Now that the state's medical marijuana program has been revived, officials say it will take about 15 months for the first patients to buy the drug legally in Maryland. Shannon Moore hopes her twin sons survive.
Her 3-year-olds, Nicolas and Byron, already have lived longer than expected while battling as many as 30 seizures a day from Miller-Dieker syndrome, a disease that causes brain deformities. Moore hopes a marijuana extract will reduce their seizures.
"The hardest part is feeling hopeless," the Frederick resident said. "If you've done everything you could, it might not be enough."
Despite the General Assembly's actions last week in revamping the stalled medical marijuana program and decriminalizing possession of 10 grams or less of pot, many questions remain unanswered about implementing the laws. Doctors, growers and dispensaries are waiting to learn the details of regulations that will govern the fledgling medical marijuana industry. Police across the state are evaluating the impact of the decriminalization measure on crime-fighting strategies, and the statewide prosecutors organization has called for a veto by Gov. Martin O'Malley.
Experiences in other states show that even after months of legislative debate in Annapolis, Maryland could face unexpected twists. When Colorado started its medical marijuana program, the electric company needed bigger transformers to power the lights at indoor marijuana farms, and growers found that they needed to put locks on trash bins because people were trying to get discarded marijuana stems and buds.
Cheverly Police Chief Harry Robshaw, a member of Maryland's Medical Marijuana Commission, faults lawmakers for not defining some key issues better.
For example, the decriminalization measure does not specify whether police can continue searching a suspect after finding marijuana weighing 10 grams or less. Should they issue a citation on the spot and leave? Or keep looking, in case the suspect has a much bigger supply?
"Nobody has the answer to that," Robshaw said. "That's what worries law enforcement."
From the outset, Maryland's medical marijuana program will have tighter controls than the one California started 18 years ago.
California regulators have no control of the estimated $1 billion industry and don't know how many growers or dispensaries operate. The California Police Chiefs Association and other lobbying groups are pushing for state oversight.
"It's chaotic and out of control," said Chula Vista Police Chief David Bejarano, the association's first vice president. "Anyone can obtain a recommendation for medical marijuana. There is no oversight or protection to the patient."
Dr. Paul Davies, chairman of Maryland's Medical Marijuana Commission, estimates that it will take until the third quarter of 2015 to establish the network needed to put the drug in patients' hands. The panel will develop and propose regulations by September, he said.
"We are actively putting a plan together," he said. "We're already on it."
According to Davies, this is how Maryland will form the network: Once the commission proposes the rules, they will be reviewed at several levels, including by the Maryland Department of Health and Mental Hygiene, the attorney general's office and a legislative oversight committee. After an approval process of about four months, the commission will take applications from physicians and prospective growers and dispensers.
The legislation — which O'Malley has said he will sign into law — calls for no more than 15 growers to be licensed in the first year but gives the commission the discretion to add licenses later. Licenses will be issued after a background check.
"We're hoping there will be strong interest among physicians," Davies said, noting that there is likely to be strong demand for grower's licenses.
The commission was set up as part of last year's medical marijuana legislation, with 11 members drawn from fields such as medicine, pharmacy, law enforcement and substance abuse treatment. The revamped law expands the number to 14.
J. Darrell Carrington, lobbyist for an Anne Arundel County company that is interested in seeking a grower's license, expects significant competition for the permits — and not just from folks with a few acres and an interest in recreational marijuana.
"These are apples and oranges," he said. "We are looking to make medicine for people."
Carrington, who represents CFB Consulting in Pasadena, said that means growers will need secure, sterile, indoor facilities and will have to have extensive testing done by independent laboratories.
In Colorado, it's common for growers to spend nearly $500,000 to enter the business, according to the Marijuana Industry Group, which represents growers and patients in the state. The high costs come from the required seed-to-sale tracking system, video surveillance and irrigation networks, said Mike Elliott, the executive director.
"This is an extremely difficult business to be a part of," he said. "If you screw up, you can end up in prison."
Del. Dan K. Morhaim, sponsor of the Maryland medical marijuana legislation and the General Assembly's only physician, predicted that doctors would gradually gain interest in obtaining licenses to recommend marijuana for patients.
Morhaim, who specializes in emergency and internal medicine, predicts that initial interest will come from specialties such as pain management, neurology, oncology, orthopedics and rheumatology. He says he hopes the commission will move quickly because patients are suffering without the drug.
"I think it should be done with as few delays as possible, as responsibly as possible," the Baltimore County Democrat said. "There's no reason you can't do both."
Tyler Kutner, 20, who uses marijuana to treat muscle spasticity caused by cerebral palsy, plans to enroll in the medical marijuana program.
"I'm cautiously excited," said Kutner, who lives in College Park. "I live in chronic pain."
Gail Rand of Annapolis, another parent who wants to use medical marijuana for a child, is concerned about rules that limit access to the drug. She was happy that the program was broadened — the state previously had focused on academic medical centers — but would like patients to be able to get more than a 30-day supply of the drug at a time.
"When parents of a special-needs child have to pick up medicine every 30 days, it can be quite challenging," said Rand, whose 4-year-old son, Logan, suffers up to 10 seizures a day because of epilepsy. "I don't know right away where the closest dispensary will be. We can't just go to the local CVS."
Meanwhile, police departments across Maryland will have to adjust to enforcing the decriminalization measure.
When it is no longer a criminal offense to possess small amounts of marijuana — the law would take effect Oct.1 — Maryland residents should not expect a wave of police officers to suddenly shift toward more violent crimes. In today's war on drugs, recreational users are not targeted by vice, narcotics and street cops, police said.
"It's too early to tell" how the law will affect policing, said Mayor Stephanie Rawlings-Blake. Baltimore's Police Department did not respond to requests for comment.
"It really won't change our strategy from a crime-fighting standpoint," said Lt. T.J. Smith, spokesman for Anne Arundel County police. "It just changes the citation."
The Maryland State's Attorney's Association voted Thursday to ask O'Malley to veto the legislation, saying it would create too many problems for police officers.
Baltimore County State's Attorney Scott Shellenberger, the group's first vice president, questions how police would handle drug-free school zones. And he wonders what would happen when police issue civil citations for marijuana possession and arrest the same people with drug paraphernalia such as crack pipes.
"We feel we could do a little better next year," Shellenberger said of asking for a delay.
A spokeswoman for O'Malley, a former prosecutor, declined to comment at length on the association's request but said the governor still plans to sign the decriminalization measure.
Mark Cheshire, a spokesman for the Baltimore state's attorney's office, said he expects that caseloads will drop for prosecutors who handle the diversion program for low-risk offenders. That program offers people charged with marijuana possession a chance to avoid conviction through community service. Nearly 4,500 people went into the program last year, up from about 1,400 the year before.
The decriminalization measure's biggest change centers on how police cite offenders. Currently in Maryland, marijuana possession is a misdemeanor that carries a maximum 90-day jail term. Under the new law, adults found with less than 10 grams of pot would get a civil citation and pay a fine; they would no longer be sent to jail.
Peter Moskos, an assistant professor at the John Jay College of Criminal Justice in New York, said the new law will not make streets safer.
"People aren't shooting each other in East Baltimore over small amounts of marijuana," said Moskos, a former Baltimore police officer. "Cities have [decriminalized marijuana] for decades. It's had no impact."
Still, proponents of decriminalization consider passage a victory. They hope the measure will eliminate disparities for black males, who are twice as likely to be prosecuted for marijuana possession as white males.
The legislation won't alter decades-old police tactics, officials said. Drug-sniffing dogs are not being retired. Finding small amounts of marijuana is often a doorway to bigger investigations and a way for police to search for evidence of other crimes.
Robshaw plans to order his officers who come across marijuana to keep searching if they find probable cause. If they find 10 grams or less, "the civil citation should be the last step," the Cheverly police chief said.
He'll make another change: issuing scales to officers so they can determine whether small amounts of marijuana fall under the 10-gram limit. Still, Robshaw expects immediate court challenges to the law, including in cases in which officers find evidence or contraband after issuing a civil infraction.
One proponent of decriminalization said the greatest impact would be on the "collateral consequences" for people who have criminal convictions under the current law.
Years-old arrest records have blocked offenders from getting jobs or student loans, said Rachelle Yeung of the Marijuana Policy Project. "It's a lot more harmful than the substance itself," she said.
Now, fewer people will carry the stigma of a drug arrest, she added, and they will find it easier to get hired by employers.
Kym Byrnes of the Baltimore Sun Media Group contributed to this article.