 Hello, I'm Marcia Joyner, and welcome, welcome to Cannabis Chronicles, a 10,000 year odyssey. So tell me, Muse, of that plant of many resources, was wondered far and wide the ancient plant of food, fuel, fiber, cultivated for millennial. As we venture through the past 10,000 years, we will explore and discover the plant which derives cannabis. The plant is hemp, cannabis, hash hash, hashish, hashish, cannabis and religion, cannabis and medicine and cannabis and Uncle Sam, oh my dear, dear, dear. And so our odyssey begins. Today our odyssey is not long ago and far away, it is current and it is progress. And we are doing this old dance with Uncle Sam. So our guest today, Dr. Otto, is an advocate for medical marijuana use and has been working with the Hawaii State Legislature to get it right since 2012. And so we want to talk to him today, not only, he's a real doctor and an ophthalmologist I think. Correct. But we want to talk to him today about Schedule 1. What that means, how the government has taken a plant, a weed as it was, that God gave us, it was here when we were here. So a Schedule 1. We want to talk to the doctor about what is a Schedule 1, what is called, why are we defining this weed as a Schedule 1? And what else is on Schedule 1 and how do we move from Schedule 1 to just plain ordinary everyday kind of, can we use this as a medical healing. So my guest today is Dr. Cliff Otto, who is a graduate of New York Medical School, did his transitional internship in the Army, how long were you in the Army? Total of eight years on active duty. Great. And now you are here practicing, so you go from island to island because we were trying to catch you between islands. Yes. I travel every week primarily to the big island in Maui, seeing our retina patients over there, folks with diabetes and macular degeneration who are plentiful unfortunately and in need of a lot of attention, so that keeps me pretty busy. So that's a great idea because those neighbor islands are so in need of all kind of medical attention. Yes. How long have you been involved with cannabis? Well my journey into the medical use of cannabis began around 2012 when a friend was diagnosed with colorectal cancer and had to undergo chemotherapy for reduction of the tumor and then surgery and then additional chemotherapy after surgery. And he turned to cannabis to help with the pain, with the nausea because of his loss of appetite and found remarkable benefit. And that was really my first direct experience with how this can be used medically. And I believe that because of his medical use of cannabis that really saved his life because otherwise his appetite would have been so bad that he would have stopped eating, he would have lost weight, his immune system would have dropped out and then he probably would have succumbed to secondary infections. So I was very impressed with how that was able to assist in his overall medical care and I started doing some research online looking at peer reviewed articles and I was amazed at how much has actually been done. There was a significant amount of research done back in the early 70s when it looked like this might become more available and accepted until everything got shut down with the prohibition of this substance and so I looked at the medical side and that motivated me to then look at the legal side to see how our patients could get access to this substance and use it safely and effectively. And that's when I really became more of an advocate because I was exposed to all of the limitations of our current law and how it's actually hurting our patients. But now like a program is 10,000 years. So we've known about this around the world. This is nothing new or foreign or whatever you. So what happened? What happened somewhere in between? Henry Ford, his first car was made of hemp. The fuel for the car was hemp. The Indian, in India, in China, they've been using it for thousands of years. What happened in America somewhere in there? Somebody said let's don't do this. The paper that the Declaration of Independence was hemp. What happened? Well, I think you've already shown very clearly on your previous shows that a lot of this started in the 1930s with a conscientious effort to remove hemp from our industries. And so probably since you've already documented that, a good place to start might be 1970 where significant changes were made in how our country regulated controlled substances. Because at that time there were several different laws in effect that tried to regulate controlled substances and also consider international obligations. And so in 1970s when the federal controlled substance act was created. And that is, I see as a very substantial step towards leading to where we are now. Because that's set everything in motion and set up certain standards that we're still battling against. Because, I don't know, it just seems crazy that it would even be listed as a controlled substance. Well, actually I don't think it's crazy at all. If you look at how the controlled substance act came into effect, it makes total sense that marijuana is still in schedule one. Because when the federal controlled substance act was created, marijuana at that time did not have any accepted medical use. There had not yet been any state that it's accepted the medical use of marijuana under state law. So because you have these certain criteria for these different schedules, Congress had to look at where marijuana would fit into that structure. And because it had no accepted medical use, and because a substance must have accepted medical use in order not to be in federal schedule one. They put it in federal schedule one pending the Schaefer report, which came back and said it should probably be decriminalized. President Nixon threw that out, and thereby doomed marijuana to be in federal schedule one. And ever since that happened, there have been groups that have been fighting and petitioning to try and remove marijuana from that schedule. Well, now if we go back to Nixon, that whole thing was during the anti-Vietnam movement. That was, and I think it was racist, because people were using marijuana during that whole era of anti-war, and that was a way to put those people in jail. Sure. And the tapes that have been released certainly document that prejudice on the President's part. Yeah. So I'm not sure, when you mentioned that, okay, now things are beginning to make sense. However, in my learning process, because all of this is new to me, I found that the federal government owned a patent in 1945 that said this was had medical benefits. But they are a patent. Sure. And yet they say, well, there's no medical benefits. Well, that's because the way that the Drug Enforcement Administration and the FDA look at this substance, they only consider that something has medical use if it has gone through controlled clinical trials. And that's something that the FDA controls. So it makes total sense that they do not consider that it has accepted medical use because of their way of judging that. But what we need to realize is that FDA approval is only one type of medical use. And we know there are at least three types. There is FDA-approved medical use. There is grandfathered medical use, as in aspirin. Aspirin has never gone through clinical trials in FDA approval and is used worldwide and isn't even in controlled substance. And it's a bark of a tree. Exactly. And then we have cannabis, which has been accepted under state law. And so state-accepted medical use is the third type of medical use. Unfortunately, the Department of Justice and the DEA do not want to recognize that type of medical use. And quite frankly, I don't think it's their responsibility to do that. I would point to the states that have exercised their authority to accept the medical use of controlled substances. Here we are now. The state approved this in 2000, and this is 2017. And we're still knocking on the door. What is it going to take? I know you've been at this since 12, so that's a lot of time. What is it going to take for the state to move? Now the health department is terribly slow. Not only this issue, lots of issues. So what do we have to do? Well, how do we support your effort? What do we have to do? Well, I think we have to be very careful about the wording when we talk about this issue. When you say approved, and people will say, well, they legalized medical marijuana. I think the better way to say that would be the state accepted the medical use of marijuana in 2000 because of its sovereign authority to accept the medical use of controlled substances. And that's an authority under our system of government known as federalism, where certain rights are retained by the states and certain rights are delegated to the federal government. And in this case, the authority to accept the medical use of controlled substances rests with the state. In fact, we even have a Supreme Court case in Oregon or Gonzales versus Oregon in 2006 in which the Supreme Court decided and confirmed that the Department of Justice does not have the authority to declare illegitimate a standard of medical care accepted under state law. And so the action that needs to be taken is on the part of the state. And I've been trying to work with our state lawmakers who, as you said, are slow to change and slow to accept a different way of thinking. And you almost have to flip this whole issue upside down and look at it from a state rights point of view instead of a federal governing large body that we're just waiting for them to do something. Well, we are going to take a break. And when we come back, we will talk more about this marvelous weed called cannabis. Thank you so much. This is Stink Tech, Hawaii, raising public awareness. Guys, don't forget to check me out right here at the Prince of Investments, I'm your host, Prince Dyke, each and every Tuesdays at 11am, Hawaii time. I'm going to be right here. Stop by here from some of the best investment minds across the globe and real estate, finances, stocks, head funds, managers, all of that great stuff. Thank you. Freedom. Is it a feeling? Is it a place? Is it an idea? At Diveheart we believe freedom is all of these and more regardless of your ability. Diveheart wants to help you escape the bonds of this world and defy gravity. Since 2001, Diveheart has helped children, adults and veterans of all abilities go where they have never gone before. Diveheart has helped them transition to their new normal. Search Diveheart.org and share our mission with others. And in the process, help people of all abilities imagine the possibilities in their lives. Welcome back. I'm Marcia and we are visiting with Dr. Cliff Otto. And he is championing moving medical cannabis from a schedule one to something that we can all live with. So, tell us, how do we move with the state? Now, with state's rights, the Supreme Court says the state can do this even if Jeff Sessions is trying to interfere with that. Can we make this trip with the state to leave Jeff Sessions in D.C.? What can we do? Well, actually, I think it would probably be a good idea to include Attorney General Sessions in all of these discussions because when the state was first contemplating this medical program in 2000, it left the Department of Justice completely out of discussion, assuming that the federal government wouldn't approve it so I even ask them. And I think that's a bit of a mistake given the impact that state medical use can have upon the Federal Control Substances Act. And so a lot of folks will say, well, federal law always preempts state law. And that's true when you have a conflict between the two. But in this case, I'm trying to point out that there is no conflict between our state law, our state medical cannabis law, and the Federal Control Substance Act because the Federal Control Substance Act says that if a substance has accepted medical use, it cannot be in Schedule 1. And our state law says that it does have medical use. So they're actually in agreement. The conflict is with a federal regulation, an outdated federal regulation that still has marijuana on the Schedule 1 list and an interpreted rule that the DEA adopted before any state had accepted the medical use of marijuana that they had to make up in response to some lawsuits. And they created on their own, without Congress's input, this what's called the five-part test. And one of those tests is the substance has to have gone through clinical trials, controlled clinical trials before we can say that anything has accepted medical use. And we have to keep in mind that that is an interpretive rule by an administrative agency. And an administrative agency's interpretive rule does not preempt state law. And this is the way the Controlled Substances Act was created by Congress with the intent that states, being the experiment where we work on some of these issues and changes in our society, are allowed to occur and then they can impact upon federal regulation. And in this case, our state has accepted the medical use of marijuana, but hasn't taken the next step. And so we have this direct conflict between the state and federal regulation of marijuana, which is creating all of the problems that we're seeing right now with dispensaries operating under the assumption that they're violating federal law, with banks not being able to get involved, with the Veterans Administration not allowing its doctors to do these certifications. So that's where we really need to focus is looking at the law. And it might be a little strange for a doctor to say, well, this is not a matter of science because the DEA has its own studies that it's doing that can support keeping it in federal schedule one. This is about the law and about how state law directly affects the Controlled Substances Act. Well, when you look at the, what is that called? The oxycodone, all of those opiates. If those things are legal, how is it that this ordinary plant, it just blows my mind that those things went through clinical trials? Yes. And that's why they have accepted medical use because of those. It has nothing to do with degree of danger. The previous acting director of the DEA in response to a petition from Rhode Island in Washington said, degree of danger has nothing to do with federal scheduling. It's about these criteria. And he even recognized that there are substances in lower schedules that are more dangerous. But that's not the way the criteria works in the Controlled Substances Act. What are those substances in schedule one? What are those? Well, there's quite a list actually, but people point to heroin, LSD, and marijuana is the three top ones. And you could also argue that LSD probably shouldn't be in there with some of the data coming out on its use in psychotherapy. But that's a different topic entirely. But they're holding these substances in schedule one based on their policy that substances have to go through controlled clinical trials before they can have accepted medical use. And in this case, we're in a very unique situation where our state and over half the states in the Union have given medical use to a schedule one controlled substance. That's never happened before. And that's why we're in this situation that we're at because people are assuming just wait for the feds to do something first. And I don't believe that's the way to go. Again, Doctor, would you please tell us again about what the Supreme Court ruling was about the state's rights so I get it clear? Sure. This was a case in Oregon where the state had given medical use to a schedule two controlled substance for aid in dying. And the Attorney General issued a rule saying that was not the practice of medicine. It was illegal. And so the state and the Attorney General got into a series of court cases and went all the way to the Supreme Court. And as I mentioned, the Supreme Court in its ruling determined that the Department of Justice does not have the authority to declare illegitimate a standard of medical care accepted under state law. So that tells us that's a key piece because that tells us that states do indeed have the authority to accept the medical use of controlled substances and that that authority and that change in medical use can have an impact on federal law. And so right now we're in this situation where we've given marijuana accepted medical use but we haven't taken that next step to reharmonize the federal and state regulation of this substance. How can we ordinary citizens, how can we help? What can we do? Because this makes perfect sense, especially when you mentioned Oregon and aid in dying because cannabis would go so far in assisting patients at the end rather than the morphine. It would be so much, death would be so much easier than this sedation, this constant sedation with morphine. Okay, all right, never mind. Yes. So what can we do? We are at a point now where people across Hawaii are interested. If you see the lines in front of the dispensary for people waiting to buy the numbers of people that have cards, cannabis cards, is that what it's called? The registration card. Registration card, which is the state issues. Of course the state has to make money on it. And when you look at the numbers of people that are interested, how can we, that cadre of people, how can we help? What can we do? Well, I think the first thing we need to do is stop pointing fingers at the DEA because a lot of people are blaming Attorney General Sessions for where we're at right now. And I think he's just carrying on the tradition and the policy that they've had for a long time and following the Federal Controlled Substance Act to the degree that he is because states are not going back to them and saying, no, this has accepted medical use, something needs to change. So ultimately, I think it comes back to the individual citizen and resident because it's our government. And we've become so absorbed in our smartphones and all of our distractions that we've lost sight of that. And we're letting other people run our government for us who are not listening to what's important. So I think the first thing to do is for patients to say that they're fed up with being labeled as violating federal law. I don't think anybody should exist under the assumption that they're federal criminals. I'm very sensitive to that subject because of my own medical license. So I'm always looking at trying to protect our patients and trying to correct this situation. So if you look at our State Medical Use of Cannabis Act, there are very few protections for our patients. There's an affirmative defense if they get arrested. But what if somebody comes and steals their plants? What if they're getting raided by these rogue groups that are flying around and stealing plants at harvest time? We need protections in place for our patients. And we also need the state to recognize in our statuette that state medical use is currently accepted medical use in treatment in the United States. I believe that statement needs to be in our law and I believe that that would put the onus back on the Department of Justice. And I think if our state took that step, which would require our lawmakers to allow that bill to be heard, which is quite a challenge, and allow and get some support from the governor and from our Attorney General, who I feel should be supporting states' rights on this issue. If we can get that into our law, then that puts the onus on the Department of Justice and they can either remove marijuana from Federal Schedule I, which would be a huge step and probably something they don't want to do right now, or they could exempt Hawaii, Hawaii's medical use of cannabis program from enforcement of Federal Schedule I, which would mean it would be very clear that we are not violating federal law. And we can still have all the regulations in place and allow banking to come online, allow insurance companies to possibly be involved. So I believe it takes a concerted effort from our patients, and it's difficult for our patients because they're ill. They're doing whatever they can to take care of themselves, but we need a concerted effort to get our lawmakers and our governor to realize that this is something that has to change as soon as possible. The governor seems to be on our side. Seems to be. And since he's running for reelection, maybe this is the time to go see him. Well, we're just about out of time. Will you come back and talk more with us? Oh, I'd love to. Because we have to make this happen, and we can only do that if someone like you will step forward. Again, thank you, Dr. Oda. Aloha, this has been a real pleasure, and we will see you next week. Aloha.