CT: With Booming Medical Marijuana Program, Some Fear Shortages

Photo Credit: Peter Hvizdak

With 26,353 patients enrolled in the state’s medical marijuana program as of Saturday, up one-third since May 2017 — and with the program’s Board of Physicians scheduled to vote on whether to add opiate withdrawal to the list of approved conditions — dispensary owners are concerned about whether there will be enough supply to meet the ever-growing demand.

However, one of the producers and a lobbyist for the four growers, as well as Consumer Protection Commissioner Michelle Seagull, say they are confident the four can meet the expected increase in consumers.

“We have no problem handling additional patients,” said David Lipton, CEO of Advanced Grow Labs in West Haven, one of the four original — and still only — licensed medical marijuana producers in the state. “We’re projected out to be able to handle product for about 75,000 patients.”

Advanced Grow Labs, with 48 employees, has expanded twice since it opened in the fall of 2014, when there were about 2,000 certified patients in the program. The other growers, in Portland, Simsbury and Watertown, also have expanded to double or triple capacity, according to Linda Kowalski, lobbyist for the growers’ Connecticut Medical Cannabis Council.

“Connecticut’s medical marijuana program is regarded as one of the best in the country, and our members are proud to play an important role in this innovative and compassionate program,” Kowalski wrote in an email.

She said the producers have spent millions in expansion and that “the quality and purity of their products lead the nation while their pharmaceutical grade products are available to all patients in Connecticut’s program.”

The state program has ballooned in growth since it began with six dispensaries and those 2,000 patients, and could explode if the Board of Physicians adds opiate use disorder and opiate withdrawal to the 29 conditions now approved for adults and seven for children.

The board, which tabled votes on opioids and progressive degenerative disc disease of the spine when it met Feb. 26, will take up the two conditions again on June 25.

Patients who are certified to use marijuana for painful conditions such as cancer and sickle cell disease report that cannabis has allowed them to reduce or eliminate their use of opioids, said Angela D’Amico, owner of the Compassionate Care Center of Connecticut in Bethel. Opioid dependence has become a national epidemic.

“We get phone calls from parents whose children are coming out of rehab” for opioid addiction, but “we can’t certify them,” D’Amico said.

Laurie Zrenda, owner of Thames Valley Alternative Relief LLC in Montville, said, “I see people on a daily basis who have come off their opioids using medical marijuana.”

Seagull said of the possible approval of marijuana to treat opioid addiction, “It would likely add a large number of patients.” Once Seagull ratifies the board’s vote, the new condition must go through a legislative committee and regulatory review board, before it’s added to the approved list. “And during that regulations process the state, and the production facilities, would have time to consider the appropriate options for expansion,” Seagull said.

Meanwhile, “there have definitely been periods of time when we’ve had issues and short supply of things,” Zrenda said. The dispensary owners have formed their own Medical Marijuana Academy within the Connecticut Pharmacists Association and, Zrenda said, “As a group we sent two representatives to go and visit the commissioner to talk about the issue of supply.”

The pharmacists would like a fifth grower to be approved, Zrenda said. “The patient count is increasing, new conditions are coming on board … and we have had issues of supply problems in the last couple of years.”

But she said she understands the reluctance to approve another grower. “I think they worry about them surviving given that it is a huge investment,” Zrenda said. “It’s a huge expense to run a growth facility. … I know the state wants to keep them going and doesn’t want them to go belly-up.”

Zrenda said both growers and dispensary owners also have to contend with the U.S. tax code, specifically Section 280e, which forbids a business from deducting any expense connected to “trafficking” in controlled substances, and marijuana is listed as a Schedule 1 drug, along with heroin and cocaine. Selling it is still a federal crime.

That means the cannabis businesses can’t deduct payroll or equipment as normal business expenses. “If a normal business pays 25 percent in tax, we’re probably paying 60 percent,” Zrenda said. “It isn’t the big money-maker that everybody thinks it is.”

There are now nine dispensaries across the state — up from the original six — and the Consumer Protection Department has asked for applicants to open three to 10 more in the fall.

D’Amico said the addition of new dispensaries could bring on shortages, because the growers are required to offer the same amount of product to each dispensary. She said the allocation should be based on each dispensary’s number of patients.

“It’s medication. How do you tell your cancer patient in the middle of chemo, ‘Sorry, we can’t supply you with what you’ve been on’?”

Seagull said, “Right now we’re not planning to add new producers, but we’re continuing to monitor the situation. Right now we’re comfortable that the producers have the capacity to serve our patients.”

Advanced Grow Labs’ Lipton said his plant on Frontage Road in West Haven started at 16,000 square feet, is now up to 41,000 and “we’re more productive per square foot.” Starting with five employees, in addition to five owners, AGL now has 48 employees, he said.

Besides the growing areas, there are genetics rooms, where hybrids are developed from “mothers and clones,” Lipton said. “We have a lot of new genetics and also a lot of new products. We’ve got a lot more products that we are making for the patients in Connecticut now. In any given day in the dispensaries, they’ve got 200 to 230 different products they have available to sell.”

The program is based on a pharmaceutical model, with physicians — there are now 897 registered doctors — certifying their patients to buy up to 2.5 ounces of cannabis a month.

The patients then work with the pharmacists to choose a strain, from Lexikan — known on the street as lemon skunk — to Gwyniva, and what form to use, whether to smoke, vape, insert a capsule under the tongue, or eat as a cookie or brownie.

Each product has a particular ratio of THC, the hallucinogenic cannabinoid, to CBD, which doesn’t make the user high but which reduces anxiety and nausea and aids in sleep.

With more products to choose from, the dispensary owners can run into spot shortages of particular items. “We get deliveries twice a week from every producer,” D’Amico said. “Each dispensary can get 200 vials of XYZ. If my pharmacist orders that late … it’s not available to us anymore.”

Zrenda said that, for “some strains that are high in CBD, there was a long time when we didn’t have any [for] at least a couple months.”

“Supply and demand is a real issue, especially for products that people love. They can’t keep it up,” said Michael Petruzelli of Hamden, a medical marijuana patient who suffers from spina bifida caused by his father’s being exposed to Agent Orange during the Vietnam War. “What happens is, you find something that works for you … Guess what, it’s not available. There’s probably about five key strains that they should be growing every month.”

He said he favors Lexikan flower. “It’s a very, very good sativa. “It’ll make the most miserable person really happy.” Sativa is one of two types of cannabis, along with indica. Hybrids are created using characteristics of the two.

“Growing patient numbers means changing demands for specific types of medication,” Seagull said. “While growing capacity exists, producers also have to anticipate demand for specific medication types months in advance, and may not have a large stock of the exact medication a dispensary facility is looking to purchase on short notice.”

Petruzelli believes adding another grower would bring prices down, although he said he’s noticed prices dropping recently.

Lipton said prices have dropped now that the growers have recouped their startup costs. “Prices have definitely come down for the patients since the program started,” he said. “We’ve all put the money into our facilities, we’ve paid the money to the state. … I don’t think someone could start new and be competitive.”

The Consumer Protection Department’s Board of Physicians will meet at 8:30 a.m. June 25 at 450 Columbus Blvd., Meeting Rooms C and D in the North Tower. They are expected to vote on opioid withdrawal and progressive degenerative disc disease at the meeting, which is open to the public.