The state has allowed medical use of pot since 1998 and the passage of Initiative 502 last year allowed the sale of marijuana to adults for recreational use at licensed stores, which are expected to open by late next spring.
Lawmakers have worried that the largely unregulated medical system would undercut the taxed, recreational system. Meanwhile, U.S. Justice Department officials have warned that the state's medical cannabis status quo is untenable.
The state's Liquor Control Board gave its final recommendations Wednesday to the Legislature about how it believes the medical system can be brought under the umbrella of Initiative 502.
It suggested allowing licensed I-502 stores to sell medical cannabis, which would be subject to the same high excise taxes as recreational pot. However, patients who sign up for a proposed mandatory state registry of medical marijuana users would be exempt from paying sales taxes.
In one change from an early draft, the board is not recommending that home grows by patients or their providers be banned -- a proposal that especially angered patients. Instead, the board is calling for them to be allowed to grow six plants. Under current regulations, they can grow 15.
The board also suggests cutting how much pot patients can have from 24 ounces to three ounces -- which is still more than the one ounce adults are allowed under the recreational law.
Retaining some ability to grow pot at home did little to placate opponents of the changes, who said they would fight the moves in Olympia.
"We've had this law for 15 years and it seems to work pretty well," said Philip Dawdy, a longtime medical marijuana activist. "What is the big screaming need for a registry on patients? When are we going to register recreational users? What is the problem with allowing patients to have 15 plants and 24 ounces?"
Some lawmakers and police officials have suggested that the proliferation of medical dispensaries in Washington -- establishments that aren't allowed by the medical marijuana law -- shows they're largely a front for commercial marijuana sales.
Dispensaries started opening more frequently in the past few years, despite not being explicitly allowed, and have been tolerated by authorities.
Earlier this year, the Legislature directed a work group comprised of staff members from the liquor board, Department of Revenue and Department of Health to evaluate how medical and recreational marijuana markets might coexist. The board was directed to send its final recommendations to the Legislature by Jan. 1. Lawmakers could take up the issue in the next session.
Other recommendations include requiring patients under 17 to have the consent of a parent or guardian before they use cannabis. There are no age restrictions in Washington's medical marijuana law as it exists.
The definition of "debilitating" pain would be tightened. Medical marijuana authorizations could be granted only for pain that significantly interferes with a patient's daily life, in addition to other qualifying conditions such as cancer. Medical professionals would be barred from running practices that focus almost exclusively on granting marijuana authorizations.
Sen. Ann Rivers, R-La Center, said the recommendations are largely in line with a bill that she introduced last session to reconcile the two markets.
"The medical marijuana initiative created a loophole large enough to drive a truck through for general use participants," she said. "Anyone could go get an authorization, and they would never have to pay the taxes that we were promised when we were voting on the initiative. We had to tighten up and strengthen regulations for both."
Rivers said the key difference between her bill -- Senate Bill 5887 -- and the recommendations approved Wednesday are that in addition to the sales tax exemption for patients, there would be an excise tax exemption. She said that bill will receive a hearing when the next legislative session begins next month.
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