In Race to Launch Adult-Use Market, Medical Patients and Caregivers Feel Stuck on Sidelines

As adult-use consumers and businesses gear up for the debut of Vermont’s retail market, medical patients and caregivers say they are still waiting for much-needed fixes to a program that has seen little substantial reform in at least a decade.

In March, the state’s medical program received a D rating from Americans for Safe Access, a nonprofit that represents cannabis patients, doctors and researchers.

Jessilyn Dolan, founder of the Green Mountains Patient Alliance and the Vermont Cannabis Nurses Association, said it has been “sad and frustrating” to see patients repeatedly overlooked throughout the roll-out of the new legal industry. 

“We’re working for an adult-use program and making a lot of changes and spending a lot of time and energy and a lot of testimony, a lot of community input,” she said, “while we’re just allowing our medical program to stay stagnant and not move forward and not do anything differently.”

“The legislature was focused on the retail programs. And I will qualify that immediately by saying the CCB worked really hard to listen to us and that they took our ideas seriously. But they were hamstrung by the legislature.”
— Fran Janik

The Cannabis Control Board took over the management of the medical registry from the Department of Public Safety in January, and in March, the panel adopted emergency rules to keep the program running after previous statutes expired. But without legislative action, there’s not much the board can do to begin implementing reforms the community has long called for.

“The legislature was focused on the retail programs. And I will qualify that immediately by saying the CCB worked really hard to listen to us and that they took our ideas seriously,” longtime patient advocate Fran Janik said. “But they were hamstrung by the legislature.”

Among the measures that never made it past a first reading this session was S.186, which would have increased the number of plants caregivers or patients can cultivate to six mature plants and 12 immature, as well as raised the number of patients caregivers are allowed to serve from one to two. The bill stalled in the Committee on Health and Welfare. 

From medical patient Amelia Machia’s perspective, expanding the caregiver program is the best way to ensure patients can fill their needs outside of the state’s medical dispensaries, which have been criticized for low product quality, poor oversight, high prices and lack of accessibility. 

“As long as we have that 1:1 ratio of one patient per caregiver, that’s only going to be a drop in the bucket.”
— Amelia Machia

To make that a reality, Machia said two patients per caregiver, while an increase on the current limit, is not enough. 

“As long as we have that 1:1 ratio of one patient per caregiver, that’s only going to be a drop in the bucket,” said Machia, who is also the director of communications for the Green Mountain Patients Alliance. “I think that if you have a tier one or tier two cultivating license, you should be able to care for up to five to 10 patients at a time if you have the space and are willing to do so.”

Machia would like to see the state establish a medical co-op that would allow caregivers and cultivators who are growing for patients to offer their excess cannabis for patients to shop tax-free. Patients should also have the ability to shop without being taxed at adult-use dispensaries, Dolan said, which are currently subject to more stringent requirements around third-party testing than medical dispensaries are. 

As of June 2021, there were 4,767 patients enrolled in the state’s medical registry, according to the Cannabis Control Board. That’s compared to about 6,000 patients in June 2018, shortly before legal recreational cultivation went into effect.

“The fact that we have a medical program that has less consumer safety and education mandates than our adult use program is almost an oxymoron. It just doesn’t make sense,” Dolan said. “So that’s probably the number one concern.”

Buying from retail operations would also give patients access to a wider selection of locally-grown, craft cannabis not offered at the corporate medical dispensaries. However, due to the concentrate potency caps instituted this session, not all patients may be able to find the products they need at adult-use shops. 

“I think that people are going to rely on caregivers that are out of the system…. It’s less expensive, it’s more reliable, it’s more personal.” — Fran Janik

Advocates warn the continued lack of progress could make patients favor the legacy market. As of June 2021, there were 4,767 patients enrolled in the state’s medical registry, according to the Cannabis Control Board. That’s compared to about 6,000 patients in June 2018, shortly before legal recreational cultivation went into effect.

“I do think that you’re going to see less people renew their cards, and that’s going to take the medical system, and shrink it,” Janik said. “I think that people are going to rely on caregivers that are out of the system. They’re still going to do it. It’s less expensive, it’s more reliable, it’s more personal.” 

There is also a pressing need to expand the list of qualifying conditions to become a medical patient, advocates told Heady. But Machia noted that an updated iteration of the state’s Symptom Relief Oversight Committee, which was disbanded in March, has yet to materialize. Getting the new committee in place should be a priority before significant legislation moves forward, she said. 

“Patients deserve better. We can do a lot better. We’re a small little state, we can lead the way and be an example to the rest of the country as to how it should be.”
— Jessilyn Dolan

She hopes that once the control board gets through the license applications that are currently pending, there will be more capacity to focus on the medical program. 

“Having spoken with all of the members of the CCB, they’re very passionate about helping patients and about improving the medical market and the program as a whole,” Machia said. “They just need to have the time and the space to dedicate to it.” 

Dolan’s worry is that the legislature will need to spend a good chunk of the next session making tweaks and fixes to the adult-use market, potentially pushing the concerns of medical patients onto the sidelines once again.

To ensure that doesn’t happen, Dolan said adult-use businesses and consumers need to rally behind the medical cannabis community by submitting testimony, speaking up in meetings and hearings, reaching out to representatives and asking the state and the CCB to prioritize patients.

“Patients deserve better. We can do a lot better. We’re a small little state, we can lead the way and be an example to the rest of the country as to how it should be. So that’s my hope,” Dolan said. 

She added, “Sometimes it’s rose-colored glasses, but I’m gonna keep wearing them for now, and keep advocating and being as loud as we can, so that we do get the time and the prioritization next year.”

Thanks for reading! 🙏🏽

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