HomeMy WebLinkAbout12052017 - packet CITY OF UKIAH
PLANNING COMMISSION AGENDA
Regular Meeting
CIVIC CENTER COUNCIL CHAMBERS
300 Seminary Avenue
Ukiah, CA 95482
December 5, 2017
6:00 p.m.
1. CALL TO ORDER
2. ROLL CALL
3. PLEDGE OF ALLEGIANCE
4. APPROVAL OF MINUTES
a. The Minutes of November 8, 2017.
5. APPEAL PROCESS
All determinations of the Planning Commission regarding major discretionary planning
permits are final unless a written appeal, stating the reasons for the appeal, is filed with
the City Clerk within ten (10) days of the date the decision was made. An interested party
may appeal only if he or she appeared and stated his or her position during the hearing
on the decision from which the appeal is taken.
6. COMMENTS FROM AUDIENCE ON NON-AGENDA ITEMS
The Planning Commission welcomes input from the audience. In order for everyone to be
heard, please limit your comments to three (3) minutes per person and not more than ten
(10) minutes per subject. The Brown Act regulations do not allow action to be taken on
audience comments.
7. SITE VISIT VERIFICATION
8. VERIFICATION OF NOTICE
9. PLANNING COMMISSIONERS REPORT
10. C,5C❑725C6[� �3257�
11. CONSENT CALENDAR
12. NEW BUSINESS
a. Discussion and Possible Action Regarding the Cancellation of a Regular Meeting of
the Planning Commission on December 13, 2017.
13. UNFINISHED BUSINESS
14. ADJOURNMENT
ADA ACCOMODATION: If you plan on attending the public hearing and need a special
accommodation because of a sensory or mobility impairment/disability, or have a need for an
interpreter, please call Cathy Elawadly at the City of Ukiah at (707)463-6752 to arrange for those
accommodations to be made.
Page 1 of 1
CITY OF UKIAH
PLANNING COMMISSION MINUTES
Regular Meeting
CIVIC CENTER COUNCIL CHAMBERS
300 Seminary Avenue
Ukiah, CA 95482
November 8, 2017
6:00 p.m.
COMMISSIONERS PRESENT COMMISSIONERS ABSENT
Mike Whetzel, Chair
Christopher Watt
Laura Christensen
Mark Hilliker
Linda Sanders
STAFF PRESENT OTHERS PRESENT
Craig Schlatter, Community Development Listed below, Respectively
Director
Kevin Thompson, Planning Manager
Adele Phillips, Associate Planner
Darcy Vaughn, Assistant City Attorney
Cathy Elawadly, Recording Secretary
1. CALL TO ORDER
The regular meeting of the City of Ukiah Planning Commission was called to order by
Chair Whetzel at 6:00 p.m. in the Council Chambers of the Ukiah Civic Center, 300
Seminary Avenue, Ukiah, California.
CHAIR WHETZEL PRESIDING.
2. ROLL CALL
Roll call was taken with attendance as listed above.
3. PLEDGE OF ALLEGIANCE
Everyone recited.
4. APPROVAL OF MINUTES
a. The Minutes of October 25, 2017.
M/S Sanders/Hilliker to approve the Minutes of October 25, 2017, as submitted.
Motion carried by the following roll call vote: AYES: Sanders, Christensen, Hilliker,
and Chair Wetzel. NOES: None. ABSENT: None. ABSTAIN: Watt.
5. COMMENTS FROM AUDIENCE ON NON-AGENDA ITEMS
6. APPEAL PROCESS
Note: For matters heard at this meeting the final date to appeal is November 20, 2017,
at 5:00 p.m.
7. SITE VISIT VERIFICATION
Page 1 of 5
Minutes of the Planning Commission, November 08, 2017, Continued:
8. VERIFICATION OF NOTICE
9. PUBLIC HEARING
a. Dogwood Dispensary ❑Request for review and approval of a Dispensary Use Permit
to operate a Medical Marijuana Dispensary at 904 N. State Street; APN 001-351-39.
File No.: 2652-UP-PC.
Presenters: Craig Schlatter, Community Development Director and Adele Phillips,
Associate Planner.
Associate Planner Adele Phllips advised the applicant has chosen to withdraw their
application due to lack of public support.
PUBLIC HEARING OPENED: 6:03 P.M.
Public Comment: None.
PUBLIC HEARING CLOSED: 6:03 P.M.
Note:
• Public member Robert Werra, M.D., submitted written correspondence received by
Planning staff on November 07, 2017, incorporated into the minutes as
�1A6�1�FiC�7�
9.
b. Review of the proposed Cannabis Related Business Ordinance, and possible
recommendation to the City Council.
Presenters: Craig Schlatter, Community Development Director, Kevin Thompson,
Planning Manager, and Darcy Vaughn, Assistant City Attorney.
Power Point presentation given by Kevin Thompson, Planning Manager.
PUBLIC HEARING OPENED: 6:31P.M.
Public Comment: Kitie Sommers, Robert Werra, Councilmember Jim Brown,
Councilmember Maureen Mulheren, Memo Parker.
PUBLIC HEARING CLOSED: 6:41P.M.
There was Planning Commission discussion concerning the Cannabis Related Business
Ordinance relevant to commercial cannabis uses and corresponding definitions from the
Medicinal and Adult Use Cannabis Regulation and Safety Act (MAUCRSA) provided for in
Attachment 2 (CalifornlD��RP P F�&lf.X[� C�Po�lI�M7� LFF-K��LQI�'CSM/❑of the staff report in
connection with the proposed corresponding zoning districts listed on page 1 of the staff
report that would require approval of a Major Use Permit.
It was the consensus of the Planning Commission regarding the Cannabis Related
Business Ordinance that further consideration be given to:
• Possibly slowing down the process of adopting the Cannabis Related Business
Ordinance;
Page 2 of 5
Minutes of the Planning Commission, November 08, 2017, Continued:
• Possibly limiting certain use types to the Heavy Commercial (C-2) and
Manufacturing (M) zoning districts and determine whether these particular uses
should be allowed by right or require a Major or Minor Use Permit and establish a
distance requirement from residential areas that may border the Heavy Commercial
(C2) and Manufacturing (M) zoning districts;
• Consider establishing an Overlay Zone where such commercial cannabis uses
would be a better fit;
• Would like to see a one-year review of any approved Minor or Major Use Permit for
the permitted use types as defined in Attachment 2 of the staff report allowed to
operate in the prescribed zoning districts.
• Would like the Cannabis Related Business Ordinance to be reviewed annually.
Planning Manager Kevin Thompson:
• Acknowledged the aforementioned discussion and noted the creation of an Overlay
Zone would require going through the Zoning Code and General Plan Amendment
process.
The Planning Commission provided recommendations to City Council regarding Cannabis
Related Business Ordinance Amendments from the November 8, 2017 meeting as follows:
1. In the Heavy Commercial (C2) and Manufacturing (M) zoning districts, on locations at least
250-feet from residential parcels (measured from parcel line to parcel line)the following would
be allowed with a Minor Use Permit:
a) Manufacturing - Level 1 (Nonvolatile) for sites that manufacture cannabis products using
nonvolatile solvents, or no solvents.
b) Testing Laboratory- A laboratory, facility, or entity that offers or performs tests of cannabis
or cannabis products.
c) Distribution- The procurement, sale, and transport of cannabis and cannabis products
between permitted and licensed cannabis businesses for the distribution of cannabis and
cannabis products.
2. In the Heavy Commercial (C2) and Manufacturing (M) zoning districts, on locations at least
250-feet from residential parcels, (measured from parcel line to parcel line)the following would
be allowed with a Major Use Permit:
a) Specialty Indoor-for indoor cultivation using exclusively artificial lighting, between 501 and
5,000 square feet of total canopy size on one premises.
b) Specialty mixed-light- for cultivation using a combination of natural and supplemental
artificial lighting at a maximum threshold to be determined by the licensing authority,
between 2,501 and 5,000 square feet of total canopy size on one premises.
c) Specialty cottage- for cultivation using a combination of natural and supplemental artificial
lighting at a maximum threshold to be determined by the licensing authority, 2,500 square
feet or less of total canopy size for mixed-light cultivation, up to 25 mature plants for outdoor
cultivation, or 500 square feet or less of total canopy size for indoor cultivation, on one
premises.
Page 3 of 5
Minutes of the Planning Commission, November 08, 2017, Continued:
d) Nursery- means a licensee that produces only clones, immature plants, seeds, and other
agricultural products used specifically for the propagation and cultivation of cannabis.
Maximum canopy of 5,000 square feet.
e) Cannabis Microbusiness- A Cannabis Related Business operating under a state Type 12
license for microbusinesses, or a state cannabis license type subsequently established,
DQO�I-HI�Q1J�PAJ-iC�i LC�1�Q�I C�P LF �X�DQQ�19�1�RC�i❑
§26070(a)(3)(A), as may be amended from time to time, which cultivates less than 5,000
square feet of cannabis and acts as a licensed distributor, Level 1 manufacturer, and
retailer on the same Premises. A Cannabis Microbusiness that also acts as a Cannabis
Retailer must also comply with the provisions of Division 6, Chapter 8 of the Ukiah City
Code.
Motion/Second Hilliker/Sanders to provide direction to City Council regarding the proposed
Cannabis Related Business Ordinance, as discussed above. Motion carried by the following roll
call votes: AYES: Christensen, Hilliker, Sanders, Watt, and Chair Whetzel. NOES: None.
ABSENT: None. ABSTAIN: None.
Break: 8:00 P.M.
Reconvene: 8:06 P.M.
10.
a. Consider Adoption of Resolution Adopting Procedures of Conduct for Conducting
Planning Commission Meetings and/or Consider Adoption of Resolution Adopting
Order of Agenda for Planning Commission Meetings.
Motion/Second Sanders/Christensen to adopt Resolution 2017-01 adopting Procedures
of Conduct for Conducting Planning Commission Meetings and adopt Resolution 2017-02
establishing the agenda order for Planning Commission meetings in accordance with the
requirements of the Procedures of Conduct for Planning Commission meetings.
Motion carried by the following roll call votes: AYES: Christensen, Hilliker, Sanders,Watt,
and Chair Whetzel. NOES: None. ABSENT: None. ABSTAIN: None.
b. Discussion and Possible Action Regarding the Scheduling of a Special Meeting of the
Planning Commission on November 16, 2017 and Cancellation of a Regular Meeting
of the Planning Commission on November 22, 2017.
Motion/Second Sanders/Christensen to adjust the Planning Commission meeting
schedule for November and December 2017, as follows:
• Cancel the regular Planning Commission meeting of November 22, 2017;
• Next Planning Commission meeting (special meeting) is December 5, 2017;
• Cancel the regular Planning Commission meeting of December 27, 2017.
Motion carried by the following roll call votes: AYES: Christensen, Hilliker, Sanders,Watt,
and Chair Whetzel. NOES: None. ABSENT: None. ABSTAIN: None.
Note:
• The Planning Commission will meet on the regular meeting day of December 13,
2017.
11. 3/ C1 1 ,1 C�,5❑�72 5[$�❑32 57
Page 4 of 5
Minutes of the Planning Commission, November 08, 2017, Continued:
Presenter: Craig Schlatter, Community Development Director.
12. PLANNING ❑2 0 0 ,66,2 1 C56�❑32 57
Presenter: Commissioner Mark Hilliker.
13. ADJOURNMENT
There being no further business, the meeting adjourned at 8:31 p.m.
Cathy Elawadly, Recording Secretary
Page 5 of 5
At#nchment # �_
THE PRESS DEMOCRAT• SUNDAY, SEPTEMBER 24, 2017 -
'�� Courcil wants to preserve ���IS
��5��' warehouse space, also
bans outdoor potgrowtng CONTIIVUED FROM A3
������A]'� gy�,p��pN are more than a dozen up commercial real es-
V�� r��xsss n�rcocxnr other conditlons such as tate prices and rents.On
' complying with electri- Wednesday,only a couple
C������ The largest city in northern cal, plumbing and fire of people addressed the
Sonoma County is saying"no" codes,filtered ventilation council on the topic with-
to max�juana — no dispensa- to prevent mar�juana out voicing any dissexit
ries, no cannabis businesses odors, and security mea, 'Tm glad we didn't
� and no outdoor cultivation. g�s, chase the gold ring of
���P�� The Windsor Town Councii Most of the discus- mar3juana tax that seems
�r last week unanimously intra sion centered to be the 1►xre
duced an ordinance prohibiting on enforcement, for the county
any type of marijuana busi- with the cou.*�- :� and other jur�s-
nesses within dl agreeing that ` , dictions," said
�y-..
city limits, in - any unautho- +""' . Bill Adams, vice
part to pre- � rized culfivation � ,- president of the
serve ware- � could be subject —�-r Windsor UniBed
house space ^*� 4.k to a fine of up to school board.
from being $1,000 per plant He said allow-
gobbled up by '�-� for each day the g�� ing commercial
the newly le- : violation re- p�p{�e grows and man-
J�o �� galized indus- ' mains unabated. ufacture of mar-
tr'3'• p�� � Enforcement will be uuana products creates
� 1 � But town Fudge driven by complaints; revenue, but "at a price
� � �,0 Qr officials also police officers and town that I think our commu-
� t� �,��' want to avoid any associated employees will not be nity isn't entirely clear
�(/ O �V problems, such as burglaries actively searching for un- what that's going to be."
Q' �J G�O� and robberies of cash-heavy authorized cultivation. The Town Council did
�. marijuana businesses. Councilman Bruce make an egception to al-
Q "Windsor remains primarily Olu�epkie said Windsar low deliveries to Windsor
Cy a family-oriented town," said has limited commercial residents from out-of-
q4' Mayor Debora Fudge,who said space and he didn't want town pot dispensaries.
�' there has been little call from the town to esperience a
� the citizenry of Windsor to situation like the one in You can reach Sta�"Writ-
adopt a more lenient attitude Santa Rosa, where the er Clark Mason at 707-
toward cannabis. emerging cannabis in- 521-5214 or clark.mason(a�
Windsor Police Sgk Andy dustry is filling empty pressdemoc�'at.com.
Cash said that in previous meet- warehouses and driving On Twitter Qdarkmas.
ings leading up to Wednesday's
action, it was clear the coun-
cil wanted Windsor to have a
"small town vibe.They wanted i ' �j�,� ,�,�
to keep a bedroom community, }� (_���
a wholesome community.
OV'ith the passage last Novem- � � �
ber of Prop. 64 legalizing rec-
, reational, .�nnsahis.stat,��rul�.. -
� adults can possess up to an
ounce of marijuana and culti- � 1 ; ,
vate up to six plants per resi- r��
dence.
But cities and counties oan ,
put strict restrictions on in- �}�fi/� �� ���'�0,-� n � ��, �.�t/'
�-fJ�,:. (�
door cultivation and prohibit T �'I �,� 1 '
outside grows like Windsor did ,, � �J
wednesday. � C� � � �}��'"'�'N�i
Under those rules, the six
plants must be inside, and an
over-the-counter permit is re- �
` quired from the community de- ��� /�m
velopment departrnen� There �� f
TURN TO CANNABIS»pAGE A4 � � � li��l�
l
_ �
January 30, 2017 C�"��\ � -T7�
l.C�/�
To: Ukiah City Councilperson �� -�� �
Regarding Medical Marijuana Dispensaries �
I would request that you ban Medical Marijuana dispensaries within the city limits of Uki .
The need for them is not medically justified and their presence is a serious risk to our children
and adolescents. The claims of inedical benefit from this plant are vastly exaggerated and fail
the test of both common sense and medical scie �e�, S�c hen does a single plant containing
chemicals that benefit dozens of diverse medical��e�s -�om cancer to warts? Never, in my 60
yeazs of inedical practice and never in the 2000 years of inedical history. One,two or three
related conditions at most may benefit, but never"any serious illness" (quotation from California
Medical Marijuana Law of 20 yeazs ago). And this is confirmed by medical science,the science
that you and I depend upon for our modern medical caze. I enclose the summary of the landmazk
medical review of"Cannabinoids for Medical Use. A systemic review and meta-analysis." This
2015 article in"Journal of American Medical Association"is written by worldwide authors in
one of the most prestigious med.ical journals in the world. They reviewed all of the scientifically
controlled studies of the last 50 yeazs worldwide. Their 17 page article with 197 references
concluded moderate to low quality evidence of benefit better than placebo for certain pain
condirions, spasticity,nausea and vomiting from chemo-therapy, weight gain and chronic"HIV"
wasting disease, sleep and Tourette's syndrome. This evidence of very limited medical marijuana
value is echoed in the JAMA editorial and the Sonoma County Medical Society Journal editorial
which are enclosed. Our local certified pain specialist prefers non-marijuana pain meds and my
wife's oncologist similarly preferred non marijuana for her nausea from chemo-therapy for
safety and effectiveness reasons. Chronic HIV wasting disease is virtually a disease of the past
due to effective eazly treatment medications.
I am aiso enclosing the recent UDJ article pointing out the significant dangers of marijuana for
children and adolescents by Doctor Casey Johnston,Ukiah Pediatrician. The vast majority of
marijuana dispensed at a"medical dispensary"would go not to any serious medical problem but
instead solely for pleasure or profit.
In summary Medical Marijuana dispensaries should be banned within our city linuts for lack of
established medical need and positive dangers to children and adolescents. I apologize for this
late input to you,but I've been away for a period of time. I also realize you aze under great
pressure to enact pemussion for these businesses. But I urge you to follow the example of the
city of Sonoma and others in Sonoma County that have banned medical marijuana dispensaries
within their city limits. The few people who might truly need medical marijuana can readily
acquire it outside of our city limits.
Sincerely Yours,
����(��- ��'. s, �( �o,�,�e,--�. �AR��9 �� .� .
� � G�!h_G a�-.,�'�
Robert Werra, M.D. 0-k u����° � � �� KtCE�VED
er�r �JR, c,rkJA� � �
d �'°aK � NOV 0 7 2017
7D7 3tr 893 j
���Q A'D�•.,� CITY OF UKIAH
'�uj� BUILDING/PLANWING DEPARTMEN7`
February 9, 2017 I
�������
To: Ukiah City Council � ' � �
��
As a physician in the Ukiah and Mendocino County ea, because of the lack of demonstrated
medical benefits and documented dangers to adults and particularly to children and adolescents, I
would request that you ban Medical Marijuana Dispensaries within the city limits of Ukiah.
�'A /� �
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Volume 313,Number Z4
� Pages 2395-2508
Journal uf the
American Medical Association
�
Research Opinion Clinical Review�Education
, Original Investigation Viewpoint CBnical Crassroads ,
, z433 Implantable Cardioverter-Deflbrlllator 2ats Broadiy Neutrallzing Ant3bodies za74 Medic�l Marijuana fiorTreatment
Use Amang Medicare Patients and the Oevelopment of Vacdnes of Chronic Pain and Other Medical and
� With Low Ejection Fractlon sF Haynes and T eradtey PsychiatNc Problems:A Clinica!Revtevy
� After Acute Myocardial Infarct(on 2421 Th2 2015 US Dietdry Gtlldeli�Ps: KP HIII .
SD Pokomey and Coauthors 1_ifting the Ban on Total Dietary Fat
� 2441 Asso[jatiOn 8etween Earty 5[reening D Mozaffarian and DS Ludwig From theJAMA Netwark
for Patent Ductus Arteriows and In-Hos ftal 24a4 MetFarmin as Initial Oral Therapy
P 2423 FDA Regulation of IndoorTanning in Type 2 Diabetes
� MortalityAmongEuuemely Preterm Infants Devices and Opportunities R15tem and E1 Mu
J-C Roz�and Coauthors for the Hemodynamic for Slcin Cancer Preventlon ��
f EPIPAGE 2 Study Group D Mays and J I<raemer JAMA Clinical Guidelines Synopsis
' za�ts UseofPhosphodiesteraseTypeS z4z5 Unrest(nBaltimore: z4s5 Perioperative�-BlockerTherapy
` fnhibitors for Erectile Dysfunttion The Role of Public Health r scem and as Cffu
and Risk of Malignar�t Melanoma �s wen and�nn sharrstetn
5 Loeband Coauthors ConUnuing Medical Education
� Za55 CannabInoids for Medical Use: A Piece ofMy M3nd Z488 Online Quiz Questions
� 2az7 1'm Sor
� ASys�emat{c i�viewarrd Meta wnalysis ry JAMARevlsfted
PF 4'lhitir,gand Ccxcs�,ars J51<ahn
� z499 Carrespondence:Ben Frenldin's Views
Editorial
1 2429 Underutilization of Implantable 1AMA Pattent Page
Cardioverter-Defibrillators in Older Patients �08 �����ariJuana
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i z49t Cannabinoid Dose and Label Accuracy Z4�4�AMA infographic 2498 Paetry and Medkine
in Edible Medical Carmabts Products
� R Vandrey and Coauthors z4�5 Health Agendes Update
� za�6 Clinipl Trials Update "' issue Highlights and Complete Contents
Comment&Response 2417 News From the Centers for Disease on page 2401
z493 Housin�for Homeless Adults
, Wlth Mental Illness Control and Prevention �
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� z494 Flaws in Patierrt Safety Measures
, 24se Dosing Recommendations
for I�ew Otal AMimagulatrts
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PUBLICATION ;fl�il'ill�il�('���il�'I�'�(i�ll(1������I��I'��Il��l'i�11��11��(i •
Research
Original ir�vesti�ation
Cannabinoids for Medical Use
� A Systematic Review and Meta-analysis
Penny F.Whiting,PhD;Robert F.Wolff,MD;Sohan Deshpande.MSc;Marcello Di Nisio.PhD:Steven Duffj,PgD;
� Adrian V.Hernandez,MD,PhD;1.Christiaan Keurentjes,MD,PhD;Shona Lang,PhD;Kate Misso,MSc;
� Steve Ryder,MSc;Simone Schmidlkofer,MSc;Marie Westwood,PhD;Jos Kleijnen,MD,PhD
�
�� Editorial page 2431
� Cannabis and cannabinoid drugs are widely used to treat disease or alleviate . Related article page 2474
symptoms,but their efficacy for specific indications is not clear. . ,
= Supplemental content at
To conduct a systematic review of the benefits and adverse events(AEs) � jama.com
of cannabinoids.
E5 Twerity-eight databases from inception to April 2015.
IOH Randomized clinical trials of cannabinoids for the following indications:
nausea and vomiting due to chemotherapy,appetite stimulation In HIV/AIDS,chronic pain,
spastic'tty due to multiple sclerosis or paraplegia,depression,anxiety disorder,sleep disorder,
psychosis,glaucoma,or Tourette syndrome.
o x7rtat7�o�v ANb 5vN7HE5�5 Study quality was assessed using the Cochrane risk of bias
tool.All review stages were conducted independently by 2 reviewers.Where possible,data
were pooled using random-effects meta-analysis.
M,a�N ouTCO1wE5 aNn mEasU12E5 Patient-relevant/disease-specific outcomes,activities of
daily living,quality of life,global impression of change,and AEs.
RESULTs A total of 79 trials(6462 participants)were included:4 were judged at low risk of
bias.Most trials showed improvemerrt in symptoms associated with cannabinoids but these
associations did not reach statistical significance in all triais.Compared with placebo,
cannabinoids were associated with a greater average numher of patients showing a complete
nausea and vomiting response(47%vs 20%;odds ratio[OR],3.82[95%CI,1.55-9.42];
3 trials),reduction in pain(37%vs 31%;OR,1.41[95%Ci,0.99-2.00];8 trlals),a greater
average reduction in numerical�ating scale pain assessmerrt(on a O 10-point scale;weighted
mean difference[WMD],-0.46[95%CI,-0.80 to-OJ1];6 fials),and average reduction in
the Ashworth spasticity scale(WMD,-036[95%CI,-0.69 to-0.05];7 triais).There was an
increased risk of short-term AEs with cannabinoids,including serious AEs.Common AEs
included diuiness,dry mouth,nausea,fatigue,somnolence,euphoria,vomiting,
disorierrtation,drowsiness,confusion,loss of balance,and hallucination.
co;ic�.uS�oNs aNC1 Re�EvpNCE There was moderate-quality evidence to support the use of
, cannabinoids for the treatment of chronic pain and spasticity.There was low-quality evidence
� suggesting that cannabinoids were associated with improvements in nausea and vomiting
due to chemotherapy,weight gain in HIV irifection,sleep disorders,and Tourette syndrome.
Cannabinoids were associated with an increased risk of short-term AEs.
Author Affiliatfons:Author
affiliations are listed at the end of this
artide.
Corresponding Author.Penrry
Whfting,PhD,NIHR CLAHRC West.
University Hospitals Bristol NHS
Foundation Trust,Ninth Floor,
� Whftefriars,Lewins Mead,Bristol B51 '
2NT,United Kingdom(penny.whiUng
JAMA.2075;313(24):2456•2473.doi:10.1001/jama.2015.6358 @fbristol.acuk).
2456
jama.com
��su nvu
�IF��S:�Y":'1i . Edkorlals represeM the opinions of the authors andJAMA
and not those of the Ame�ican Medical Association.
Medical Marijuana
Is the Cart Before the Horse?
Deepak Cyril D'Souza,MBBS,MD;Mohini Ranganathan,MD
There is a pressing need to develop new medications for many Third,unlike most FDA-approved drugs that typically have
debilitatingrnnditions.Novelapproachesbasedonmarijuana 1or2activernnstituents,mazijuanaisarnmplexofmorethan400
or its constituent cannabinoids,if proven,could be added to compounds including flavonoids and terpenoids and approxi-
•�, the azmamentarium of avail- mately 7o cannabinoids other than O9-tetrahydrocannabinol
i able treatments.In this issue (THC}�.These cann�binoids havemdividual,interactive,and even
AuthorAudiolnterviewat ofJAMA,reviewsbyWhiting entourageeffects(effectsofacompoundthatazeonlyappreciable
jama.com et all and Hill�provide de- inthepresenceofotherrnmpounds)thatarenotfullyunderstood
` tailed assessment of the phar- and that contn'bute to the net effect of marijuana.Although clini-
Related articles pages 2456 macology,indications,ben- cal trials for some of the qualif}ring conditions and studies in ani-
and 2474 efits,adverse effects,and laws mal models of those conditions have been conducted with indi-
related to medical marijuana and the cannabinoids,and the re- vidual cannabinoids(eg,THC or cannabidiol[CBD]),given that
sults and conclusions aze consistent.There is some evidence to marijuana has so many mnstituents,the results of studies with
support the use of marijuana for nausea and vomiting related individual cannabinoids(eg,THC or CBD)cannotbe extrapolated
to chemotherapy,specific pain syndromes,and spasticity from to marijuana and vice versa.In addition,unlike FDA-apprwed
multiple sclerosis.However,for most other indications that medicationsthathavearelativelyuniformcomposition,thecom-
qualifybystatelawforuseofinedicalmarijuana,suchashepa- positionofcannabisprepazationscanvarysubstantiallyinitscon-
titis C,Crohn disease,Pazkinson disease,or Tourette syn- tent of THC and CBD,such that precise dosing maybe difficult.
drome,the evidence supporting its use is of poor quality.State Given thevariable composition,patients will have to experiment
laws vary widely regarding conditions for which marijuana is with different strains and doses to achieve the desired effects,
approved and the dispensable legal limit Both reviews raise im- without much input or oversight by physicians.
portant issues worthy of fiuther discussion. Fourth,some individual cannabinoids aze already com-
First,for most qualifying conditions,approval has relied mercially available in the form of dronabinol and nabilone.
on low-quality scienrific evidence,anecdotal reports,indi- These drugs aze administered orally,and some published data
vidual testimonials,legislative initiatives,and public opin- aze available to guide dosing.In contrast,there aze few data
ion.Imagine if other drugs were approved through a similaz on dosing smoked medical marijuana for many of the quali-
approach.The US Food and Drug Administration(FDA)re- fying medical conditions for which it is used.
quires evidence from at least 2 adequately powered random- Fifth,wtule the acute adverse effects of marijuana are quite
ized climcal trials before approving a drug for any specific in- well known,the effects of repeated exposure,as would occur
dication.For most of the conditions that qualify for medical with medical marijuana,need further study.Approximately 1
marijuana use,the evidence fails to meet FDA standazds.It has in io adult users of marijuana develops addiction,and this
been azgued that the lack of high-quality evidence reflects the number is even higher among adolescents 4 Tolerance and de-
difficultyinconductingmarijuanareseazchintheUnitedStates. pendencewithaccompanyir►gdown-regulationanddesensi-
If so,the federal and state governments should support and tization of type i cannabinoid receptors occur with repeated
encourage such research so that high-quality evidence can be exposure 5 Based on this profile,marijuana dosing will have
generated to guide decisions about medical marijuana use for to be increased over time to achieve the same effect.A dis-
the conditions for which the existing evidence is either insuf- tinct withdrawal syndrome is also well recognized.
ficient or of poor quality. There is also a small but definite risk of psychotic disorder
Second,there aze inconsistencies in how medical condi- associated with marijuana use,as well as a significant risk of
tions aze qualified for medical marijuana use within a state and symptom exacerbations and relapse in patients with an estab-
between states.For example,in Connecticut,psoriasis and lishedpsychoticdisorder.6Thus,explicitcontraindicationssuch
sickle cell disease but not Tourette syndrome qualify,even as schizophrenia,bipolar disorder,or substance dependence
though the supporting evidence for all 3 conditions is uni- needtobeidentifiedalongwithmeasuresto�n;mi�ethelike-
formly of very low quality.Similazly,posttraumatic stress dis- lihood that persons with contraindications would be able to ob-
order(PTSD)is approved as a qualifying condition in some but tain medical marijuana.Perhaps US states should establish
not all US states.These differences reflect inconsistencies in clinical follow-up programs to monitor long-term outrnmes pro-
evaluating and applying current evidence toward decision mak- spectively,especially negative outcomes(eg,new cases of psy-
ing about qualifying indications for medical marijuana use. chosis)in patients with contraindications.
jama.com JAMA June 23/30,2015 Volume 313,Number 24 24:
Opinion Editorial
Sixth,theintieractionsofmazijuanawithotherdiugsthazmay braindevelopmentisassociatedwlthlong-lastingchangesinbe-
1�emncu�nth'presm'bedforq�alifyingconditionsneedfitrther haviorandcognitlon.
'� study.Thereareclaimsthatmedicalmarijuanamayallowpatients Eighth,itisimportanttounderstandthemechanism(s)un-
s tolowertheiropioidanalgesicdoses.However,thee�stingevi- derlyingthepoternialbeneficialeffectsoFinarijuanaoritscon-
� dence does notsupport this contention.'�Furthermore,there is stituent cannabinoids.Specifically,it is uncertain how or why
� some evidence of cross-tolerance between cannabinoids and marijuana could be effective in treating eplepsy,sickle cell dis-
! opioids9 that should be rnnsidered in attempting to partially or ease,PTSD,Crohn disease,psoriasis,or amyotrophic lateral
' fullysubstituteopioidswithmarijuanainthetreattnentofpain ,sclerosis—conditions with no obvious cop�mon pathophysi-
;� syndromes.Perhaps medicalmazijuanashould aLsobeincluded ology.Perhaps marijuana provides nonspecific subjective re-
in monitoring databases as has been done for opioids and ben- lief,similaz to the effects of benzodiazepines. '
zodiazepines,so physiaans could have a morn complete under- For physicians,the legal implications of certifying patIents
standing of the medication profile of their patients. for medical marijuana remain uncle�r given the differences be-
Seventh,emergingevidencesuggeststhattheend�ran„abi- tweentheviewsofstatevsfederalgovemmentMarijuanaisclas-
noidsystemiscriticalinbraindevelopmentandmaturational sifiedasaScheduleIsubstancebytheFDA,meaningithasnocur_
processes,especially durin.g adolescence and early adulthood. rendy accepted medical use and a high potential for abuse from
� The endocannabinoid system is involved in�on elongation, a federal perspective.The prescription,supply,or sale of mari-
neurogenesis,neuralmaturationandspecifiication,gliaforma- juanais�7legalbyr�����ore,itisnotimowntowhat
tion,neuranalmigration,andsqnapticpn�n�ng,'O�'�rthermore, extent,ifany,aphysicianwhoceitifiesapatientformedicalmari-
theendocannabinoidsystemevolvesduringadolescence uUn- juana may be liable for negative outcomes(eg,motor vehicle
1�lceendocannabinoids,wlrichhaveshortdurationsofaction, crashes),ItisnotlmowilifinelpraCtiCeincnranreWj]lcove�'liabIl-
exposure to exocannabinoids(present in marijuana[eg,THC]) ity attnbutable to physicians certifying medical mazijuana use.
activatestheendocannabinoidsysteminaprolongednonphysi- Inconclusion,ifthestates'initiaiivetolegalizemedicalmari-
ologicalmanner.Inpreclinicalstudies,adolescentexposureto juanaismerely�veiledsteptowardaIlawingacoesstorecreational
cannabinoids has been linked to long-lasting alterations in the marijuana,then the medical mmmunityshouldbe left out ofthe
endocannabinoid system,as well as other neurotransautter process,andinsteadmarijuanashouldbederrin+�nat;�ed.Con-
systems?�Collectively,theserhangesintheendocannabinoid versely,ifthegoalistomakemazijuanaava�ableformedicalpur-
system have been linked to affective,behavioral,cognitive,and poses,then it is uncleazwhy the approval process should be dif-
neurochemical consequences that last into adulthood.Data on ferent from that used for other medications.E�ridence justifying
theeffectsofrepeatedexposuretomarijuanaamongyouthmust marijuanauseforvariousmedicalconditionsw�7lrequffethemn-
necessarilyrelyonepidemiologicalstudies,whichthusfarsup- ductofadequatelypowered,double-blind,randomized,placebo/
porttheanimaldataindemonstratinglong-termconsequences activecontrolledc]inicaltrialstotestitsshort-andlong-termef-
including rngnitive deficits and increased risk for psychosis. ficacyandsafety.Thefederalgovemmentandstatesshouldsup-
Carefulrnnsiderationisneededtodetermineatwhatageexpo- portmedicalmarijuanaresearch.Sincemedicalmazijuanaisnot
suretomedicalmarijuanaisjustifiablebecauseofthefollow- alife-savinginbetvention,itmaybeprude�towaitbeforewidely
ing factorse(1)brain development continues until age 25 yeazs; adoptingits use unUllrigh-quality evidence is available to guide
(z)theendocannabinoidsystemisinvolvedinbraindevelop- thedevelopmentofarationalappravalprocess.Perhapsitistime
ment;and(3)cannabinoid exposure during critical periods of to place the horse back in front of the cart.
ARTICLE INPORMATION REFERENCES "
8.Portenoy RK,Ganae�Motan ED,Allende 5,et al.
AuthorAffillaUons:DepartmentofPsydiiatry,Yale 1.WhitingPF,WoIffRF,DeshpandeS,etal. Nabiximolsforopiaid-treatedcancerpatientswfth
UniversitySchool of Mediclne,New Haven, Cannabinoids for medi�al use.JAMA,do1:101001 POO�Y'������ronic pain_J Pain.20R;13(�:
Connectiwt(DSo�aa,RanganathaN;Psychiatry �ama.2015.6358. 438-449 doi:lOJ016/J Jpain2012.01.003.
Service,VA Connecdart Healthore System,West 2, Hill KP.Medkal man7uana for Veatment of 9•Bushlin i,Ra¢enfeld R,Devi LA.
Haven(D'Souza.Ranganathan);Abraham R�'bicoff ��nic pain and other medical and psychiatric tannabinoid-opiotd IMeractions during
Resgarch Faalities,Connectiat Mental Health P�����i,�0.1001/jama1015.6199. neuropathic pain and analgesia.CurrOpin Pham�aaol.
Center,New Haven(D'Souza.Ranganathan). 2010:10(I):80-86.
Corresponding AuU�oi:Deepak Cyril DSouza, 3.Elsohly AAA,Slade D.Chemtcal mnstitueMs of
MBBS.MD,Psychiatry Servke,VA Connecticut marijuana.Li(e5ci.2005;78(5�539-548. 10.Maccarrone M.Gwm3n M.Madtie K,et ai.
pbell Ave,West 4.Hali W,Degenhardt L Adverse heahh ef(ects of �0�mming of neurel celis by(endo)
Healthpre5ystem,950 Cam cannabfioids,NntRevlVewaKd.2014:15(W:786-801.
Haven,CT 06516(deepak.dsouza(�dyalaedu). non•mediml onnabis use.LanaeG 2009;374
(9698):1383-1391. 11.Femindez-RuizJ.Bertendero F Hem�ndez ML,
Co�rflict of interest Disdowres:The authors have Ramos JA.The endogenous onnabinoid system
mmpleted and submitted the ICMJE Form for 5. ��nen J.Goodwin R5.U CT,et al.Reversible and bratn developmeM.Trends Neurosci.2000:23
Disdosure of Potential Corrflicts of Irrterest Dr and regionaliy selecdve downregulation of brain n):�q,.20.
i D'Souza reports receipt of gant wpport from the �nnabinoid CBl receptors in chronic datly cannabis
NIH,AbbVe,and Pfizer and serving on the S�"O��•����►Y•z�12:17(6):642-649. 12.Rubino T,Zamberletti E,Parolaro D.Adolescent
IConnecticut Board of Physidans that advises the 6.Radhakrishnan R,WflWnson Sl;D'Saaa DC ��ure to cannabis as a risk fa�tor for psychiatric
Commissioner of Consumer Protection regarding Gone to pot—a review of the associatbn between d�s°rders'�Ps�d�°ph°rm°°°�2012:26(1):TT7-188.
implemention ofthe AccConcemingthe Patllathre cannabisand psychosis.FraritPsNddatry.2014,5:54. �•Rubino T,Prini P,Pisdtelli F,et al.Adol�cent
Frar t
Use of Marijuana.Dr Ranganathan reports receipt 7.�lis RJ,Toperoff W,Vaida F,et ai.Smoked �P°sure to TtIC in female rats d'�srupts �
af grarrts from Insys'therapeutics. � medidnal onnabis for neuropathic pain In HN. ��Opmentai changes in the prefrontal cortex.
Neu o hormacol Neuro6lol Dis.2015;73:60-69.
ropsyrh p ogy.2009:34(3):672-680.
{ ?a32 JAMA June23/30,2075 Volume313,Number24
jama.com
EDITORIAL
The Second �nd of Prohib�tlon
Jeff Sugarman, MD
y patients often ask me for yaung adults whose pre-frontal cortical of booze.In Last Call:The Rise and Fall
marijuana prescriptions. regions are still developing. of Prohibition, author'Daniel Okrent
One recent patient said she Anti-epileptic effects of THC have observes,'"There may have been some
neededaprescriptionforhercancerand beenwidelycitedasproofofpotential people who were being prescribed
that cannabis was proven to help with benefits of cannabis;but a Cochrane because there w�s a perceived medical
that.How many ways can I unpack the meta-analysis revealed that studies need,but it was really a way for some
ridiculousness of that request?First of all, of those purported benefits were not physicians and pharmacists to make a
she did not have cancer.Even if she did, adequately powered and were of low few extra bucks:'S
I could not find any credible evidence quality.z The meta-analysis not only Medical marijuana patients who
that cannabis cures cancer.She was not found inconclusive evidence of efficacy, are truly searching for relief from their
undergoing chemotherapy and there- butalsothatTHCmay actuallypromote ailments would be better served by
fore could not claim she was seeking seizuresinsomepatients.Heavyregvlar recommendations from the medical
relief Erom the nausea that accompanies cannabis use,especially in adolescents,is mmmunity that are based on high-quality
it,one symptom that cannabis has been associated with higher rabes of persistent evidence.Many patients,however,are
shown to treat effectively.Furthermore, negative outcomes in adulthood,indud- just seeking cannabis for pleasure,and
cancer is not one disease,but many.Any ing increased rates of inental illness and doctors who prescrbe the drug may find
chance of successful treatment requires cognitive impairment 3 it easy to construct medicalized explana-
tailored therapy rigorously studied to I would caution against making tions for the benefits while getting paid
show survival benefit.My conclusion conclusions about the beneficial effects to do so.
was that the patient was just looking fior of cannabis on potentially serious disor- At the end of Prohibition, society
access to cannabis by abusing the medi- ders based solely an firsthand experience. decided that the risks of alcohol were
cal marijuana law.I was upset because Anecdotal observations aze insufficient outweighed by its benefits and the
she was asking for my complicity. to exonerate adverse events of any drug. impracticaliry of criminalizing it.With
There is much anecdotal information While insights gained in the clinic are the passage of Proposition 64,Califor-
purporting that cannabi$cures every- sometimes intriguing,they should be nians have decided the saule for recre-
tivng from aches to xenophobia.Despite used as a launching pad for rigorous ational cannabis.State resid'ents 21 and
the widespread medical use ofmarijuana study and hypothesis testing before over can now grow up to six plants and
in California and 27 other states,well- conclusions aze drawn. possess one aunce of marijuan�but it is
executed scientific studies on its effi- It seems likely that most patients who still illega�-to sell cannabis without a state
cacy for many conditions for which it is obtain marijuana for ostensibly medical license,smoke in public or drive under
prescnbed aze lackir►g or have produced purposes use it for reareational purposes. the influence.Importanfly,cannabis use
mixed results.Although federal dassifi- Population characteristics from a survey is still illegal under federal law.
cation of cannabis as a Schedule I drug of nine California medical marijuana The passage of Prop 64 will likely
hampers research, evidence for the clinics revealed that the clients were decrease the use of illegitimate medi-
legitimate medical use of marijuana or overwhelmingly familiar with canna- cal marijuana prescriptions.While there
cannabinoids is limited to a few indi- bis 4 My point here is not that cannabis may be societal benefits for decriminal-
cations,notably HIV/AIDS cachexia, is"bad,"butthatinmedicalizingitsuse izing the recreational use of cannabis,
nausea/vomiting related to chemother- for just about any ailment,the medical we must be aware that there is potential
apy,neuropathic pain, and spasticity community is wmplicit in a widespread harm in uncritically accepting canna-
in MS 1 In contrast,there is significant conflict of interest,fraud and hypocrisy. bis use as benign.At least the medical
literature on its potential adverse neuro- During Pro�ubitio�y the U.S.Treasury community may no longer be passively
logical efEects,particularly for chronic Department authorized physicians to sanctioning its use for spurious medical
and heavy users and in adolescents and write prescriptions for medicinal almhoL conditions.O
Every 10 days,patients willing to pay ,
Dr.Sugarman,a Santa Rosa defmatologist, about$3 for a prescription and another Send comments to osbom53@sonic.net.
chairs the SCMA Editorial Board. $3 or$4 to have it filled could get a pint (References appear on page 20.)
Sonoma Medicine Winter 2017 7
.
Tuesday,J8ril18Ij124,2017))MORE AT TWITTER.COM/UDJNEWS,FACEBOOK.COM BY SEARCHING FOR THE UKIAH DAILY JOUR
YOUR HEALTH � �
Secondhand srnol�e inc�udes rnari uana �
. J.
With the passing of . . �. �
Proposition 64,children's ,;.:' `
everyday exposure to can- " '
nabis con- �',r?.
tinues to ��'� -•
��� `'' increase, t .. � .. .z.
�-�; especia11y re- �
:y garding the ,.,' . : ,, �. •..�; .
'� risks of sec- ;��' � '��,,�.'.;� `' .
ondhandin- :y�'i . . •'�:;, ..;�, .:•
Caseq halation and �'�`� . r;�u���', , ;;:: .�:
7ohnston accidental �'�;: r . r''��;_y,�-Ra'_�'tt:• '=r- :,� .•-
ingestion.In _ ' �.: � �
;;i:'.�.•; _ �+�:-
December 2016 the Pediat- `� +��?
ric Research journal pub- _ . ,s`'�� �
•Y=�...;. ..
lished a study led by pedi- ' '•'
axrician Dr.Karen Wilson
that found significant lev- =-
els of mari,juana metabo- •� - ' ' �y-
lites in the urine of infants ` � _ • �
•J-y.
1
and toddlers whose par- t _ = � ; "���•
ents smoke man,juana.In � r
children 1 month to 2 years �<::::. ;:�.,: : • �.��.�_ •
of age,75 percent of urine FILE PHOTO
sa.mples ftom children Studies are showing traces of marijuana in children whose parents smoke it.
whose parents reported
marijuana use were posi-
tive for THC metabolites. teens whose brains are still randomized clinical trials Mothers should be
Highly lipid-soluble, developing and wlnerable. with it. strongly advised to avoid
marijuana accumulates in In fact,Walker notes that A study this past De- any form of THC while
body and especially brain 1 in 10 adults will become cember in Colorado led by pregnant and breastfeed-
tissue,readily crosses the addicted compared to 4 Mount Sinai pediatrician ing.Mothers found positive
placenta,and is transferred in 10 teens.Leslie Walker, Dr.Karen Wilson showed for THC in urine screens
in breastmilk.Cannabis MD,division chief of Ado- that marijuana meta.bolites should be strongly advised
research has shown asso- lescent Medicine at Seattle were found in the urine of to avoid continued eacpo-
ciations between prena- ' Children's Hospital, children exposed to mari- sure to this drug while
tal exposure with growth The most common over- juana smoke.In the study breastfeeding and should
retardation,mood disor- dose incidents in children of children 1 month to 2 be counseled that contin-
ders,learning disabilities occur when the drug has yea.r olds hospitalized for ued exposure of their in-
and even long-term�nem- been combined with food bronchiolits,l6%of over- fants to cannabis may pro-
ory problems.Wilson's re- in an"edible"form of mar- a11 samples were posi- duce severe long-term neu-
cent research suggests that �juana.This is because tive.75 percent of samples robehavioral consequences.
these consequences can marijuana ingested in this in which parent reported Children whose mothers
also affect young children manner can have a stron- maiijuana use were posi- use marijuana during preg
e�cposed to secondhand ger and prolonged effect, tive in urine.ct the devel- nancy have a higher risk of
smoke. especially in children un- oping teenage brain and stunted gmwth a.►yd of de-
Through a number of der the age of 12. cause problems with atten- veloping ADHD, 'ety,
studies,Denver pulmonolo- In these instances,kids tion,motivation and mem- and depression I ter in life.
gist Dr.Dauid Beuther ar- mistake"edible"marijuana ory. . Some studie uggest
gues that m�ri�juana smoke (like gummy bears,brown- THC is highly lipid-solu- that if you use arijuana .
exposure is just as da.nger- ies,lollipops,etc.)for reg ble which explains its high during pregn�.ncy,your
ous as tobacco smoke,put- ular food and eat it un- concentrations in brain baby may ha�e problems,
ting children at higher risk knowingly.Small children and body tissues. including:
for viral and other infec- are at higher risk based on Cannabis has enormous Premature birth.This
tions and chronic illnesses their size and wei�ht. Be- affinity for milk and pro- is birth that happens too
such as�=�c���aa an�heart cause ediL�le products have duces a milk;`plasma ra- earTy,�icfore 37 weeks of '
disease. very high amounts of mar- tio of 8.although the levels pregnanc}:
In-addition,accidental ijuana,the symptoms are in milk are generally con- Lot;-birth«�eight.This is
ingestion of edible forms m0�5Ev�P�-un a sinali sidered subclinical.THC yhen a hshu.is�h-�
r�m�rijuana(ct�ocolate, shild.M�v young,children. Crasses�he placertta rRa�l- iwg less than 5 pounds,8
gummy bears,cookies,etc) who consume marijuana ily,and there is increas- ounces.Your baby alsQ,may �
is the most common type edibles�£equt�te hospit�l�,d= ing evidence that it may in- ha�e shoi't bbdylerigth b�•
of cannabis overdose inci- mission due to the severity crease rates of growth re- sma11 head size.
dents in chiidren. of their symptoms. ta.rdation and adverse Stillbirth.This is when a
Smoking marijuana As marijuana is still il- neurodevelopment follow- baby dies in the womb af-
is still banned in public legal under federal law,it ing prenatal eacposure. ter 20 weeks of pregnancy.
places and within 1000 makes it very difficult for THC is highly lipid-solu- If you smoke marijuana I
feet of a school,day-care laboratories to get permis- ble which e�cplains its high during pregnancy,you're �
center or youth center and sion to conduct random- concentrations in brain about twice as likely to
other loca.tions where to- ized clinical trials with it_ and body tissues. ha�e a stillbirth.
bacco is already prohib- `"There is no reason to One study indicated an wthdra.wal symptoms, �
ited.Proposition 64 pro- believe that it is any safer increased incidence of re- like tremors(shakes)or
hibits the sale of cannabis than tobacco smoke ex- duced head circumference long periods of crying af-
to nonmedical users under posure,"he sa.ys,point- in young adolescents(9-12 ter birth.These symptoms
age 21 and includes regu- ing to studies showing years of age)who were ex- usually go away within a �
lations regarding child-re- marijuana smoke in rats posed in utero to heavy few days after birth.
sistant containers for mar- is just as bad as tobacco mazijuana use.5 Prena- Problems with brain de-
ijuana products.Despite smoke or even worse.Beu-• ta1 exposure resulted in velopment,which may af-
these regulations,o�r chi1= ther suspects that second- •' a higher rate of low birth fect your baby's behavior,
dren are at risk of short hand marijuana smoke or� weight infants and child- memory,problem-solving
and long-term neuro-de- va,por will put children at hood leukemia.6-8 Re- skills and ability to pay at-
velopmental and ca.rdio- risk for problems like in- cent studies have sug- tention later in life
pulmonary problems-from creased risk of viral infec- gested a reduction in long After smoking or in-.
secondhand exposure tions,asthma and other re- and short-term memory haling marijuana,the on-
within their homes. spiratory illnesses.It could retrieval and retention in set of symptoms is quick
The bottom line is that even increase the risk of children exposed to prena- (within 5-30 minutes),but
marijuana.users must be developing chronic condi- ta1 cannabis.These chil- symptoms typically do
extra vigilant in keeping tions like heart disease and dren were also weak in not last long(a couple of
mari,juana inaccessible to stroke later in life,he spec- planning,integration,and hours).
children and NOT use mar- ulates. judgment sldlls. In contrast,after inges-
ijuana products in the pres- "To a degree we suf- Both human cohort tion of marijuana in the
ence of children to mini- fer from lack of evidence," studies and studies in an- form of food or beverage,
mize secondhand smoke Beuther says."But with- imals cleariy suggest that the onset of symptoms can
and THC exposure. out the federal OK it's dif- early eacposure to cannabis take as long as 1-4 hours,
Call the Poison Control ficult to study it"As mar- is not benign and that can- and symptoms can last for
Cemer at(800�22-1222 for ijuana is stili illegal under nabis exposure in the peri- several hours.
concerns about exposure. federallaw,it makes it very natal period may produce
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ITEM NO.: 12a
MEETING DATE: December 5, 2017
� City of Ukiah
CONIMUNI'1'Yll�VELOPMliN'1' 30aSEM1NA122'AVENUE
1)�YA1ti:ti1�N1 UK1AH,C;A 95482
AGENDA SUMMARY REPORT
Subject: Discussion and Possible Action Regarding the Cancellation of a Regular Meeting
of the Planning Commission on December 13, 2017.
Background:
The Planning Commission will consider the cancellation of a Regular Meeting of the Planning Commission
on December 13, 2017. This is due to the lack of agenda items scheduled for New Business.
Discussion:
The Planning Commission regularly meets the second and fourth Wednesdays of each month. At its
November 8 meeting, the Commission set the schedule for remaining meetings for the holiday season.
Originally a meeting was scheduled for a planning project application, but the applicant has since decided to
postpone submittal of their project to the Commission for approval.
There being no formal business scheduled for December 13, Staff respectfully requests Planning Commission
cancel this meeting. The next regular meeting of the Planning Commission will be January 10, 2018.
Recommended Action(s): Approve the cancellation of a regular meeting of the Planning Commission
on December 13, 2017.
Alternative Commission Option(s): 1. Do not approve the cancellation of a regular meeting on
December 13, 2017; 2. Select a different date for a re-scheduled second meeting in December.
Citizens advised: N/A
Requested by: Craig Schlatter, Community Development Director
Prepared by: Craig Schlatter, Community Development Director
Coordinated with: N/A
Attachments: None