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Rollout of medical marijuana has been spotty in other states

FILE - In this Oct. 20, 2018, file photo marijuana clone plants are displayed for sale by Interstate 5 Farms at the cannabis-themed Kushstock Festival at Adelanto, Calif. California became America's largest legal marketplace, while Canada became the second and largest country with nationwide legal recreational marijuana in 2018. (AP Photo/Richard Vogel, File)
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Almost three years after voters passed a medical marijuana amendment in Arkansas, the state was able to finally open its first dispensary this month.

Although regulators approved the first medical marijuana dispensary, the drug’s distribution is still uncertain, according to the Arkansas Democrat-Gazette. Medical marijuana may have become available, but enough is unlikely to be produced anytime soon to supply the 11,000 residents or so who are able to purchase it.

Only three of five licensed growers have started cultivating plants, and just one has harvested them. Legal and bureaucratic setbacks have also delayed the program, according to the Democrat-Gazette. The process of evaluating dispensary applications took longer than expected, and the cultivation permit process has been challenged in court.



“We didn’t have our cultivation facilities graded independently; they were graded by this commission themselves, and it was a mess,” said David Couch, the lawyer who drafted Arkansas’ medical marijuana amendment.

In Missouri, the regulations for its own medical marijuana rollout were finalized last week.

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The Department of Health & Senior Services has been tasked with overseeing the regulation and operation of the state’s medical marijuana program.

Patient and business applications are now available, DHSS will accept patient applications starting July 4, and business applications starting Aug. 3. The department will score applications until Dec. 31, before licenses are distributed in 2020.

The initiative to legalize marijuana for medical purposes passed in November, making Missouri the 33rd state to join the club. Being late to the game, Missouri could benefit from the experience of its neighbors when implementing its own medical marijuana law.

Arkansas approved a constitutional amendment legalizing medical marijuana in 2016.

The reason Arkansas was so late in opening dispensaries, according to Couch, is because there was no mechanism to speed up the application process. Dispensaries that were finally approved are taking longer than anticipated to be operable.

“They mucked this up bad,” Couch said about the commission responsible for setting up the program. Though he says Arkansas is close to having medical marijuana available, he laments that there should have been a “hammer” in the amendment that could’ve gotten medical marijuana out in Arkansas sooner.

“Whatever system you guys have to award the actual licenses and stuff, it just needs to be open and transparent and independent of politicians,” he said about lessons Missouri could learn from the process. “That’s what really screwed this thing up in Arkansas.”

In Illinois, the medical marijuana law has morphed several times since it was passed as a pilot program by the General Assembly in 2013.

Originally, medical marijuana was restricted to those 18 years or older, but this was later changed to allow children under the age of 18 to use medical marijuana as long as they have the consent of their parents.

Additional illnesses had to be added to the list of qualifying conditions for medical marijuana, according to Conny Moody, a representative of the Illinois Department of Health. Additions included post-traumatic stress disorder, terminal illnesses and other debilitating conditions.

The pilot program was set to expire in 2018, effectively making it illegal, but in 2016 it was extended to 2020.

In other changes, Illinois eliminated the need to fingerprint patients, which allows convicted felons to participate, and the state allowed caregivers to administer cannabis oil to students on school grounds.

Currently, Illinois has introduced a program to reduce reliance on opioids by using medical marijuana as an alternative, Moody said.

The Illinois Department of Public Health states that the program“allows access to medical cannabis for individuals who have or could receive a prescription for opioids as certified by a physician licensed in Illinois.”

Missouri has 10 debilitating conditions listed on its draft rules, though it allows a licensed physician to identify other chronic, debilitating or medical conditions that could qualify.

Comparatively, Illinois lists 41 conditions and Arkansas has 19 with the ability to add more. Illinois has a laundry list of qualifying conditions, while Arkansas allows for any condition that is approved by the Department of Health.

Other issues worrying Missourians, such as keeping the money from medical marijuana in the state, have already been addressed in states like Arkansas, as well as Missouri.

Couch said the Arkansas amendment ensures that 60 percent of the ownership of any medical marijuana entity has to belong to Arkansas residents. Similarly, Missouri also has a provision ensuring that 51 percent of ownership remains in the hands of Missourians.

Another important consideration is supply and demand when it comes to medical marijuana. Often, as in Arkansas right now, the demand is expected to exceed the initial supply.

According to Paul Armentano, a member of NORML, shortages are often caused when “only a limited number of operators are initially licensed in a staggered manner, or in jurisdictions where the total number of operators are arbitrarily capped.” Initial demand is often greater than the available supply, and regulatory fees can lead to inflated prices.

When deciding how many cultivation facilities were needed, Couch said Arkansas anticipated around 70,000 patients for medical marijuana based on a population of 3 million people, half that of Missouri. They allowed for a maximum of eight cultivation facilities and 40 dispensaries. The dispensaries are also able to grow their own plants and buy and trade among themselves based on a limited number of plants, according to Couch.

He said he looked at New Mexico’s medicinal marijuana program when it came to deciding how many facilities they would need.

In contrast, Missouri’s amendment will allow for a maximum of 60 cultivation facilities and 192 dispensaries, according to current draft rules for medical marijuana in Missouri, though according to a study by University of Missouri, the state may have overestimated the number of patients who would be eligible for medical marijuana.

The original amendment assumed that there would be 100,000 qualifying patients by 2022, but the study by MU says it may be as low as 26,000.


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