus prefers biting human. Because all mosquitoes were reared under the same food condition, the results on the impact of land use and land cover should be valid. It is important to assess the impact of land use and land cover on vector-borne disease transmission when an economic development plan that significantly alters land use and land cover is being formulated. This study suggested that deforestation is the worst scenario, re-cultivation with banana plantation or other economically valuable trees such as rubber trees could boost incomes and reduce malaria transmission risk at the same time. Therefore, government policy should encourage local farmers to re-cultivate on deforested land. The estimated daily survival rate for An. sinensis and An. minimus under different land use and land covers provides a valuable parameter in modeling vector population dynamics and malaria transmission risk.When California voters approved Proposition 64 in 2016, legalizing recreational cannabis for adults, they fundamentally altered the state’s cannabis landscape. They also, albeit unintentionally, furnished UC researchers with intriguing new avenues of potential inquiry — many of which are blocked by federal law and pursuant UC policy. For example, researchers interested in the cannabis-derived sprays and beverages readily available at California’s retail cannabis establishments cannot obtain those products for research purposes by any permissible means. Licensed cannabis businesses dot the state today, but cannabis research still operates within the same strict constraints that have hindered it since legalization was a futile sentiment on a bumper sticker. Because state law is subordinate to federal law, Proposition 64 is subordinate to the 1970 Controlled Substances Act. Associated with that act is a “scheduling” apparatus, overseen by the Drug Enforcement Administration , that identifies cannabis as ripe for abuse and devoid of medical merit. Thus, along with heroin and other Schedule I substances, the psychoactive variety of cannabis cannot under federal law be cultivated, processed, sold, consumed — or, for the most part, researched. 

The University of California, as a law-abiding institution, complies with the Controlled Substances Act and its nearly total cannabis prohibition. As an institution that receives federal funding, UC complies with the Drug-Free Workplace Act and the Safe and DrugFree Schools and Communities Act — which require universities, if they wish to receive federal funding, to implement policies prohibiting on-campus activities such as possession or use of controlled substances. UC personnel, including staff, faculty and UC Cooperative Extension specialists and advisors, are therefore prohibited, in their professional capacities, from direct contact with the cannabis plant or its extracts, and also from certain types of indirect contact. They cannot, for example, visit cannabis cultivation sites or advise cannabis growers on topics such as yield increases. Researchers can’t even use cannabis or cannabis-derived products in medical studies — unless they fulfill a rather daunting set of federal requirements. Those requirements for medical studies include obtaining a Schedule I license from the DEA; submitting research protocols for Food and Drug Administration approval; submitting to the FDA an investigational new drug application ; and, as a non-federal matter, gaining the approval of a state entity, the Research Advisory Panel of California . If all goes well, researchers can then obtain cannabis or cannabis-derived substances from a DEA-licensed cultivator, a DEA registered bulk manufacturer or, with a DEA import license, a foreign exporter. The only DEA-licensed cannabis cultivator is the University of Mississippi, which grows the plant under a contract funded by the National Institute on Drug Abuse . Bulk manufacturers of cannabis products such as tetrahydrocannabinol — the psychoactive component in cannabis — include, for example, vertical grow system the Massachusetts based life science company MilliporeSigma . Providers of imported cannabis products — such as Tilray, a Canadian firm — must be based in jurisdictions where such products are legal. No matter which path researchers choose, the process isn’t fast or easy. “You need a patient, dedicated team willing to jump through extra hoops at the institutional, state and federal levels,” says Jeffrey Chen, Executive Director of UCLA’s Cannabis Research Initiative. Even so, Chen reports, federal restrictions on types and sources of cannabis products can prevent researchers from conducting cannabis studies at all. And again, only medical researchers are eligible to obtain cannabis for research. Those who wish to perform agronomic studies, for example, are simply out of luck. For all that, opportunities to research cannabis are not scarce around the UC system. Observational studies of cannabis users are permissible, though the cannabis in question cannot be provided by the university and must be consumed off campus. Researchers interested in the legal or economic dimensions of cannabis, or in cannabis policy, will discover few obstacles in the Controlled Substances Act. Several UC researchers are vigorously investigating the environmental consequences of cannabis cultivation — and in fact Proposition 64 has effectively expanded the scope for such research. According to Ted Grantham, a UCCE specialist at UC Berkeley and co-director of the UCB Cannabis Research Center, researchers can now interact with cannabis growers — to learn, for example, about their cultivation practices — in a way that grower reluctance previously precluded. Today, Grantham reports, “a subset of growers is very interested in day lighting the cannabis industry to establish its legitimacy as an agricultural crop rather than an illicit substance.” In years to come, UC investigators will likely perform extensive research on industrial hemp.

This form of cannabis, which contains extremely small amounts of THC, is useless for producing a “high” — but very useful for making fabrics, insulation, paper and more. Until recently, however, federal law did not distinguish between low-THC hemp and high-THC cannabis — nor between THC and cannabidiol , a nonpsychoactive cannabis compound purported to relieve medical conditions ranging from arthriThis to anxiety. The legal landscape for hemp and CBD began to change on the federal level in 2014, when that year’s Farm Bill allowed universities to cultivate industrial hemp for research purposes . In June of last year, the FDA approved a CBD-based medicine for treatment of epilepsy-related seizures. With last December’s passage of the 2018 Farm Bill, industrial hemp became a legal crop — pending establishment of a regulatory framework to govern it. Hemp-derived CBD now appears on course for complete de-scheduling by the DEA, and the FDA is wrestling with how to regulate the CBD-based consumer products already hitting the market in many states. Amid this liberalization of federal law on hemp and CBD, it becomes easy to envision UC academics and UCCE personnel performing agronomic studies with hemp — and providing California hemp growers with the same sort of research-based knowledge that has long been available to cultivators of almonds, grapes and lettuce. Federal laws identify cannabis as one of the most dangerous drugs with no medical use, and its cultivation, possession, and distribution are criminally prosecuted. At the same time, many states adopt a different view admitting the medical benefits of cannabis and advancing decriminalization and legalization policies. As of 2019, 14 states and the District of Columbia have legalized cannabis for recreational use, and 35 states and the District of Columbia have legalized it for medical use. California’s cannabis policy makes for a special case. Owing to its large population and gross domestic product, California is the most prominent market of legal cannabis in the US . In 1996, California voters made history by passing Proposition, which legalized the medical use of cannabis. Twenty years later, in 2016, the state adopted Proposition 64, which permitted cannabis for recreational use with record rates of public support . Los Angeles and San Francisco lead by example in creating a supportive environment for the legal cannabis market. Their governments adopted social programs designed to lower the barriers for individuals with past cannabis convictions 1 and expedite the expungement of cannabis-related records.2 Nevertheless, it would be erroneous to assume that acceptance of cannabis arose with the same intensity across California counties and cities. Local jurisdictions have discretion over deciding whether to allow or forbid cannabis companies within their borders. At the moment, only one-third of California cities permit the distribution, cultivation, testing, manufacturing, or sale of cannabis, while the rest have passed ordinances forbidding any cannabis-related economic activities within city borders. This project is the first and the most comprehensive study of the unfolding process of cannabis legalization, which empirically addresses a set of interrelated questions. First, how is the legalization of cannabis for recreational use spreading across California cities? Second, what accounts for the uneven legalization of cannabis across California cities? And third, what does the case of cannabis legalization reveal about the relationship between legitimacy and legality more generally?

The AUMA initiative appropriately prohibits sales of marijuana to minors and prohibits anyone under the minimum age be allowed in any store that sells marijuana and marijuana products, including staff. This provision is stronger than regulations for retail alcohol stores, which explicitly allow underage people in convenience stores. However, AUMA fails to include other important provisions that will prevent underage access and appeal including vending machine, internet and mail order sales, coupons, promotional discounts, and sales of flavored products, including THC-containing e-liquid. The AUMA initiative also prohibits marijuana businesses within a 600-foot radius of “a school providing instruction in kindergarten or any grades 1 through 12, day care center, or youth center that is in existence at the time the license is issued, unless a licensing authority or a local jurisdiction specifies a different radius.” AUMA establishes a series of discretionary criteria for determining whether a license should be issued, including “excessive concentration.” However, this term is not adequately defined and is applicable if such limitation did not impede development of the legal market or perpetuate the illicit market. The effectiveness of these licensing criteria is severely hampered because they are discretionary and lack specificity. An important provision in AUMA is that local governments will be permitted to adopt retail licensing restrictions stronger than the state law. Good public health practice, cannabis grow equipment based on provisions for tobacco retailers, would prohibit marijuana retail stores within 1,000 feet of schools and parks. There would be requirements against issuing new licenses in areas that already have a significant number of retail outlets, which would not be contingent upon whether or not such limitation impeded market growth.

Retail marijuana businesses would be prohibited from selling marijuana through vending machines or self-service displays, using coupons including digital coupons, promotions, discounts, sale of flavored products , and other offers that would encourage underage initiation and frequent use, as well as impulse buys. In addition to these prohibitions, the law would also mandate that retailers be required to verify government-issued identification cards through age-verification systems for face-to-face sales. Electronic commerce such as internet, mail order, text messaging, and social media sales would be prohibited because these forms of nontraditional sales are difficult to regulate, ageverification is impossible, and they can easily avoid taxation. The state would establish a minimum set of restrictions for marijuana retailers that local governments could not weaken and local governments would be permitted to adopt stronger regulations than the state law, including additional annual licensing fees and penalties for noncompliance . The stated goal of the AUMA initiative is to simultaneously “legalize marijuana for those over 21 years old [and] protect children.” However, there are no provisions that will prevent marijuana retail stores from being located within 1,000 feet of a college or university property, recreational center or facility, public park, library, or a game arcade, malls, movie theaters, churches, substance abuse treatment facilities, or hospitals, where underage people are likely to congregate. Furthermore, it will be legal to sell marijuana in ways that will increase underage persons’ access and appeal, through vending machines, self-service displays, and coupons, and through nontraditional sales, such as the internet, mail order, text messaging, and social media. Under the AUMA initiative it is likely that marijuana legalization will have a negative impact on the health of young people and communities of color.

Experience from tobacco and alcohol control shows that retailer density is positively associated with youth and young adult smoking and alcohol use. It is likely that marijuana retail density will have the same impact. There are also no provisions that will require new marijuana retailers be located a minimum distance from other retail stores or that will limit the number of marijuana retailers in a specific geographic unit . This is a key problem with tobacco retailers and alcohol outlets in poor communities, and is an emerging issue in Colorado’s minority, mostly Latino, neighborhoods with retail marijuana. Similar to tobacco and alcohol, it is likely that marijuana retail stores and marijuana cultivation sites will be over-concentrated in low-income communities and communities of color. In order to uphold the social justice goals on which the initiative stands, it is important that clustering and over-concentration of licensed marijuana facilities is prevented. While an age-restriction for marijuana and compliance checks to deter sales to underage persons are included in the initiative, it severely limits the capacity to use the licensing system to enforce this restriction on retailers by suspending or revoking licenses for businesses that sell to underage persons. In particular, the initiative states that retailers will be penalized if they “intended” or “knowingly” sold to underage persons. Experience from tobacco and alcohol control demonstrates that requiring knowledge makes enforcement difficult, if not impossible, and compliance much less likely. Further, the initiative’s language requiring licensees see documentation prior to selling or transferring marijuana is weak and at risk of being violated by marijuana retailers. The initiative states a licensee shall not sell marijuana unless presented with “documentation which reasonably appears to be a valid government-issued identification card showing that the person is 21 years of age or older [emphasis added].” Rather than creating a duplicative system, a public health framework would model the marijuana retail licensing system on existing inspection systems or the Target Responsibility for Alcohol Connected Emergencies programs in California.

As with tobacco and alcohol enforcement programs,marijuana retailers would be required to ask for identification from anyone that looks under the age of forty. Marijuana retailers would be required to enter government-issued identification cards into age-verification system for face-to-face sales or the transaction would be cancelled. Violations would be for cases in which retailers do not ask for identification before selling marijuana to consumers and for cases in which the retailer asked for identification but still sold marijuana to an underage person without the state having to prove intent. The AUMA initiative maintains separate medical and retail marijuana markets, complicating policy efforts to prevent initiation and reduce marijuana use. The experience in Colorado, where the separate medical and retail marijuana markets are being maintained provides strong support for a unitary market. In Colorado, although legalization advocates claimed that retail marijuana legalization would reduce the number of medical marijuana users, the medical marijuana industry has continued to grow. Regulatory in consistences between the medical and retail markets are likely driving medical marijuana market growth. For example, marijuana possession and cultivation limits are higher for medical marijuana than retail marijuana, medical is more affordable because it is exempt from state and local excise taxes, and persons under age twenty-one can purchase marijuana through the medical marijuana program but not through the retail market. It is important to avoid complexity in the marijuana regulatory environment because complexity favors large corporations with the financial resources to hire powerful lawyers and lobbyists. A public health framework for marijuana legalization would create a unitary market, in which all legal sales are regulated as retail marijuana and marijuana products, and the medical market is eliminated. A unitary market would simplify regulatory efforts, including licensing enforcement, vertical grow rack implementation of underage access laws, prevention education programs, and taxation. A unitary market would also avoid sending mixed messages to the general public about the safety of marijuana, particularly as more research accumulates on the adverse health effects. Without a unitary market, it is likely that California, which has a stronger medical marijuana advocacy community and industry than Colorado, will experience similar regulatory distortions. It is important to note that in 2015 the State of Washington merged its medical and retail marijuana markets. Licensed marijuana retailers that want to also sell medical marijuana are required to obtain a medical marijuana endorsement that meets the Department of Health’s requirements. The AUMA initiative focuses funding on youth-centered substance abuse treatment programs without a specific mandate dedicated to the primary purpose of preventing and reducing marijuana use and protecting the public from secondhand smoke exposure. The experience from tobacco control is that dedicating taxes solely to youth-based and school programs is not the best way to prevent initiation or minimize use, and may have counteractive effects. Evidence-based tobacco prevention and control programs aimed at the general population are the most effective way to prevent youth initiation. AUMA assigns the Department of Health Care Services , an agency that provides information to the public on how to improve access to health care services, such as Medi-Cal and Family Planning, responsibility to educate on and prevent substance use disorders in youth. The initiative allocates $5 million from the General Fund to the DHCS to develop and run a public information campaign on the provisions of AUMA, penalties for sales to minors, dangers of driving while intoxicated by marijuana, potential harms of using while pregnant or breastfeeding, and potential harms of over consumption. In contrast, the California Department of Public Health’s media budget for tobacco control was $43 million when it first aired in fiscal year 1989/90. There are no funds earmarked to provide for the continued public information program or for an ongoing statewide media campaign aimed at the general population informing the public on the harms of marijuana use, production , driving under the influence, secondhand smoke, industry manipulation, or offering cessation services for users.

The Legislature will have to appropriate these funds from the General Fund to continue such a public information campaign. Beginning in Fiscal Year 2018-2019, AUMA would require sixty percent of the left over marijuana tax revenue to be allocated to youth programs “designed to” educate and prevent substance use disorders. These programs may include prevention and treatment services for youth and caregivers, early intervention services, grants to schools to develop school-based intervention programs , grants to programs to address substance abuse for homeless youth, family-based interventions, and workforce training to increase the number of available behavioral health staff with substance use disorder prevention and treatment experThise. The DHCS is given broad latitude to determine where the funding is allocated and how much a particular program will receive. For example, the DHCS may dedicate most of the funding toward prevention and early outreach or it may dedicate most of the funding toward workforce training. If funding exceeds demand for youth substance abuse prevention and treatment services, then funds may be dedicated to treatment for adults with substance use disorders. Because these programs will not impact market growth, it is likely that the marijuana industry will either not oppose or may lobby to continue their funding. As is the case in tobacco and alcohol control, dedicating taxes to programs other than marijuana prevention and control may be popular among policymakers and likely will be promoted by marijuana companies to displace effective denormalization campaigns. Often these programs are not controversial and fund important causes like early childhood education, college scholarships, or to fund state school projects , or focus prevention programs on pregnant women and children, or provide funding to healthcare services unrelated to preventing tobacco or alcohol use. Without a specific legal requirement, the emphasis on substance abuse prevention and treatment programs suggests that funding will not go towards preventing and reducing marijuana consumption. For the same reasons as the tobacco and alcohol companies, marijuana companies may endorse these programs to boost their public image and strengthen relationships with policymakers. Marijuana companies may also launch voluntary youth prevention programs or corporate social responsibility projects, to displace effective denormalization campaigns used to prevent and control marijuana use. Similar to the alcohol industry’s “drink responsibly” campaign, which is ineffective at informing the public on the actual harms of alcohol use, in 2014, the Marijuana Policy Project launched its own “Consume Responsibly” campaign, with the “goal to educate [consumers] about the substance, the laws surrounding it, and the importance of consuming it responsibly.” It is likely that marijuana responsibility messages on consumption will be used to promote marijuana and marijuana products rather than providing accurate public health information to deter and minimize use. As noted above in California use of tobacco, a legal product, has been dropping while use of marijuana, despite being illegal, is rising.

NIH cannabinoid research support increased from $111.3 million for 285 projects in 2015 to $189 million for 408 projects in 2019, with more than a doubling of funds dedicated toward cannabis and cannabinoid therapeutics from 2015 to 2019, from $21 million to $46.5 million , about 0.5% of the overall NIH research budget. Of the 27 NIH components, 20 supported some cannabinoid research in 2019. NIDA was the primary source of support, with $118.7 million for 258 projects. Noteworthy changes include the National Center for Complementary and Integrative Health research on the potential therapeutic benefits of minor cannabinoids and terpenes and the National Cancer Institute workshop and research funds dedicated to cannabinoids and cancer. In addition to NIH, additional sources for funding have become available for cannabis and cannabinoid research. For example, in 2000, $3 million per year for 3 years was appropriated to the California state-funded Center for Medicinal Cannabis Research based at the University of California, San Diego, through legislation calling for a research program to oversee medical research of cannabis and cannabinoids. This center, now funded by revenue from taxes on adult-use cannabis sales, was initially created to conduct and support clinical trials on the efficacy of cannabis. The research agenda expanded to include supporting clinical trials on the efficacy of cannabis and cannabinoids to determine optimal dosing, timing, and modes of administration; comparing the efficacy and safety of various delivery methods; assessing the safety and toxicity of cannabis in the medically ill; and conducting limited preclinical studies. Although funding is available only to investigators at institutions based in California, submissions are high, vertical growing weed with 55 applications received in the past 2 years. Yet, similar to NIH funding rates, the CMCR awards are very competitive, with a 12% funding rate . The volume of grants submitted demonstrates the eagerness of researchers to do work in the field, and the limited success rate exemplifies the difficulty in obtaining funds. In addition to state-funded research, private philanthropy and foundation support are other sources for supporting cannabis and cannabinoid research for specific conditions.

Without funding, it is impossible to cover the expenses associated with the study, among which are personnel, participant expenses, study medication, and the costs to maintain regulatory approvals and drug storage security . With limited funding opportunities and the highly competitive nature of those that exist, a proposal’s impact and novelty are weighed alongside the study’s feasibility and potential for success in trial initiation and completion. A key component of study feasibility for cannabis and cannabinoid studies is the existing infrastructure needed for this type of research, including institutional support for this research, investigator expertise, and a schedule I license, if required for the study medication proposed in the grant application. As such, to obtain funding, it is optimal for the researcher to demonstrate experience in the field and have the support necessary to have successfully applied for and obtained a schedule I license. This is nearly impossible for most new investigators given that obtaining a schedule I license requires funding to support 1) the secure drug storage space and 2) a study that is submitted for IRB, FDA, and state regulatory approvals. These mutually dependent conditions create a situation that shuts out new investigators, especially those based at institutions that do not have infrastructure in place to support clinical studies with schedule I substances.Until recently, NIH did not have pathways specifically dedicated to provide funds to study the therapeutic effects of cannabis; however, funds were set aside to investigate the potential adverse effects of the plant. Hence, 25 years ago, to assess whether cannabis could be useful in patients with AIDS wasting, Donald I. Abrams and colleagues in the Department of Medicine at San Francisco General Hospital, California, proposed a clinical trial that was funded to primarily determine the safety of adding cannabis to HIV protease inhibitors, which also allowed for the potential study of the therapeutic effects of cannabis in this population .

A second study funded by the CMCR 20 years ago sought to determine the effects of inhaled cannabis on neuropathic pain in patients with HIV-related peripheral neuropathy. This trial was designed to enroll 16 participants in a pilot phase to assess the activity of inhaled cannabis and calculate the sample size needed for a follow-up randomized controlled trial if the initial results were encouraging. The study involved 9-day inpatient stays in the San Francisco General Hospital Clinical Research Center. Inpatient studies were favored for research involving this schedule I substance to ensure that the participants were using cannabis as described in the study protocol and not diverting it to family or friends. Participants were not allowed to have visitors or leave the Clinical Research Center ward. To standardize the inhaled dosing, the Foltin uniform puff procedure was employed . To anchor the participants’ subjective description of their pain, the heat and capsaicin experimental pain model was performed to provide a more objective measurement. This method involved heating an area of the forearm to 40 C and then applying capsaicin cream, creating an area of allodynia and hypesthesia that was mapped with a brush and a piece of foam while the subject looked off in another direction. These areas were measured before and after exposure to the study drug. The trial was successfully completed with 50 participants enrolled in the randomized trial .Simultaneous with funding awarded to assess the effects of cannabis on HIV neuropathy, the Abrams team was awarded a CMCR grant to study cannabis in combination with opioids inpatients with breast and prostate cancer with painful bone metastases. This study also involved 9-day inpatient stays in the San Francisco General Hospital Clinical Research Center, and most of the study procedures were identical to those used in the HIV neuropathy study. However, in the time that it took to complete the neuropathy study, only 3 participants enrolled in the cancer pain study. In an effort to increase accrual, eligibility was expanded to include any cancer patient with any pain. Ultimately, the funding for the cancer pain study was withdrawn. Barriers to enrollment of cancer patients in this trial were considered. It was suggested that cancer patients may not be interested in spending unnecessary inpatient time . The IRB expressed concern about inflicting experimental pain models on cancer patients. In addition, patients in San Francisco have long had access to cannabis without having to consent to a trial and risk getting randomly assigned to receive a placebo. In an effort to bypass the need for inpatient Clinical Research Center admission, an outpatient study to examine the effects of cannabinoids on delayed chemotherapy-induced nausea and/or vomiting was designed and favorably reviewed for funding by the CMCR nearly 2 decades ago. Patients who had experienced delayed nausea after the first cycle of chemotherapy were then randomly assigned to receive true cannabis cigarettes and placebo dronabinol, placebo cigarettes and active dronabinol, pipp shelving or placebo cigarettes and placebo dronabinol. The target sample size was 81. After enrolling the first 8 patients in this study, aprepitant was licensed and improved for this precise indication. Local oncologists lost interest in referring patients to a trial where a placebo was possible in view of the new available effective treatment option. Having only enrolled 10% of the accrual target, trial funding was withdrawn. The question of possible synergy between cannabinoids and opioids still loomed as a compelling area of investigation despite the failure of the initial attempt to study it. In an effort to be sensitive to the potential concerns of cancer patients regarding the smoked method of cannabis administration, use of the Volcano vaporizer as a smokeless delivery system for cannabis was explored. In healthy volunteers, the dose-dependent subjective effects and pharmacokinetics of smoked and vaporized cannabis were compared.

Findings demonstrated that vaporization was a safe and effective delivery system and likely had reduced respiratory risk compared with smoked cannabis . The Abrams team then submitted a proposal to NIDA to do a pharmacokinetic interaction study in patients with cancer on sustained-release morphine or sustained-released oxycodone to determine whether it was safe to add vaporized cannabis to the regimen. After screening 218 cancer patients who expressed interest, only 1 had met the eligibility criteria and enrolled in the trial. The most frequent reasons that potential participants were deemed ineligible were because they were not taking the correct opioid analgesic, or more commonly, they were taking the sustained-release morphine or oxycodone preparations 3 or 4 times a day, which would not allow for the 12-hour opioid kinetics curve desired. Rather than forfeit funding because of lack of accrual, the protocol was modified after several months to eliminate cancer-related pain as an entry criterion and included any participants with any pain as long as they took the sustained-release opioid twice a day. With the expansion of the eligibility criteria beyond cancer patients, the study was successfully completed .More recently, a colleague of Dr Abrams, Kalpna Gupta, PhD, works with transgenic mice with the human sickle hemoglobin gene that experience pain. In her laboratory, she found that cannabinoids ameliorate the chronic hypoxia-reoxygenation – evoked acute pain in the mice. Approximately 8 years ago , she was seeking a collaborator interested in doing a human proof of principle study to accompany a grant that she was submitting to the National Heart, Lung, and Blood Institute. Having completed the opioid-cannabinoid pharmacokinetic interaction study, the Abrams team felt that a trial in sickle cell pain would be easily designed using a similar protocol as most of the participants would be on opioid analgesics. By this time, CBD had come bursting onto the scene as the most favored cannabinoid. A 4-arm trial was envisioned comparing THC-dominant cannabis, CBD-dominant cannabis, a balanced blend, and a placebo. However, funding was only available to support 2 arms, and 1 had to be a placebo. Eager to evaluate a CBD-containing product, the team requested that NIDA provide a balanced strain, and they received a 4.4%THC to 4.9% CBD chemovar. The goal of this inpatient randomized, double-blind, placebo-controlled crossover trial was to determine the analgesic and subjective effects of cannabis in sickle cell patients maintained on opioid analgesics. This study required approvals from multiple regulatory bodies as described in Section General Challenges for the Clinical Researcher, and more than 1 year elapsed from the time the protocol was submitted to the IRB for approval when enrollment began. Nearly 3 years later, only 23 of the target 35 patients had completed both arms of the crossover trial; similar to cancer patients, patients with sickle cell disease also found the inpatient component difficult .In the early fall of 2018, a minor media storm described a seafood restaurant in Maine that was proposing to expose lobsters to marijuana smoke prior to cooking . At least three testable assertions were made including 1) that some psychoactive constituent of cannabis would be transferred to the lobster via open air respiration , 2) that this would have specific behavioral effects similar to those produced in vertebrates and 3) that the cooking process would remove intoxicating psychoactive constituents from the meat thereby rendering it safe for human consumption. This latter assertion was related to a claim that “a steam as well as a heat process” would bring the lobster to 420 °F , which would presumably require broiling or oven baking in preference to the more typical boiling or steaming cooking method. These assertions lead to at least two key questions. Can air exposure to Δ9-tetrahydrocannabinol , the primary psychoactive constituent of cannabis, produce significant tissue levels of the drug in lobsters? If so, does it have any discernible behavioral effects? Lobsters are aquatic species that respirate via gills located inside their carapace. Lobsters can survive in air for many hours up to a few days, if they are able to keep their gills wet enough to function, but they do go into oxygen debt, e.g. across a 24 h emersion from water . It is unclear if the gill structures would support the uptake of THC that is rendered airborne via smoke particulate or Electronic Drug Delivery System device vapor.

To discover an answer, we will look at medical marijuana, crime, arrest, unemployment, and mortality rates in California counties from 2005-2014. The arrest and mortality rates will be used specifically to examine the possibility of marijuana being a substitute drug. Today, there are approximately 572,762 medical marijuana patients in California, which is equivalent to 1.49% of California’s population. While recreational use of marijuana has not been legalized in California, it is estimated that 9% of Californians use marijuana.3 If recreational marijuana use is legalized in California, it is possible that the percentage of marijuana users will increase. Given that California already has numerous marijuana farms and is predicted to provide 60-70% of the United States’ crop if legalized within the state, according to the International Business Times, it is pertinent to analyze the outcomes marijuana has on California’s society today. In 2010, the number one cause of death among 25-64 year olds in California was drug overdose. Many individuals have grown up with the notion that marijuana is a gateway drug to other illicit “hard” drugs. These other substances could include cocaine, heroin, methamphetamines, and prescription drugs, all of which can be extremely addicting and fatal. Since 1999, deaths from painkiller drug overdoses have increased 400% for women and 237% for men.6 This causes us to think of potential solutions for fatal substance abuse. If medical marijuana can be offered as a substitute drug, pipp racks will it decrease drug-poisoning deaths? According to a survey implemented by the U.S.

Department of Health and Human Services from 2005 to 2011, illegal drug use percentages were much higher in unemployed individuals than individuals with some sort of employment.7 Specifically, it was shown that 18% of the unemployed were involved in illegal drug use, compared to 10% of part-time workers and 8% of full-time workers. This causes us to question whether or not there’s a relationship between drug use and unemployment. When California passed Proposition 215, referred to as the California Compassion Use Act, it allowed patients, along with their primary physicians, to possess and grow marijuana for medical use, once given a referral from a California-licensed doctor. In 2004, California passed SB 420 to supplement Prop 215. The SB 420 specified the amount of marijuana each patient could possess and cultivate and created a voluntary, statewide, ID database through California health departments. This database is run by the California Department of Public Health and will be used to estimate marijuana use for this report. While both Prop 215 and SB420 protect patients and physicians from arrest in California, marijuana continues to be a federal crime, where there is no differentiation between medical and recreational marijuana use. Currently, the Drug Enforcement Administration has marijuana listed as a Schedule I drug, defined as a drug with the highest potential for danger and abuse and is listed along with heroin, LSD, and ecstasy. Schedule I drugs are assumed worse in comparison to Schedule II drugs, which are recognized to be less abusive. Schedule II drugs include cocaine, methamphetamines, and other highly addictive prescriptions. According to the Office of National Drug Control Policy, the reason marijuana legalization is refused at the national level, is because marijuana use is believed to increase the use in other illicit drugs. This brings us back to the question of whether or not marijuana can act as a substitute, rather than a “gateway”, to other hard drugs. While there has been little to no research done in the area of recreational marijuana, there have been many articles published on the effects of medical marijuana legalization. In 2013, Anderson et al. published a paper that studied the effects of MMLs on traffic fatalities across the nation by using alcohol consumption as an instrument. The authors first used price data to observe the effects on the marijuana market after the MML took effect.

They found that the supply of high-grade marijuana dramatically increased, while the lower quality cannabis was moderately impacted. Getting to the basis of their main goal, they used data on traffic fatalities within a 20-year period, across 14 states, to determine if marijuana was a substitute for alcohol. It was discovered that there was an 8-11% decrease in traffic fatalities within the first year of legalization with an even larger effect on traffic fatalities involving alcohol consumption. The authors then used individual behavioral data to examine the probability of consuming alcohol in the past month, binge drinking, and the number of drinks consumed after the MML took place. They found that these probabilities drastically decreased after the legalization occurred. When looking at alcohol sales, it was also discovered that there was a decline of 5% on beer consumption in the age range of 18-29. The MMLs were then used as an instrument of beer consumption to establish the amount of traffic fatalities. It was deduced that for every 10% increase in beer sales per capita, alcohol related traffic fatalities increased by 24%. The article goes on to conclude that marijuana does have a substitution effect on alcohol, especially among young adults, which inherently declined traffic fatalities.There is currently a working paper called “The Effect of Medical Marijuana Laws on Marijuana, Alcohol, and Hard Drug Use,” where Hefei Wen studied these effects using geographic identifiers and by estimating a state-specific time trend model that included two-way fixed effects. It was discovered that the relative probability of marijuana use among individuals over 21 increased by 16%, the frequency of marijuana use increased by 12-17%, and marijuana abuse and dependency increased by 15-27%. While there was an overall increase in marijuana use after MMLs went into effect, there was no strong evidence that showed marijuana use increased in youth.

While the authors predicted that there could be a spillover effect of marijuana on other substances, there was no significant evidence that marijuana caused increases in alcohol and other drug use. A more recent study done through the Drug and Alcohol Review examined medical marijuana as a substitute for alcohol, prescription drugs, and other illicit substances. The data was taken from a cross-sectional survey, completed online by 473 Canadian medical marijuana patients. The analysis found that 87% of patients substituted cannabis for one or more substances. This included an 80.3% substitution rate for prescription drugs, a 51.7% substitution rate for alcohol, and a 32.6% substitution rate for other illicit substances. These rates serve as evidence that marijuana can “play a harm reduction role in the context of use of these substances, and may have implications for abstinence-based substance use treatment approaches.” While these results show significant effects for marijuana substitution, there are an estimated 2.3 million users of cannabis in Canada alone, pipp rack making it difficult to assume a survey of only medical marijuana patients represents the entire population of all marijuana users. An additional study was done through the University of Virginia in 2014 that examined how MMLs affect crime rates. The author, Catherine Alford, decided to use difference-in-differences estimations where she controlled for state specific crime trends by collecting data across states over time from 1995-2012. It was discovered that after the implementation of MMLs, overall property crime and robbery rates increased. However, if the MMLs allowed for home cultivation, robbery rates actually decreased by about 10%. While these results show a positive relationship between MMLs and the previously mentioned crime rates, there was no statistically significant effect on violent crime rates. However, a study done in 2012, by the Center on Juvenile and Criminal Justice, showed that after California passed the SB 1449 for the decriminalization of marijuana, youth crime rates were at an all-time low. The SB 1449 allowed for a small possession of marijuana to count as an infraction, instead of a misdemeanor. Within a one-year period from 2010-2011, youth arrests declined by 16% for violent crime, 26% for homicide, and 50% for drug arrests. The author, Mike Males, concluded that the only significant explanations for a dramatic decline in juvenile crime rates would be the passing of SB 1449 and the improvement of socio-economic programs in California’s poor neighborhoods. In the previous reports examined, crime rates, drug and alcohol use, and traffic fatalities were all studied after the passing of MMLs among multiple states to discover any significant effects. While my proposed project would like to examine both crime rates and drug use affected by marijuana, it will look purely at California county data across a 10-year period and will not focus on age-specific crimes. The following report will also include an analysis of how the issuance of medical marijuana identification cards affects other drug and alcohol use, controlling for unemployment. The methodology used to answer the research questions above will be a series of multiple regressions with county and year fixed effects. To begin the analysis, we will determine how MMIC issuance affects crime rates. This regression will include unemployment as a right hand side variable to control for variations in the workforce.

A regression will be run for every type of crime rate, as well as for total crime, in order to discover if marijuana has individual effects on different types of crime. In addition to regressing crime rates on MMICs, drug and alcohol arrest rates will be regressed on MMICs to examine if there’s a substitution effect between marijuana and other drugs and alcohol. Because arrest and crime rates do not depend solely on MMICs, we will also include unemployment rates as a right hand variable. After analyzing the number of MMICs on crime and arrest rates, drug, alcohol, and other mortality rates will be regressed on the number of MMICs issued per county. The point of this is to observe whether or not marijuana has a negative effect on drug and alcohol related deaths, implying that marijuana is a substitute for other drugs. Because cross-sectional data will be used, there are unobservable events that could affect the analysis within that time period. For example, the Great Recession occurred from 2007-2009, which could have possibly increased crime rates. In order to combat time trend errors in the model, I will add annual fixed effects. This will allow the model to absorb any overlooked effects dependent on time. Because California counties are diverse and not all of them implement laws to the same extent, county fixed effects are also necessary for all regressions. By using these fixed effects, we will control for county-specific omitted variables that are time invariant. Relevant county-controlled variables may include the number of police stations or type of legislation implemented within a single county. The main data set we will use is the number of MMICs issued each fiscal year per county. This data was collected by the California Department of Public Health when SB 420 was implemented in 2005. The count of MMICs is updated through September 2015, but we will only use the number of cards issued from 2005-2014 since all other data is given annually. The cards issued each year range from zero to 1475. Because each card is only valid for one year, we assume that these annual numbers include renewed cards. There is a variation in these numbers between counties and time due to the fact that some patients may not have renewed their cards and every county implemented this system at different times. Because it is a voluntary identification system, any significant results would be under estimated. The MMIC data has been converted into number of MMICs issued per 100,000 people, as shown in 7.1.1 of the Appendix, in order for an easier interpretation between variables. It should be noted that some counties did not participate in some years and many others had zero medical marijuana cards issued at the beginning of 2006. Sutter and Colusa counties still have not applied this system and thus have no observations. Because there is no data on medical marijuana cards issued, Sutter and Colusa counties were omitted from all data sets. Table 4.1 below offers summary statistics for the MMICs issued per 100,000. In order to use unemployment as a right-hand side variable in the models, data from the California Employment Development Department was collected and offers per county unemployment rates from 1990-2014. This data will allow us to have a stronger model when examining the given research questions.

Los Angeles was the first county to industrialize dairy production ; the number and size of milk cow herds expanded to supply the rapidly expanding demand for dairy products. By 1925, Los Angeles County was the leading producer of milk in the state, driven by population growth after World War I. The high cost of hauling fresh milk long distances meant dairies were located near the demand for the milk. Scientific advancements in breeding, urbanization squeezing available land for grazing, and the introduction of drylot feeding by Dutch immigrant dairymen also drove the industrialization. Drylot feeding, also known as corral feeding or zero-grazing –essentially the practice of concentrating cows into a small acreage and bringing their food to them – was revolutionary for California dairy production . This practice succeeded in California because the abundance of local agricultural by-products like sugar beets and citrus and the availability of cheap hay made drylot feeding affordable, actually increasing milk production per cow compared to grazing . A quote from the 1946 book California Agriculture written by the University of California College of Agriculture faculty exemplifies this well.The Great Depression almost sank the dairy industry in California; surplus production, price cuts, and unregulated competition between processors, retailers, and farmers became known as the Milk Wars of the 1930s. The government stepped in with a Federal Milk Marketing Order to help regulate national milk prices, but Californians, both farmers and distributors, argued it was a local issue, pushing instead for state legislation.

The Young Act of 1935 set minimum prices for fluid milk in California, stabilizing the industry and increasing profits for farmers . California would maintain its own price regulations under a state MMO, indoor grow rack resulting in less aggregate milk produced , until 2018 when the dairy industry voted to move to the federal MMO . The new stability from the state MMO allowed farmers to invest in new technologies. This included upgrading facilities to have stainless steel and tile for sanitary improvement and, more importantly, introducing machines that milked cows with a vacuum pump connected to a cooler for immediate processing. These upgrades reduced the labor required for milking and enabled herd sizes to grow significantly in number . As urban expansion in Los Angeles increased land values, farmers were able to sell their dairies at high returns and move east towards the Valley, often choosing to buy more land, build new dairy structures, and expand their herds. This cycle of urban encroachment, farm relocation, and herd expansion reoccurred several times during the 1930s and 40s in Los Angeles County, until eventually most of the dairy had moved to San Bernardino . For the same reason 40 years later, dairy farmers in Marin established the first agricultural land trust to protect family farms from urban development pressures in the Bay Area . Between the 1970s and 2000s, California production rates accelerated, surpassing Wisconsin as the leading producer of milk in the 1990s with almost 20% of the U.S. total production . This acceleration is attributed to unique geographic features of California that created ideal conditions for growth, despite several setbacks related to land prices, water availability, and the relatively late start for the industry . The warm climate allowed for large herd sizes without the need to house them indoors during the winters; the nearby crop production of high quality alfalfa and fruit or vegetable by-products, especially almonds-hulls, that helped minimize costs of feed; the geographic isolation of the state requiring sufficient in-state processing facilities; the large and diverse population creating demand and labor for the industry; and the early adoption, or rather invention, of dairy science technology, have all helped bolster and accelerate dairy industry expansion .

Throughout the past two decades, California remained the leading dairy producer in the country and became known for its “megadairies” of more than a thousand cows in a herd . The technological developments and huge herds established a new mode of production for dairies, unlike anything attempted by the traditional dairying states in the Midwest and Northeast. Yet the industry in California is still heterogenous. Organic dairy production is heavily concentrated along the coasts, in Marin, Sonoma and Humboldt, while conventional dairies and concentrated animal feeding operations dominate the Central Valley. Despite the large size of the farms, 99% of dairies are considered family farms1 . The environmental impacts of dairy production are primarily methane emissions from enteric fermentation and manure storage, water quality impacts due to nitrogen and phosphorus excretion from manure lagoons, and water and land use for feed production . California has implemented mandates for reducing greenhouse gas emissions to 40% below 1990 levels by 2030. While California’s agriculture sector makes up a smaller share of GHG emission compared to transportation and energy, its emissions have more than tripled since 1990 . There are currently efforts to reduce methane emissions in dairy production; with state programs that incentivize anaerobic digesters for manure, or alternative manure management practices like composting or separating solids; as well as increasing the productivity per cow to reduce the GHG footprint per unit of milk produced; and research into feeding seaweed supplements to reduce methane gas from digestion . Water quality impacts are acutely felt in the San Joaquin Valley, as drinking water is contaminated with nitrates from agriculture, including manure from dairy concentrated animal feeding operations , which is associated with higher rates of disease and cancer . In Marin County, Conflict over land use for grazing is exemplified by tensions between conservation efforts to re-establish free-ranging tule elk in Point Reyes National Seashore and the long-term beef and dairy producers in the designated pastoral zone . The unique history and geography of California has both supported and challenged the expansion of the dairy industry into the modern day giant of milk production. The following literature review looks at structural changes in dairy production in California, the United States and globally through the lens of political economy.

Fundamentally, agriculture is the production of living things, relying on plants, animals, and life sustaining ecological elements like water, soil, air, and sunlight to grow food, fiber, and fuel. For the entire history of humanity, and even in a modern capitalist society, agriculture and access to food has been, is, and will continue to be essential to the function of society. The expansion of agricultural production and the planned food system has enabled the development of all other sectors of the economy and society. With fewer people producing food as their occupation, ebb and flow system producing more of it is both necessary and opportunistic. The study of food and agriculture is undertaken by many disciplines; biologists, chemists, economists, historians, sociologists, anthropologists, and geographers – this long list exemplifying its complexity and importance. Within the discipline of Geography, and sometimes overlapping with other social sciences, there are several sub-disciplines that attempt to capture and explain the relationships between environmental, economic, political, social, and cultural factors that converge in the production of food. These sub-disciplines include political economy of agriculture, political agroecology, rural agrarian sociology, black food geographies, and sustainable agriculture and food systems, etc. For understanding California’s milk production, I am interested specifically in literature related to: agricultural production, rather than supply chains or consumption; animal agriculture, although CAFOs rely wholly on feed from corn, soy, and hay growers, and benefits from crop production by-products; and industrialized operations, although there remains a small amount of small-holder dairy operations in the state. For understanding the realm of industrialized animal agriculture, that which California milk production lies within, the political economy of agriculture is the most appropriate sub-discipline to contextualize the structures that shape change in the dairy industry in recent history.The political economy of agriculture is a cross-disciplinary concept that deals with the relationship between agricultural production and structural forces. “The political economy of agriculture investigates how “structural changes” in agri-food systems shape the means of production, thereby constraining and/or enabling producers’ decision-making ”. Political economy of agriculture is rooted in liberal and Marxian traditions and the belief that capitalism is the organizing force for agriculture in the U.S. The clearest difference between political economy of agriculture and political ecology of agriculture is that the former focuses more on structures, while the latter leans more toward individual agency and also tends to emphasize topics of environmental conflict and ethics. The following subsections describe three themes of agrarian political economy related to structural changes that shape dairy industries: capitalist penetration of agriculture, productivism, and the treadmill of production.In the production of living things, agriculture presents natural barriers to capital penetration. The Mann-Dickson Thesis states that “[c]apitalist development appears to stop, as it were, at the farm gate” which is to say that the unique nature of agriculture and food production, such as the perishability of food or the long production time compared to labor time, hinder the accumulation of capital in agriculture.

In the pursuit of surplus value, capitalism must transform and subvert these natural processes into a source of productivity, a process known as the real subsumption of nature . In the United States, dairy operations have overcome natural barriers to capital such as perishability, long production time, and waste in the following ways. Fluid milk is highly perishable, which presents many risks to the producer. “The more perishable the commodity is and the greater the absolute restriction of its time in circulation as a commodity on account of its physical properties, the less it is suited to be an object of capitalist production” . Standards for sanitation and food safety, and the interest of prolonging the shelf life of milk, led to the invention of pasteurization and refrigeration. Too little time on the shelf is coupled with too much time for production. The long production time of has been shortened with concentrated feeding to increase weight gain and shorten time until puberty, and the use of hormones to increase the imminence and volume of milk production. That said, unlike most other agricultural products, milk production requires daily ‘harvesting,’ increasing the labor time. Finally, the production of milk inevitably coproduces manure and methane as waste. This becomes problematic under intensified conditions, requiring removal and creating sources of pollution. The generation and concentration of manure produced in large dairy operations is dealt with using flush systems to waste lagoons, resulting in water pollution and methane emissions. These three examples of agriculture’s unique properties that hinder capitalist penetration, but are still overcome with certain interventions, or sub-sumptions of nature, set the stage for the other transformations that have occurred in the dairy industry, detailed below. The concept of productivism, or the emphasis on increasing agricultural production above all else, appears frequently in the literature about dairy production in the Global North. In 1993, Lowe et al. defined productivism as “a commitment to an intensive, industrially driven and expansionist agriculture with state support based primarily on output and increased productivity”. Jay describes how productivist sentiments shaped the New Zealand dairy industry to expand rapidly in the 1980s, resulting in dual pressures to maintain its economic efficiency while reducing its environmental impact. In their summary of three different narratives about the preferred trajectory of milk production in the Global North, Clay and Yurco situate the growth of the US dairy industry in the 20th century as the result of productivism after World War II, couched in language about growing a nation through growing strong bodies with “more milk”. Attitudes of productivism manifesting as the intensification of milk production were, and continue to be, the catalysts for multiple other forms of transformation at the dairy farm and industry.The treadmill of production is a concept coined by Cochrane to explain how economic pressures to lower prices and competition with other producers keeps agribusiness in a constant state of the pursuit of growth. Schnaiberg built on this concept in 1980 by applying the treadmill of production to explain the increasing demand for natural resources resulting in increasing environmental degradation . The use of new technology or resources by early adopters eventually brings a boost in production, which allows that producer to eventually lower their prices, making their product more competitive on the market. To compete, other producers must also adopt the new technology or increase in resource use, until eventually most producers have either invested in the technology or gone out of business because they could not produce enough compete.

We included measures of employment indicating whether respondents were employed, temporarily unemployed or seeking work, or part of a residual category that included retirees, students, and stay-at-home spouses or partners. The study was approved as exempt by the UCSF institutional review board on July 16, 2016. The 2016 survey contained 3,058 respondents. Weighted probabilities of use in each category, by sociodemographic characteristics, are shown in Table 1. Overall prevalence rates were 14.5% for cigarette smoking, 5.6% for ENDS use, and 9.5% for cannabis use. Prevalence of separate use for tobacco and cannabis, for all modalities, was 6.1% and prevalence of simultaneous tobacco and cannabis use was 3.4%. As shown in Table 1, rates of cigarette smoking, ENDS use, and cannabis use were higher for men than women. Rates of cigarette smoking and combined cannabis and tobacco use decreased with higher levels of education, but were not associated with higher education levels for ENDS use, cannabis use, or combined use. Rates of cigarette smoking, ENDS use, cannabis use, and combined use were highest among those unemployed and seeking work and persons with disabilities, relative to those who were employed or retired. Over half of cigarette smokers who initiated smoking over the age of 18 reported smoking in the past 30 days.For cigarette smoking, there was a lower odds ratio among those with at least a bachelor’s degree and those with household incomes greater than $100,000, as shown in Table 2. There was a significantly greater odds ratio among persons with disabilities and those who had begun smoking at 15 or older. For ENDS use, grow tables 4×8 there was a significantly lower odds ratio among those aged 55 or older. For all cannabis use, women were approximately half as likely to use as men .

Additionally, those with household incomes from $25,000–$49,999 were half as likely to use cannabis as those who had incomes of less than $25,000 . For combined tobacco and cannabis use, there was a significantly lower odds ratio among some lower-income groups. There was a significantly greater odds ratio for those who were unemployed and seeking work. For using tobacco and cannabis simultaneously, there was a significantly lower odds ratio for those with incomes $25,000–$49,999 and greater than$75,000. There was a significantly higher odds ratio for those who were unemployed and seeking work or and persons with disabilities. Past research has identified the practice and consequences of simultaneous tobacco and cannabis use among adolescents, however there has been limited data on the prevalence of this practice in different population subgroups or relative to other consumption, such as use of individual substances or separate use . Existing research suggests that young adults may be more likely to engage in simultaneous use, particularly given the increase in new modalities of use , however surveillance data has not yet verified this expectation . Our findings suggest that in contrast to findings from previous research, rates of simultaneous use may be highest among those who were involuntarily unemployed and persons with disabilities rather than among youth. We also found that more people used either cannabis or ENDS than smoked cigarettes, despite the relative novelty of these products. These results suggest a transition toward modalities that allow simultaneous use, a trend that could continue or accelerate as these novel products become increasingly normalized. Research on simultaneous use suggests that such a transition would lead to more dependence and reduced quit attempts , a concern given that these sub-populations are likely to have lower income and co-occurring conditions . Our findings have limitations. The data are based solely on California residents and responses reflect a policy environment that for 20 years has focused on reducing tobacco use and increasing access to medical marijuana.

These policy changes preceded similar changes made in many other states, suggesting that these data , primarily provide insight into how use patterns may change over time in those states that also legalized medical marijuana prior to recreational cannabis. Survey responses were based on self-report and did not biochemically validate responses; previous research suggests that respondents may under report use . As a result, our findings may have failed to identify other groups at risk of simultaneous use. As states continue to legalize medical marijuana and recreational cannabis, it is critical to monitor shifts in patterns of tobacco and cannabis use. Adolescents and young adults have been a focus of prior research, particularly in light of their susceptibility to uptake of novel delivery devices such as JUUL . However our findings suggest that young adults are not necessarily the population with the highest prevalence or highest risk of simultaneous use. Simultaneous use is linked with more severe consequences than using tobacco or cannabis alone, or with separate use of these products. Our findings that simultaneous users in California were not disproportionately young adults are relevant for developing targeted prevention and cessation interventions for individuals at high risk. In addition to emphasizing risks faced by adolescents and young adults, our findings suggest that public health interventions should expand their focus to address other vulnerable populations, including persons who are involuntarily unemployed and those with disabilities. Disproportionately more rural veterans are enrolled in Department of Veterans Affairs healthcare than their urban counterparts . Most rural veterans receive care from smaller VA community based outpatient clinics established by VA expressly to improve access to care, including mental health care. Rural veterans who utilize VA community-based clinics are typically older, sicker and poorer, and experience significantly greater MH burden and poorer clinical outcomes than their urban counterparts receiving care at VA medical centers. 

VA mandates that all veterans, including those receiving care at VA community-based clinics, have access to evidence-based MH treatments. Minimally adequate MH treatment has been defined as ≥ 8 MH treatment sessions or receiving ≥ 2 months of psychiatric medication plus > 4 visits within 1 year. Nevertheless, despite access to VA community-based clinics, rurality remains one of the strongest predictors of poorMH treatment engagement. Roughly, only 20% of rural veterans with MH conditions initiate any MH treatment and even fewer complete a full course of evidence-based MH treatment. Rural veterans’ lack of engagement in MH treatment reflects a myriad of logistical barriers, paramount among them geographical distance, and lack of access to consistently available MH services. Other barriers are cultural norms in rural communities, including negative beliefs surrounding MH treatment, stigma against needing or seeking MH treatment, and stoicism, with rural veterans preferring to address MH and emotional problems within their own communities, families, and religious organizations. Motivational interviewing is an evidence-based approach to facilitating behavioral change, and multiple studies over decades have demonstrated MI’s effectiveness for MH treatment engagement among veterans. One pilot trial of 73 younger Iraq and Afghanistan veterans who screened positive for MH symptoms demonstrated that 4 brief sessions of telephone MI conducted by trained research staff resulted in 62% initiating MH treatment versus 26% assigned to receive 4 brief neutral telephone sessions . Of note, this trial was conducted in younger, urban veterans by research staff with backgrounds in psychology. However, none of these trials were conducted among rural veterans who might experience greater barriers to MH treatment engagement. In addition, ebb flow tray most prior trials have used MH clinicians to deliver MI. There is emerging evidence that peers who may have shared experiences and “speak the same language” as the populations they serve may encounter less resistance and be more effective in promoting positive change, including engagement in MH care, especially in rural populations. Here, we describe the results of a multisite pragmatic randomized controlled trial , “Motivational Coaching to Enhance Mental Health Engagement in Rural Veterans,” hereafter abbreviated as “COACH.” The trial tested a veteran peer-delivered telephone motivational coaching intervention for veterans receiving care atpredominantly rural VA community-based clinics in either Northern California or Louisiana who had screened positive for ≥1 MH symptoms but were not engaged in MH treatment. We hypothesized that veterans who received MI-consistent feedback about MH screen results and MH referrals plus several sessions of veteran peer delivered telephone motivational coaching would be more likely to engage in clinician-directed MH treatment than veterans who received MH screen results and a referral without motivational coaching . Secondarily, we hypothesized that veterans assigned to veteran peer-delivered telephone motivational coaching would experience improvements in MH symptoms, quality of life indicators, and self-care as a direct effect of peer coaching itself compared to those randomized to the control condition. Qualitative exit interviews of participants in the intervention arm were conducted to better understand trial results.VA administrative databases were used to identify veterans with the following criteria: had received primary care within 1 year of study enrollment at 1 of 8 participating VA community-based outpatient clinics: 4 facilities in Northern California and 4 in Louisiana ; and had screened positive on ≥ 1 VA MH screens or had received ≥ 1 MH diagnosis, but had never attended an MH visit , or had attended up to 2 MH visits , but without follow-up within 90 days of recruitment.

Veterans identified through VA administrative data were mailed a study information sheet and a postcard they could mail back to indicate interest in study participation. If participants indicated interest or if no postcard was received after 2 weeks, study staff attempted to contact veterans by phone. In addition, VA community-based outpatient clinic providers were encouraged to refer patients to the study and flyers were posted in their clinics. Veterans deemed eligible and interested on initial telephone screening underwent informed consent prior to enrollment. Participants were enrolled from October 29, 2015, to October 19, 2017, and the study concluded June 1, 2018. The study protocol was approved by the VA Central Institutional Review Board and the local Research and Development Committees at the participating VA enrollment sites.60-min baseline assessment by telephone to collect baseline data and verify trial eligibility. Information was collected on sociodemographics, VA service connection/disability status, and prior VA and non-VA mental health treatment experiences in the past 5 years and past 60 days. Psychometrically valid assessment instruments with published cut points were used to determine participants’ symptom status for 5 target MH disorders: posttraumatic stress disorder , depression , anxiety , panic disorder , and alcohol and illicit substance use . Additional instruments were used to assess: quality of life across 4 domains: physical health, psychological health, social relationships, and environment ; importance, confidence, and readiness for MH treatment; and logistical, stigma- and beliefs-related barriers to MH treatment . Results from the telephone baseline assessment were entered directly into a web-based data collection system and scored in real time to verify non-MH treatment-engaged participants who screened positive for ≥ 1 MH problems, thereby confirming trial eligibility. This was defined as: scoring in the “mild” range on at least 2 MH screening instruments ; or scoring in the “moderate” range on at least 1 MH screening; or scoring in the “mild” range for at least 1 substance and in the “mild” range on at least 1 MH screen.The study was a single-blind, 2-arm pragmatic effectiveness RCT comparing MI-styled veteran peer-delivered feedback on MH screen results and referrals plus 4 sessions of telephone motivation alcoaching versus veteran peer-delivered MH results and referrals without motivational coaching . The study was designed as a Hybrid Type 2 pragmatic implementation effectiveness study, in which the implementation of the trial intervention was tailored to meet the needs, resources, and preferences of stakeholders at each VA community-based clinic study site. Thus, prior to trial implementation, a formative evaluation was conducted at each of the 8 VA community-based clinic sites, beginning with qualitative interviews with study stakeholders—veterans and VA staff—to understand barriers and facilitators of MH treatment for veterans at the clinic and in the local communities. Subsequently, the study team convened lunchtime meetings with study stakeholders at each of the VA community-based clinics to review evidence for the motivational coaching intervention, provide feedback from the qualitative interviews, and to engage study stakeholders in decision making about flexible components of the trial. For instance, some clinic stakeholders preferred to be more involved with recruitment efforts than others. Also, in this formative stage, the study outcomes related to MH treatment engagement were broadened to reflect rural veterans’ preferences for self-care activities based on input from VA stakeholders at the 8 participating VA community-based outpatient clinic sites.