TALLAHASSEE — When voters made California the first state to allow medical marijuana in 1996, the rules were so lax, anyone with a doctor's recommendation could grow their own cannabis.
Not until next year will the Golden State start to regulate its growers. State ID cards are voluntary for patients, making it impossible to track everyone who is legally using medical cannabis there.
That's not how the legalization of the drug is unfolding 2,500 miles away in Florida, where state lawmakers are writing new rules to govern a medical pot program that voters overwhelmingly passed last November.
"We certainly have looked at the experiences of other states, and many of those experiences I would consider to be negative," said Sen. Rob Bradley, R-Fleming Island, who is sponsoring legislation that will shape what could become a billion-dollar marketplace. "It's really important to make sure that the storefronts reflect a true medical environment and you don't see the commercialization in an inappropriate manner that you see in other states."
Although the drug remains illegal under federal law, 28 states and Washington, D.C., allow the use of medical marijuana in some form. This long record of trial-and-error can guide Florida lawmakers and health officials as they work against a looming July deadline to put this state's medical marijuana program into place.
Three states illustrate the choices for Florida. Two of the nation's largest — California and New York — show opposite ends of the spectrum. Arizona, a Sun Belt state with an elderly population similar to Florida's, offers a middle ground.
"There's such a rich history," said Ben Pollara, executive director of Florida for Care, the advocacy group that led the campaign for Amendment 2. "Writing a medical marijuana law should not be a reinvention of the wheel."
California and New York have wildly different medical marijuana laws, but advocates say both exemplify what can go wrong.
The loose laws California's voters passed were a sign of the times, says Steph Sherer, executive director of the advocacy group Americans for Safe Access.
"It's where all the experimentation in terms of what to do and what not to do has happened," she said.
Fear of federal law enforcement cracking down led the state government to back away from regulating the industry. Instead, activists who wanted the state to play a role and elected officials who didn't struck a compromise in 2002, leaving the job of regulating marijuana to cities and counties.
The result: While a patchwork of laws limits access for some communities, other locales are swamped with dispensaries and pot doctors who make it easy to get a prescription. Florida lawmakers find it easy to lampoon as too permissive.
"We go to great lengths as a society to make sure that serious prescriptions don't get into the hands of those who aren't sick but seek to abuse it or sell it on the black market," Bradley said.
New York, which legalized medical marijuana in 2014, set up a more restrictive system.
Just five growers have licenses to produce marijuana (the state is now expanding it to 10), and storefront dispensaries were capped at 20 for a state with almost 20 million people. Qualifying conditions were limited, doctors had to take a four-hour course and patients could only use products like oils and "vape" pens — not the whole plant.
"It seemed like lawmakers were just wanting to brag that they had the most restrictive law," said Karen O'Keefe, director of state policies at the Marijuana Policy Project. "All these things just serve to make it harder for patients to get in the program."
Even among advocates who support loosened medical cannabis laws, there is disagreement over what the perfect system is. They do, however, agree on two points: Patients should have access, and there should be minimal state interference with what they can buy or how they can use it.
"What I would love to see is a state approach it and really say how can we make sure that patients can have access to this medicine?" Sherer said. "And then work backward from there."
Striking a balance
Arizona's population skews older and its politics are conservative, much like Florida.
"The demographics are so similar," says Dr. Sue Sisley, an Arizona medical researcher who has helped other states develop cannabis policies and provided input to the Florida House.
The marijuana law on the books in Arizona is less restrictive than New York's but more controlled than California's — the kind of balance Florida lawmakers are trying to strike.
Yet in two of the few instances where Florida lawmakers agree, Arizona went in a different direction.
Take the number of licensed dispensaries. Arizona has more than 100 and even that may not be enough, Sisley said.
"We barely can meet the needs of our patients," she said. "There's never enough cannabis on the shelves."
Florida lawmakers are pushing a model much like New York, where companies will grow, process and sell cannabis. Right now, the House wants seven licenses initially with another six kicking in at 150,000 patients, while the Senate proposes 12 licenses plus four more for every 75,000 patients.
Unlike other states, lawmakers in Florida have not proposed any limits on how many storefronts each company can open. Delivery sales will also likely be allowed.
Forcing companies to act as both grower and seller and limiting the number of licenses concerns O'Keefe.
"What if one of them has mites or a burglary or something that wipes out their total supply?" she said. "A free market makes a lot more sense."
Florida will also likely diverge from Arizona by not allowing people to use cannabis for chronic pain alone. The Legislature has shied away from that, though the constitutional amendment passed by voters allows doctors some leeway in deciding who needs access to the drug.
"I don't think we're compelled to include chronic pain that isn't related to an underlying debilitating condition," Bradley told senators at a workshop on his bill in late March.
In Arizona, more than 80 percent of the 119,124 medical marijuana patients use the drug for chronic pain.
New York recently added chronic pain to its law after advocates pushed for it, including Jason Pinsky, a Brooklyn-based activist and the cannabis producer for a Viceland TV show about cooking with marijuana called Bong Appetit.
For Pinsky, advocating for the legal change was personal. He switched to using cannabis after more than 10 years on opiates following back surgery and a motorcycle crash.
"Chronic pain should really be a game changer," he said. "The standard operating procedure right now with chronic pain is opiates. And there's an opiate epidemic going on."
Florida lawmakers are poised to fall somewhere between California — where all it takes a note from a doctor to buy or grow cannabis — and New York — where activists say tight controls limit the pool of patients to less than one-tenth of 1 percent of the state's almost 20 million people.
But unlike Arizona, New York or California, Florida patients' right to use medical marijuana is guaranteed in the state Constitution after 71 percent of its voters approved it last year.
House Majority Leader Ray Rodrigues, R-Estero, said he worries about some of the provisions he has seen in states like California.
A non-starter with him: smoking, which he sees as a "backdoor attempt at recreational" marijuana.
As a result, the House is pushing to adapt an existing Florida law meant to help patients with severe seizures and cancer use strains of cannabis low in the chemical THC, which causes a high.
In the Senate, Bradley says his priority is making sure people have access to medicine.
But, he doesn't want the state to look like California. To him, that means limits on advertising, a culture that cannabis is like other medicines and a prohibition on smoking the drug.
"It's important if we're going to treat this like a medicine to treat it like a medicine," Bradley said.
Contact Michael Auslen at firstname.lastname@example.org. Follow @MichaelAuslen.