A state commission charged with launching Maryland's lagging medical marijuana program hit the pause button Tuesday, postponing a final vote on already tardy regulations to tweak licensing fees and make cannabis available to patients in liquid as well as smoke-able form.
Dr. Paul W. Davies, chairman of the 15-member panel, said officials needed more time to craft rules, particularly to allow for the production and sale of extracts containing concentrated doses of marijuana's therapeutic ingredients.
"We realized that our regulations didn't cover extracts," said Davies, a pain management specialist, "and for medical use that's incredibly important."
The commission had opted initially to focus only on growing and dispensing marijuana in leaf form, Davies said, because of the "time crunch" of meeting a Sept. 15 deadline set by the General Assembly for adopting regulations. But the panel decided to respond to public comments urging it to include extracts, he said, because for some people dosing themselves by smoking marijuana isn't feasible or comfortable.
Lawmakers first approved legalizing medical uses of marijuana in 2013, but limited it to academic medical centers, which showed no interest. New legislation approved this year authorizes licensed physicians to recommend it for patients, with as many as 15 licensed growers and an as-yet undetermined number of dispensaries.
The draft regulations, already 98 pages long, are being revised to provide a separate licensing category for dispensaries that would process marijuana to extract its medicinal properties, the chairman said. Processors typically use various solvents or water to pull marijuana's active ingredients from the plant.
Davies said the panel also intends to "adjust" proposed licensing fees for growing and selling medical marijuana, which if not changed would be among the highest in the nation. He declined to offer specifics, beyond acknowledging that the commission aims to reduce at least some of the charges.
Prospective growers would have to pay $125,000 a year for a two-year license, while dispensaries would have to pay $40,000 a year, according to a fee schedule presented in September. Only one state — Illinois — is charging a higher upfront cost for growers.
Some advocates warn that steep licensing costs could drive off applicants, especially small and minority-owned businesses. But state health officials have said the fees were set to cover costs of the program, and they note that similarly high fees in Illinois didn't appear to stifle bidding for that state's medical marijuana licenses.
The commission voted to meet Nov. 13, at which time Davies said he was "99 percent certain" the regulations would be adopted and sent along to the state health secretary for review before being formally proposed.
Advocates welcomed the commission's move to allow for production and sale of marijuana extracts, and to review the fee schedule, but expressed impatience with the amount of time it's taking to get Maryland's program ready to go.
"Every day that these regulations are delayed is another day that patients must suffer without relief," said Rachelle Yeung, legislative analyst with the Marijuana Policy Project, a national advocacy group based in Washington.
Gail Rand, whose son suffers frequent epileptic seizures, urged the panel to provide for prompt sale of hemp oil in addition to extracts, saying it has been shown in other states to be safe and effective for treating conditions like her child's. But Davies suggested that may require new legislation.
Del. Cheryl D. Glenn, a co-sponsor of the bill revamping the state's program this year, later told reporters she was sure there would be new legislation next year, to fix lingering issues. The Baltimore city Democrat voiced frustration with the delayed launch, which she blamed on the commission keeping her and other advocates at arms' length as it's drafted regulations.
"I'm frustrated, to say the least," said Glenn, whose mother died of cancer in 2011 and for whom the commission is named. "I don't think anybody expected this process to take so long."