Medical marijuana dispensaries find eager patients, growing pains in Harford County

For Harford Magazine

Julie Donovan and Beth MacLeod are about to do something they never in their “wildest dreams” expected: open a medical marijuana dispensary in Harford County.

The Chestertown sisters spent the past 30 years raising their children and cultivating their careers. A former paralegal, Donovan is a computer consultant for a business that designs software for law firms, while MacLeod, a former high school biology teacher, is a marketing specialist for a wellness company.

For most of their lives, Donovan, 59, and MacLeod, 56, admit they knew little about marijuana, which is also known as cannabis. But when a friend who experienced insomnia and couldn’t eat as a result of Lyme disease saw his symptoms decrease after using the drug, they began to wonder if there was more to it.

She and her sister “are in our 50s and grew up in the Nancy Reagan ‘Say No to Drugs’ era,” Donovan says. “Then we started realizing and seeing with our own eyes how particular patients were having relief.”

This fall, the sisters will open Four Green Fields in Street — Harford County’s third cannabis dispensary. RISE Joppa, the county’s first dispensary, opened in April, and True Wellness in Aberdeen was scheduled to open in August.

Supporters of the county’s dispensaries say they give patients safe and natural options for pain and symptom relief, which they say is especially important as the heroin and opioid epidemic continues to grow.

“At the end of the day, we are helping make people feel better, people who are in pain,” says Andy Grossman, head of capital markets for Green Thumb Industries (GTI), which manages RISE Joppa. “This drug is helping provide comfort for them and helping them increase the quality of life that they currently have.”

Still, the medical cannabis industry isn’t immune to growing pains. In Maryland, there have been concerns about diversity in the market, as well as about bigger companies controlling licenses to more than one dispensary. In addition, the federal government has given its prosecutors more power to enforce laws in states where medical marijuana is legal.

And reaction from physicians has been mixed.

“You have some who believe this is not medicine and it should be managed more like any other treatment through a process similar to the” U.S. Food and Drug Administration, says Gene M. Ransom III, CEO of MedChi, the Maryland State Medical Society. “Then you have physicians who are saying, ‘Look, this is a lot less harmful than other things people are taking, and if it works or keeps them from doing things that are harmful, then maybe we should consider giving it out.’ ”

‘Not like it’s Cheech and Chong’

On a recent rainy Saturday morning, more than a dozen customers walked through RISE Joppa’s front doors, eager to purchase their doctor-recommended cannabis. Upon arrival, each one checks in at the front desk, where staff members verify they are registered with the Maryland Medical Cannabis Commission. They then present a written certification, essentially a recommendation, from a medical provider registered with the commission.

Some customers were first-timers, while others, like Ron Coyner, have visited the dispensary regularly since it opened.

Coyner, a 46-year-old former communications tower technician from Joppa, broke all of his ribs, fractured his skull in five places and broke a bone in his neck in 2005 when a piece of steel frame fell and landed on him. Most of his injuries healed, but his ribs never returned to their pre-injury state.

“I hurt every single minute of the day,” Coyner says. “I cough, it hurts. I sneeze, it hurts. I haven’t laid on my belly since 2005.”

Over the years, pain management doctors put him on an escalating dose of the opioids oxycodone and morphine, and eventually added fentanyl transdermal patches into the mix, he says.

Buying and then smoking cannabis flowers has helped Coyner stop using opioids for pain relief. A recent study published in the Journal of the American Medical Association shows prescriptions filled for opioids decrease when states institute a medical cannabis law.

According to the National Institute on Drug Abuse, marijuana use has both short-term and long-term effects. When a person smokes the drug, tetrahydrocannabinol (THC) — the main psychoactive ingredient in cannabis — passes from the lungs into the bloodstream and eventually to the brain and other organs. This can lead to mood changes, impaired body movement, impaired memory, difficulty in solving problems and even hallucinations and psychosis when taken in high doses. Long-term marijuana use can affect brain development. Physical effects, such as breathing problems, increased heart rate and vomiting, can also occur.

While many users say the drug is safe, scientific research on cannabis is limited, given legal restrictions.

But in June, the FDA approved an oral cannabidiol (CBD) solution called Epidiolex for the treatment of two rare forms of epilepsy in patients age 2 and older. CBD does not cause the “high” that comes from THC.

Coyner says he appreciates the way the industry is now regulated.

“I know now what’s in it,” he says. “It makes you wonder what we have been smoking all these years.”

On a recent visit, Coyner purchased some flower known as “Northern Lights.” Twenty percent of the strain is THC.

Customers don’t have to smoke the drug to benefit from it, RISE Joppa dispensary staff members say.

RISE Joppa offers a THC-infused lemonade and tea “elixir” customers can drink, peppermint-flavored tablets, transdermal patches that allow THC to be absorbed through the skin and powdered tinctures customers can add to water.

“It’s not like it’s Cheech and Chong [where] I’ve got to get out my bowl or I have to get out a joint and smoke it,” Grossman says. “You can use a transdermal patch, you can use creams, you can use tinctures, you can use pills. And all of those forms don’t necessarily have to get you high. They can, but they don’t have to.”

Donovan and MacLeod, along with Kal Shah, an Ellicott City resident and owner of True Wellness, say they, too, plan to offer a range of products at their dispensaries. Every product will be grown and produced in Maryland, as required by law, Shah says.

Growing pains

Overall, Grossman says the state’s medical cannabis market opened smoothly in December. The Maryland Medical Cannabis Commission pre-approved 102 dispensaries, and more than 700 providers, including doctors, nurses and dentists, have signed on to the program. A dozen of those providers are based in Harford County.

But technical and legal issues, as well as broad provider buy-in, have caused challenges.

Some lawmakers have criticized the lack of diversity in the market, so in April, the Maryland House of Delegates and Senate passed a bill that would issue seven new cannabis growing and 13 new cannabis processing licenses. It also calls for an award process that takes race and the barriers to starting a cannabis dispensary into account.

Also, while the state intended that a business could own only one store, a disputed reading of the regulations has allowed bigger companies such as GTI to gain control of licenses to more than one dispensary. GTI controls five licenses: In addition to RISE Joppa, it plans to open a dispensary in Abingdon at an undetermined date. The Maryland Medical Cannabis Commission has been considering how to address the issue.

In July, the system that automatically tracked medical cannabis use for dispensaries and consumers in real time was temporarily turned off. Dispensaries had to use a time-consuming, multi-step process to ensure consumers remain below their legal allotments.

And in January, U.S. Attorney General Jeff Sessions announced that he would give federal prosecutors more freedom to enforce marijuana laws in states that legalized the substance. This worried local physicians, Ransom says.

“Frankly, I think a lot of physicians who were considering getting the recommender license decided not to do it, or folks who had the license decided not to take any action,” he says.

Physicians also have concerns about cannabis amounts, Ransom says. If a commission-registered physician doesn’t write a specific amount on the patient’s recommendation, it defaults to the maximum amount allowed under the law, he says.

“You should really write it for the amount that you think is going to solve the issue, which can be really difficult for the physician because there’s no real guidance or science on this stuff,” Ransom says.

That’s why education is so important, Donovan says. Donovan and MacLeod, as well as Shah, say they plan to have seminars on the benefits of medical cannabis when they open. They will also reach out to doctors in the community about the drug’s benefits.

“If there’s one driving force for Beth and myself, it’s that this is medicine,” Donovan says. “This is an alternative to helping with symptoms and helping someone who has a chronic disease.”

She added: “I certainly wouldn’t force it on anybody who had strong beliefs. But I couldn’t stress enough to be open-minded. Look at what some people are saying, how people who’ve been through it have used it and how they’ve found life on the other side.”

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