Turn off Highway 99 in rural Elverta, drive five miles down the road and you鈥檒l find a dusty lot crammed with cars on this scorching Friday evening. Behind the wooden fence, for a $10 entry fee, awaits a gathering akin to a block party crossed with a high-potency farmers market.
Alongside shirtless young men displaying jars of weed and decorative bongs, there are tacos and smoothies for sale. A woman in cannabis leaf-patterned shorts peruses the merchandise, while another with a severe black bob offers dab hits near the front. The DJ occasionally interrupts his mix of throwback hip-hop tunes (do you enjoy Coolio鈥檚 鈥淔antastic Voyage鈥�?) to sell tickets for a raffle raising money for one vendor鈥檚 comatose employee.
Next to his booth, a table gives out free cannabis for veterans, who don鈥檛 have to pay to get into the event. Neither do patients with a doctor鈥檚 recommendation, like Dannie, a barber who was shot three times in his left arm and smokes cannabis to manage pain often inflamed by cutting hair.
Dannie, who agreed to be identified only by his first name, said he carries a medical recommendation because it鈥檚 safer should he ever get stopped by the police. But he still prefers buying weed at these clandestine pop-ups, where the products are more potent than at a dispensary.
鈥淚鈥檇 rather spend my $30 on something that lasts,鈥� he said.
This is just one of four unlicensed cannabis 鈥渟eshes鈥� in the Sacramento area that Bette Braden will host this week, as she does every week. The events started eight years ago for medical marijuana patients in an era of looser regulations, before California legalized recreational sales.
Since 2016, when voters approved Proposition 64, the initiative that authorized a commercial cannabis market in the state, Braden has come to view her seshes as both a business opportunity and an act of protest. Like many longtime advocates, she believes all weed use has a medical purpose, and considers it immoral that high taxes and a lack of dispensaries have made it inaccessible to many patients.
鈥淭he laws are so hideous,鈥� Braden said, as she supervised from a camp chair near the entrance. 鈥淚 used to be an activist. Now I鈥檝e gone over to the underground.鈥�
鈥楴o one really cares about the medical side鈥�
Frustration runs deep among medical cannabis patients and advocates who 鈥� by persuading voters to pass Proposition 215 in 1996 鈥� paved the way for legal weed in California, but now feel left behind in a post-Proposition 64 era. In a profit-centered system focused on recreational sales, they argue there is little consideration for patients and their unique needs.
Collectives that once provided cannabis and community largely dissolved nearly five years ago, as California transitioned to a based around licensed growers and retailers. Dispensaries, which are still by local rules, have not widely embraced a replacement program that allows them to who cannot afford to buy it. which can cost several hundred dollars to renew annually, confer few tangible benefits.
鈥淣o one really cares about the medical side, and that鈥檚 a mistake, because that鈥檚 where the value is,鈥� said Richard Miller, who has promoted patients鈥� rights at the state Capitol for nearly two decades as a member of the American Alliance for Medical Cannabis and Americans for Safe Access. 鈥淚鈥檝e been feeling over the past year like my work is a failure.鈥�
The shift to treating medical marijuana users more like customers is especially tough for older patients with limited incomes and those with chronic conditions who need a large amount of cannabis for treatment. While California physicians can recommend cannabis for conditions including arthritis, glaucoma, migraines and seizures, most health insurance plans do not cover medical marijuana because it remains illegal at the federal level.
鈥淢y life is being messed with. I should not have to continue to鈥earch out ways of finding the only medicine that has ever helped me.鈥�BONNIE METCALF, WHO USES CANNABIS TO EASE PAIN FROM AN IMMUNE DISEASE
So some cost-conscious patients seek other ways of getting their supply, such as the underground seshes sprouting up around the state. That further bolsters an illicit market that California has struggled to bring under control and alarms advocates who want patients to have high-quality, safe medicine.
鈥淭here are some things in this world that should not have a f鈥攊ng price tag. And feeling good when you鈥檙e sick is f鈥攊ng one of them,鈥� said Bonnie Metcalf, who lives in Sacramento County and suffers from sarcoidosis, a disease of the immune system that fills her body with lumps of inflamed cells called granulomas.
With an $1,100 monthly disability payment her only income, Metcalf said she cannot afford dispensary prices and relies on friends and Braden鈥檚 pop-ups for cannabis.
鈥淚t ain鈥檛 funny no more. My life is being messed with,鈥� she said. 鈥淚 should not have to continue to do this, to have to, you know, search out ways of finding the only medicine that has ever helped me in a way that I can still have a value to my life.鈥�
鈥業t鈥檚 nothing but pain鈥�
Metcalf鈥檚 body is snap, crackle, popping as she rolls into the living room in her motorized wheelchair for breakfast. An excruciating tingle runs from her neck and shoulders down through her hips and legs, she said, like a limb that has fallen asleep. It鈥檚 a dull, aching, don鈥檛-fricking-talk-to-me kind of feeling, the same agony she wakes up to every day 鈥渦ntil I get some pot in me.鈥�
鈥淎s soon as I hit this reality, it鈥檚 nothing but pain,鈥� Metcalf said. 鈥淚t鈥檚 the first thing I think about. Because how can it not be?鈥�
Metcalf does not like the side effects she experienced with pharmaceuticals 鈥� she took a steroid for her lungs that she said gave her diabetes 鈥� so she primarily sticks to cannabis and meditation to treat her sarcoidosis.
鈥淚t鈥檚 very strange, because there鈥檚 a point you get to where you don鈥檛 give a f鈥� that you have pain. You鈥檙e so euphoric,鈥� she said. 鈥淧eople would say, 鈥極h, you鈥檙e just doing it to get high.鈥� Well, yeah, dude, I would rather be in a euphoric state of mind than, you know, I can鈥檛 get comfortable. You can鈥檛 eat. Your muscles are constantly spasming. I鈥檓 on hot water bottles. I mean, it鈥檚 ridiculous.鈥�
Cannabis has been part of Metcalf鈥檚 life for decades: Now 61, she said she first smoked weed at the age of 8, when an older teen gave her a joint at the park, and became an activist for cannabis access as a teenager.
While living in San Francisco in the 1980s, she worked with cancer and HIV/AIDS patients, Metcalf said, advocating for them to be able to use cannabis in medical settings. She collected signatures for the initiative that legalized medical marijuana and, after it passed in 1996, moved home to Yuba County, where she opened her own cooperative. Metcalf said she would drive a bus of patients down to San Francisco twice a month so they could see a doctor and get their paperwork in order.
That ended after 11 years, when Metcalf became too disabled to run the collective any longer. Despite her activism, however, she now refuses to get a doctor鈥檚 recommendation or a medical card or shop at dispensaries. She鈥檚 furious at how Proposition 64 commercialized cannabis in California, prioritizing getting high over medication and with expensive licenses and regulations.
鈥淭he system that exists is bulls鈥搕,鈥� she said. 鈥淭hese rich people are paying more for packaging and branding than they are worried about medicine for people. They don鈥檛 care. It鈥檚 not a medicine to them. It鈥檚 just another money-making scheme like beer or cigarettes.鈥�
After eating a sausage scramble with green onions, Metcalf follows a meditative routine to help her mind vibrate above the pain. For her daily sacraments, she burns a bay leaf, a bundle of sage and a stick of palo santo, waving them around her body and each door in the house. She takes off her shoes and sits in the backyard for a few minutes, sticking her bare feet into the dirt to ground.
Finally, it鈥檚 time to medicate. Metcalf said she can no longer smoke weed because of the granulomas in her lungs. Instead, she takes two daily doses of FECO, a highly-concentrated cannabis extract 鈥� one in the morning to relax her body and one in the evening to help her sleep.
Back in her room, Metcalf turns on a playlist of affirmations by the musician Toni Jones and says a silent prayer (鈥淢ay all beings live in peace, harmony, love and bliss鈥�). Then she dips a fork into her jar of FECO and puts a dab of the oil on her tongue. She spits a chunk back into the jar, then bites another piece off the fork, until she estimates that she has half a gram.
The sensation starts in her head. She can feel her blood pressure calm. Her eyes relax and she sees the world in a whole different way. Everything is sparkly.
鈥淚t鈥檚 like a rain. It just starts raining,鈥� she said, as the relief slowly washed down her body, loosening her joints before arriving, finally, at her feet.
鈥淎s long as my mind is high, I can control the body,鈥� she said. 鈥淚 can choose to disconnect from the pain. I can choose to put it in the background.
鈥極ur whole system fell apart鈥�
Though it was the first state in the country to legalize medical marijuana with Proposition 215, California has always had a fraught relationship with it.
The allowed people with a valid doctor鈥檚 recommendation, as well as their caregivers, to cultivate cannabis for their personal medical use 鈥� opening the door for collectives where patients unable to grow their own medicine could pool their resources to pay 鈥渃aregivers鈥� to do it for them. Compassionate care programs offered weed to the sickest and poorest patients for minimal or no cost.
But federal pressure from the 鈥淲ar on Drugs鈥� remained, and the state was reluctant to jump into regulating medical cannabis until 2015, largely leaving the task to local jurisdictions. Writing recommendations became a , while illicit operators took advantage of the enforcement gaps to open hundreds of what were functionally retail dispensaries, enhancing skepticism about the legitimacy of the medical marijuana system.
That changed in 2019, after the passage of Proposition 64, when California began requiring collectives to . Unable to complete the expensive and complex process, . More than 60% of cities and counties in the state still ban cannabis retailers, even for medical use, though starting in January, they can no longer prohibit medical cannabis delivery.
鈥淥vernight, our whole system fell apart,鈥� said Valerie Corral, founder of the groundbreaking cooperative in Santa Cruz. 鈥淭hey were so busy counting tax dollars that they put us all out of business.鈥�
Corral received a license, but she sold it after it became clear opening and operating a dispensary would cost hundreds of thousands of dollars that her donation-based organization did not have. Now she grows cannabis and works with local dispensaries to donate it for free to patients 鈥� the result of a that, after a multiyear effort, established a replacement to California鈥檚 traditional compassion programs.
Leona Powell, a former member of Corral鈥檚 collective who smokes weed daily to deal with lingering pain from a 1978 airplane crash, said she misses volunteering in the garden and connecting with other patients at weekly meetings, where they would share information and potluck dinners. Living primarily on Social Security payments, the 75-year-old Powell said she relies on donated cannabis from a local dispensary, because she otherwise cannot afford the price of a standard eighth of an ounce, which typically costs $40 or more plus tax.
鈥淭hat鈥檚 only a couple of joints. That鈥檚 two days鈥� worth. Now what?鈥� she said. 鈥淚 don鈥檛 have that kind of money.鈥�
Efforts to formalize the medical marijuana system in California also lagged. In 2003, the state established a medical identification card for patients, mainly as a way to defuse interactions with law enforcement, but made it voluntary. Few people , perhaps afraid to register themselves with the government 鈥� though some activists did as a political statement.
At its peak, in the 2009-10 fiscal year, counties issued 12,659 annual medical cards, from the state Department of Public Health. Surveys at the time , if not more than a million, medical cannabis patients in California. By last year, the number of medical cards dropped to just 3,218, among the lowest on record.
Advocates say there is little reason to get a card, which carries an annual fee of as much as $100, on top of the cost of the doctor鈥檚 recommendation. With the card, patients are exempted from the state sales tax on their cannabis but not other state and local taxes, so they would need to spend hundreds of dollars per month at a dispensary to realize any savings. Californians can also get medical cards before they turn 21, when it is legal to buy weed for recreational use, and cardholders can purchase more cannabis per day.
鈥淭here鈥檚 a tendency to be dismissive of cannabis users鈥� among the medical establishment, which is then reflected in policy, said William Dolphin, a University of Redlands lecturer who researches and . 鈥淲e鈥檝e seen across the country a desire to wash their hands of it.鈥�
The state Department of Cannabis Control points to extensive testing and labeling requirements in the licensed market as a major benefit for patients, ensuring that Californians with potentially compromised immune systems are not using products tainted with hair, rat feces, heavy metals, illegal pesticides or mold.
In May, the department to study medical cannabis use in California, including what conditions patients are treating, what products they prefer and how they are accessing them.
鈥淚f they鈥檙e turning to the unlicensed market, we want to understand why they鈥檙e doing that so we can craft policies to bring them into the licensed market,鈥� said Devin Gray, a policy analyst with the department鈥檚 policy and research division.
鈥榃e sell products to stay alive鈥�
Even dispensaries and other organizations dedicated to the philanthropic tradition of compassionate care are struggling amid a .
Kimberly Cargile owns , which opened in a converted house near downtown Sacramento in 2009 to serve medical marijuana patients. These days, it also has a license for recreational sales 鈥� and one of the only compassion programs in town, allowing low-income patients to receive cannabis for free.
Cargile said many dispensaries are reluctant to establish these programs because of the expense. Hers, serving an estimated 200 people, runs between $1,000 and $2,000 per month for staff time to manage applications, intake stock and consult with patients.
That鈥檚 a bigger sacrifice than it used to be. After a statewide surge in cannabis sales during the early days of the coronavirus pandemic, Cargile said sales dropped by $3 million, or 20%, at her dispensary over the past two years. She鈥檚 been looking for savings everywhere she can to stay afloat, though the compassion program will remain a priority for as long as she can manage.
鈥淲e鈥檙e doing everything we can to stay true to our mission,鈥� she said. She doesn鈥檛 want a cancer patient to feel forced to turn to 鈥渄irty鈥� products on the illicit market.
鈥淭he whole entire reason I鈥檝e dedicated my life to patients鈥� rights is because I want them to have access to high-quality, lab-tested products to treat their symptoms,鈥� Cargile said.
Jude Thilman, who runs in Fort Bragg, said it is financially impossible for cannabis businesses to focus solely on medical use anymore. That has meant dispensaries providing less education for consumers, manufacturers of therapeutic products shutting down because they cannot adapt to new rules and a heritage slowly disappearing. Of the seven medicine makers that Thilman personally knew before Proposition 64, she said five have gone under and the other two are operating illegally.
鈥淲e sell products to stay alive,鈥� Thilman said, 鈥渁nd then we sell products to help people.鈥�
Medical donations through compassion programs increased over the first three years of the 2019 law, according to data collected by the state Department of Cannabis Control, though the reach remains relatively small. Last year, 440 dispensaries reported donating cannabis products to patients, fewer than a quarter of California鈥檚 nearly 2,000 licensed retailers.
Retailers reported 13,278 donations in , 41,775 donations in and 47,371 donations in . Each donation is counted separately, so the number of patients served is likely much lower.
Advocates said they initially benefited from an oversaturated commercial market, with businesses donating more products that they could not sell. But in recent months, as a dramatic price drop caught up to growers and , supply has been scarcer.
鈥淲hat鈥檚 been heartbreaking is that extinction of all the small farmers who have been our most loyal donors,鈥� said Ryan Miller, who founded Compassionate Veterans, until recently known as Operation EVAC, a program that combines peer support sessions with free cannabis to prevent suicides. 鈥淭he corporations are not stepping up, to be honest.鈥�
After his pioneering San Francisco collective had to stop handing out cannabis to patients in 2019, Joe Airone, known as Sweetleaf Joe, turned his attention to logistics for compassion programs, helping find and deliver donations. He said his efforts connected more than 3,000 patients with 1,600 pounds of free medical cannabis last year 鈥� but without more support, such as tax write-offs, for participating businesses, securing donations is getting more difficult.
鈥淎ll of our partners are taking a financial hit to do this,鈥� he said. 鈥淭here鈥檚 no incentive to do this. Zero.鈥�
鈥楬ow much are you really helping people?鈥�
In spite of the triple-digit heat, Metcalf was among some 400 people who attended the underground marketplace in Elverta that Friday evening. After visiting with Braden, she stopped by a booth for The Sisters Edibles, where she sometimes buys gummies.
Metcalf eyed the table stacked with tubs of colorful CBD-infused bears and worms, packaged by the generous handful, available for $10 each or three for $25. It was a fraction of the cost of what she could get at a dispensary, where a tin with 10 doses would be $20 plus tax.
鈥淚f you limit it, how much are you really helping people?鈥� said the owner, Jen, who said she started taking cannabis three years ago to treat her migraines and moved into manufacturing her own products to supplement her veteran disability payments. She declined to share her last name out of privacy concerns. 鈥淚 have so many people who come up to me and say, 鈥業 can get out of bed now.鈥欌��
Metcalf continued on to find some weed for her caretaker. At another small booth, she held brown mason jars to her nose, inhaling the scents of dried cannabis flowers. Dank. Like a cheese.
鈥淭hat has a nice little sweet kickback smell,鈥� she said. 鈥淚鈥檒l take a half.鈥�
With only two $20 bills, Metcalf was $10 short of the price for half an ounce. The vendor, who asked to withhold his name so as not to jeopardize applications he has submitted for cannabis delivery and manufacturing licenses, waved it off.
Touched by his generosity, Metcalf asked for his number. She knew a lot of people who might want to order from him.
鈥淒o you have a medical card?鈥� he asked. He said he didn鈥檛 charge patients delivery fees.
Metcalf, a self-proclaimed outlaw, shrugged at the idea and threw up her middle fingers.
is a nonprofit, nonpartisan media venture explaining California policies and politics.