Maryland voted for adult-use cannabis, and legislation has been introduced to create the applicable regulations. The legislators who drafted House Bill 556 and Senate Bill 516 have done an excellent job; the bills contemplate combining the current medical cannabis program and the adult use one under one regulatory agency. As the amendment process is underway, I ask them to consider two points.
First, the original medical cannabis legislation had provisions for “clinical outcomes.” Reporting this was a requirement “for collecting and analyzing data” in HB 881 (2014), HB 490 (2015) and HB 104 (2016). Cannabis certified providers and dispensaries should have been submitting information about outcomes for the various conditions treated. Regrettably, that has not happened. Now would be a good time to formulate a clinical outcomes plan. That could include requiring patients and/or certified providers and/or dispensaries to collect and tabulate the data (respecting patient privacy) in a consistent and usable form.
Consider what could be learned. What formulations might work best for the spasticity of multiple sclerosis? To ease the nausea secondary to chemotherapy? To relieve chronic pain or migraine headaches? To treat menstrual cramps and uterine fibroids? Which formulations might work best with different ages, genders and ethnicities, or for those with coexisting diseases? What routes of administration work well for which conditions? Do side effects follow predictable trends? We don’t know the answers to these compelling questions, but we should.
Given the size and scope of Maryland’s medical cannabis program, pooling and analyzing this information could identify effective treatment plans for specific disease conditions. That would put Maryland at the forefront of cannabis medical research.
Second, the legislation limits the number of cannabis licensees, whether growers, processors or dispensers. This concept should be reconsidered, especially as the bill has strict standards for safety, security and other requirements, and it grants the new cannabis commission full regulatory powers.
The original medical cannabis bills limited licensees. Those decisions were made for political expediency, and the numbers chosen were purely arbitrary. Among other problems, it led to racial disparities in the industry. A better way to regulate the industry would be to set safety, zoning and security rules, but allow the market to determine how many licensees would be optimal.
Restricting the number of licenses now means that those with deep pockets have a better chance of winning in the application process, and those with current licenses have a head-start. Entities with limited resources may not be able to participate. In effect, this approach creates a monopoly for some and turns owning a license into a tradable commodity. Imagine five, 10 or 20 years from now — if someone wants to get into the cannabis industry, they can’t because all the licenses would be already taken. Perhaps a license could be purchased, but it would be at an inflated price due to the restricted availability.
Maryland does not limit the number of people in any other given profession or industry. Any qualified entity should be able to enter the marketplace and compete, and the standards in the bill are sufficient to protect the public.
In 2018, I introduced legislation to remove the arbitrary cap on the number of growers. During the bill hearing, I was asked about the impact on current growers who had acted under the laws of the time. I responded that they should not fear competition, which would be good for Maryland’s paying customers; that new growers, including minority and small businesses, could be phased in; and — most importantly — that no entity should enjoy a legislated monopoly forever, which is the current state of affairs.
What is decided now will have implications for decades. These 2023 bills are an outstanding start, but they can be improved. Let’s learn from the lessons of the past and take the opportunity to make these key changes at the outset during this legislative session.
Dr. Dan Morhaim served in the Maryland House of Delegates for 24 years. He is the author of “Preparing for a Better End” (Johns Hopkins Press) and can be reached at email@example.com.