After years of playing competitive softball, Carly Martin began to have chronic pain in her lower back. A Division I pitcher for Howard University in college, the back pain and stress from her schedule bothered her as she trudged along the campus hills from practice to class.
The 14-year competitive player tried cannabis to ease the pain. At the end of a long day, sometimes the relief it brought would be the only thing Martin said she’d look forward to.
“I don’t think I ever associated with using it for medical reasons,” said Martin, 28, of Columbia. “But I really was.”
Today Martin works at Remedy Columbia, one of the first medical cannabis dispensaries to open in Howard County when medical cannabis products first hit the shelves in Maryland in December.
As a college athlete, Martin said she experienced a stigma surrounding cannabis use, something she hasn’t encountered as much today as Maryland has joined 30 other states with legalizing medical marijuana sales.
Growth has been rapid. Maryland dispensary sales have moved from $1.8 million in December to $8.7 million through June, with a nearly sevenfold increase in transactions.
Of the 65 dispensaries in Maryland, six are in Howard County, according to the Maryland Medical Cannabis Commission, the group that oversees the program.
The number of patients certified to obtain medical cannabis in Maryland jumped nearly 30 percent — to 35,836 from 27,585 at the end of May. Experts estimate that the number of patients typically equal 2 percent of a state’s population. For Maryland, which has a population of about 6 million, that would equate to 120,000 patients.
The state also continues to add medical providers who can recommend cannabis. The commission announced last month there are now 985 providers — primarily physicians. That’s up from 709 at the end of May.
“There’s definitely more and more patients coming in, definitely more and more people who want to get off the prescription drugs they’re on,” said Adam Scher, a wellness adviser at Trilogy Wellness of Maryland, a cannabis dispensary in Ellicott City. “It’s been wonderful help for a lot of these people.”
Scher, like Martin of Remedy Columbia, is a patient himself. He was diagnosed with a brain tumor and started surgery and radiation treatment nearly two years ago. Scher said medical cannabis has helped him get off prescription drugs and ease anxiety and chronic pain, the most common condition treated with medical cannabis in Howard County and the state.
“I’m very passionate about this, it has worked for me,” said Scher, 32, of Owings Mills. “I find it to be just way better than the pills they were giving me.”
“We are in a crisis in this country — both a chronic pain crisis and an opioid crisis,” said Mitch Trellis, the CEO of Remedy Columbia. “Anything that we can be trying to alleviate those crises we should be trying, and the solution is right in front of our eyes. It is amazing to watch.”
Options for patients
Patients must be certified and enrolled in a patient registry before they can obtain drugs, which are sold in various forms that can be smoked, swallowed or applied to the skin. Nurse practitioner Cameron Campbell is one of the 985 providers that certifies patients in the state and is recommended by Trilogy Wellness.
Campbell, who started medical cannabis clinics in Pikesville and Parkville in February, works with patients who used opiates to help cope with chronic pain.
“My job is to give these people options,” said Campbell, 30, of Baltimore City. “The thing that I appreciate the most about cannabis is, if you come to me with four different problems in my primary care office, you’ll get four different medicines — pain, insomnia, depression and anxiety, you’ll get four different medicines to treat all four. But cannabis, it can treat all four of those conditions with one simple medication.”
Campbell said he sees as many as 14 new patients a week in his clinics.
“You’ll have the patient come in who’s in their 70s that has severe chronic arthritis and doesn’t want to be on opioid medications, you have the 50 to 60-year-old who has worked a manual job and has damaged to their knees, lower back or neck,” he said. “I have a lot of patients who are younger people that don’t want to be on Western antidepressants.”
The state sets strict limits on the amount of cannabis that can be sold to a patient each month. One thing the industry struggles with, Campbell said, is the varying quality of consultations from registered providers.
“There are a lot of doctors that will provide a five-minute, in-and-out visit,” Campbell said. “We do hour-long consultations where we discuss multiple different levels of their treatment and care.”
Gene Ransom, chief executive officer of The Maryland State Medical Society, known as MedChi, said he was not aware of Campbell’s claim about the duration of consultations. MedChi does not have an official stance on medical cannabis, he said.
“We’re a professional organization and if there are physicians who want to do this, we want to help them do it ethically and legally, and if there are physicians who don’t believe in it, we respect that position and understand it,” he said.
Ransom noted there is no required additional education to recommend medical cannabis in Maryland, though MedChi offers education programs.
Some physicians supplement their education on their own. Danielle McDevitt, one of the physicians recommended by Trilogy Wellness, went to conferences on cannabis and devoted time to reading on the topic.
“I think a lot of physicians are on the same page to be like ‘OK, how can I use this appropriately, and in the best way for our patients?’” she said.
Registered dispensary agents, which includes wellness advisers, are required to be trained on federal and state laws and regulations, detection and prevention of medical cannabis diversion, standard operating procedures and security and safety procedures, among other information, according to state policy. Every 12 months, they must be educated on updated data for cannabis pharmacology, effects, dosage, drug interactions and symptoms of substance abuse.
Apart from the political debate over awarding of licenses to producers and sellers, there have been few glitches with the first eight months of cannabis sales in Maryland.
The industry also doesn’t accept insurance statewide.
The drug is not Food and Drug Administration approved and considered medically necessary in Maryland, so it isn’t covered under insurance, said Tracy Imm, the public affairs director of the Maryland Insurance Administration.
Issues with a statewide inventory control system known as Metrc have also been “a little bit of a challenge” for patients, said Robyn Davis, the senior assistant manager and head of marketing for Trilogy Wellness of Maryland.
Maryland requires the system to be updated as sales occur, which notes changes to a patient’s cannabis allotment, and if the system is operating too slowly, sales can be impeded.
“Sometimes our patients will drive quite far to get to us for a particular product or a deal that we may have, and so, for them to come and then we’re unable to give them their medication, it really is unfortunate for the patient,” Davis said. “I will say it’s gotten a little bit better, but there’s still definitely a lot of room for improvement.”
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With reporting from The Baltimore Sun.