Will Recreational Marijuana Stores Help Or Hurt Medical Marijuana Patients

Photo Credit: Richard Vogel

Mike Crawford, a medical marijuana patient and longtime advocate for marijuana legalization, may not buy much marijuana in recreational shops, since he has a medical card that lets him get the drug tax-free. But he is looking forward to recreational stores opening.

“If there’s enough competition, the price will go down,” Crawford predicted.

As recreational marijuana stores prepare to open, the implications for medical marijuana patients remain murky. Patients have different hopes and expectations, and other states have had varied results.

“One of the big impacts that we’ve seen is that the medical marijuana industry starts to decline in states after they legalize recreational,” said Chris Walsh, vice president and founding editor of Marijuana Business Daily, a publication focused on the marijuana industry.

Some advocates for medical marijuana patients have been vocal about their concerns. Representatives of the Massachusetts Patient Advocacy Alliance say they are worried about marijuana shortages and about the potential for medical marijuana dispensaries that have not yet opened to decide to only sell the drug for recreational use.

The group has been working to ensure patients get benefits like reserved parking spaces at dispensaries that sell both medical and recreational marijuana.

Nichole Snow, executive director of the MPAA, said she hopes the medical marijuana program will become “part of the fabric of the cannabis industry.”

Snow said people who are sick but have not applied for a medical marijuana card will have the opportunity to try marijuana recreationally, then apply for a patient card if marijuana helps their condition.

Patients have to go to a registered medical marijuana dispensary to get benefits like tax-free marijuana, a financial hardship discount, access to certain doses and a record accessible by their physician.

Several patients cited potential benefits related to prices, access and stigma once recreational shops open.

Crawford, who lives in Marblehead, had a medical marijuana card, let it lapse, and renewed it as more dispensaries started opening. Crawford said as more dispensaries open, prices are starting to come down, and he anticipates that will continue.

Crawford said the opening of recreational stores could also help people who are sick but who do not want to get a medical marijuana card. They might work for the government or want to possess a gun license, both of which are affected by marijuana use, since marijuana remains illegal at the federal level. Some people might not want their name in a government database of medical marijuana users.

“A lot of people are still afraid to get a medical card,” Crawford said.

Stephen Mandile, of Uxbridge, said he used medical marijuana to wean himself off opioids and other drugs after he was injured during military service in Iraq. Mandile is part-owner of dispensaries he plans to open in Hull and Hyde Park that will focus on providing marijuana to veterans.

Like Crawford, Mandile said the recreational market will help people not currently in the medical market. “A lot of patients can’t get a card due to their jobs. Now they’re going to be able to have access to tested and regulated cannabis,” he said.

Mandile said he hopes having more marijuana sold legally will also reduce the stigma for people who need marijuana for medical reasons. “The more people see it and start talking about it, it helps,” Mandile said.

Chandra Batra, a Somerville resident active in marijuana patient advocacy, has used marijuana to treat fibromyalgia and pain.

Batra said recreational shops will open up a bigger market and, over time, could drive prices down as supply increases. She said prices of marijuana in Washington and Oregon have fallen as the industry ramps up. “As more growers come online, the prices of products should go down,” Batra said.

Experts say they have seen impacts on both pricing and numbers of patients in other states.

Walsh, of Marijuana Business Daily, said in Colorado and Oregon there was a sharp dip in the number of registered medical marijuana patients after recreational marijuana was legalized.

Patients who needed medication daily for serious illnesses stayed in the medical market, Walsh said, but patients with smaller aches and pains tended to buy from the recreational market because of the convenience of not having to go to a doctor. He said the tax benefit of medical marijuana can be outweighed by the convenience combined with the cost savings of not having to apply for and maintain a medical marijuana card.

“The cost savings you typically get on the medical side with lower taxes aren’t enough for a lot of patients currently in there to convince them to stay,” Walsh said.

Long-term, Walsh said, businesses, particularly new businesses, are likely to focus on the recreational market because it is a larger market. So there could be fewer options for medical patients.

It is difficult to make comparisons among states, since every state with legal marijuana has different laws.

Adam Koh, editorial director at Cannabis Benchmarks, an independent price reporting agency for legal cannabis, said Washington and Alaska never had regulated medical marijuana markets. Oregon forced businesses to pick either a recreational or a medical license, and almost every business picked recreational.

Koh said Colorado is the most similar to Massachusetts because businesses can participate in both markets. But Koh, who previously managed a marijuana cultivation facility in Colorado, said that state had several hundred medical marijuana dispensaries open before recreational shops were legal — compared with 24 dispensaries open in Massachusetts as of March 31.

The opening of the recreational market in Colorado did not initially change medical prices, Koh said. Over time, as more cultivation facilities opened, recreational marijuana prices fell below medical prices. Colorado has a similar structure to Massachusetts where medical dispensaries have to grow the marijuana they sell, while recreational licenses let one business grow and another sell.

Cultivation licenses were first issued in Colorado in late 2014. By mid-2016, Koh said, prices in the recreational and medical markets were dropping. “We just had that influx of product into the recreational market from all the standalone cultivation operations,” Koh said.

By 2017, Koh said, there was an oversupply of marijuana, and prices began to level out, without much of a difference between wholesale medical and recreational prices. Four years into legal marijuana in Colorado, Koh said, “The prices in Colorado are less than half of what they are in Massachusetts.”