The Dilemma In Medical Cannabis

The Dilemma in Medical: The Identity Crisis within “Medical Cannabis Programs"

By Ryan Lepore

What is the point of having a Medical Cannabis Program? For some this seems like a pretty easy question to answer - though as of late I find myself having to explain the current identity crisis between “Medical Cannabis Use” and “Adult-Recreational Use.” We likely agree that any cannabis use is inherently therapeutic at its core and many of us in the cannabis community will commonly point out that we “self medicate” as non-patients in legal or a non-legalized state.

In my experience working on the medical side of cannabis, I’ve noticed the medical landscape is divided amongst two patient types. “Patient One” may utilize a medical program for regulated, safe and most importantly, legal access to cannabis. “Patient Two” on the other hand, is inundated with medical complications, prescriptions and dramatically - hope & desperation for finding a therapeutic option to finally fix their ailments. Overall both patient types seek an improvement in their quality of life, through the use of cannabis - which we all know - it would provide.

When we talk American history, cannabis use has been legitimized on numerous occasions because of its medicinal properties, whether 1850 or 1996. Due to this - we at times conflate the reason why these programs inherently exist VS. the current situation of prohibition that allows medical programs to “thrive”. To this point, medical programs are viewed as another step forward towards full-out legalization (unless you’re South Dakota). Though, this is where the conflict arises, once things go legal, our bandwidth and attention solely goes to adult use - opposed to medical use & the necessities of “Patient Two” but the needs of “Patient Two” do not automatically evaporate with adultuse legalization.

The Dilemma

Typically, “Patient One” ends up becoming the “market driver” in our medical programs due to numerous reasons but mainly because of the shorter sales cycle to educate an already frequent user on the premise of using or purchasing cannabis. Operators, providers & dispensaries end up prioritizing the patient experience towards this patient type and the second outright cannabis legalization becomes a premise - these dispensaries will commonly pursue an adultuse license, absolving their responsibilities as a medical cannabis dispensary to focus on “Patient One.”

Well wait, if it's legal cant “Patient Two” just go to a dispensary and buy the same stuff? Well yes, they can go buy “cannabis” at an adult use dispensary except “Patient Two”, commonly prefers a conversation with a medical professional (whether a doctor, nurse or pharmacist) for medical preciseness and professional reassurance that cannabis will therapeutically help with their specific complication(s). Typically medical professionals are equipped to review one’s unique medical history and the (few) pharmacological interactions between cannabis vs the other cocktail of medications they may already be taking for their condition. Since dispensary employees end up prioritizing “Patient One,” naturally employees are dis-inclined to provide the level of care or patience that is required for “Patient Two.” Most importantly, non-medical dispensary employees or budtenders should not be forced into the

position of providing medical advice to “Patient Two” considering the risks behind providing advice with a lack of medical expertise.

Now, the prescribing (recommending) Doctor should be the natural fallback in this situation, but also the doctor is not accustomed to the specifics of the store’s inventory and how those products preform best or contradict based on a trend of medical history/prescriptions. Not to mention we all know dispensaries and products are far from being equal or the same from store to store. One way around this, is requiring a medical professional to be on site at a “Medical Dispensary” to serve the needs of “Patient Two” when it's necessary.

In essence, true medical dispensaries & programs are designed for the medical personalization required to service “Patient Two.” At times this also means the patient having access to unique and specialized strains that may not be grown for high yield or quick flower times - like the strains/genetics typically found in adult-use markets. Rather these specialty strains may be tougher to grow but perform for the patients that need it, due to the designed constituent of effects for a unique strain or cannabinoid profile grown for a specialized need. Medical patients additionally need more legal protections, purchasing rights and access to affordable higher potency products as their rate of consumption may be “higher” than most, due to a debilitating condition. This segmentation between “Patient One” and “Patient Two” will be necessary until the knowledge behind the therapeutic use of Cannabis has permeated into common pharmacology and as products become nationally regulated.

Conclusion

As mentioned earlier, medical programs serving “Patient One” isn’t a bad thing - considering policy makers are encouraging “safer use” of the plant, expanding access, decriminalizing/ protecting use of the plant by it’s constituency that is already using it. Ultimately, Doctors should not be the key-holders to using cannabis legally.

Most states that operate within an adult use and medical landscape, “Patient Two” may commonly access the medical personalization through the ability to skip a long line at a dispensary, avoid strenuous taxes or access to different product types unavailable within an adult use store. That being said - most medical programs fall short of patient needs or the level of care needed for “Patient Two.” Although we could say this is due to “adult use legalization” this dilemma is actually rooted in the lack of knowledge by our legislators and advocates when we legalize for adult-use and the bandwidth it takes to understand the nuances of an industry that is similar but unlike none other.

Since there are essentially two different types of patients or “customers” in certain operator’s eyes - issues will continue to arise when addressing the true intention of a medical program vs the current needs of furthering the legitimacy behind general cannabis use. The true medicine to the current condition is still cannabis legalization. But the insistence upon patient rights and mindfulness to those that are in severe medical need is, let’s face it, the reason why we are considering cannabis legalization all together.