MD details

FINAL GRADE: B

2018-2019 Improvements

Over the last year, Maryland’s program has continued to expand. The program currently has 99,240 patients, about 2⁄3 of which have been certified. In July of 2018 the state approved eight new dispensaries, and is currently accepting applications for more cultivation facilities and other cannabis businesses. In 2019 Governor Larry Hogan signed a law that allowed medical cannabis edibles.

 

Background

Maryland’s first legal protections for patients were established in 2003 with the Darrell Putman Compassionate Use Act, which created an affirmative defense for patients possessing less than one ounce of cannabis that reduced convictions to a misdemeanor offense with a maximum $100 fine. In 2011, Maryland passed SB 308 to recognize specific medical conditions and remove the misdemeanor penalty but not the $100 fine. In 2013, HB 180 expanded the affirmative defense to caregivers, while HB 1101 allowed “Academic Medical Centers” to conduct medical cannabis research studies and established the Natalie M. LaPrade Medical Marijuana Commission to create regulations.

In 2014, the Maryland Legislature approved HB 881/SB 923, a comprehensive medical cannabis program that expanded and clarified legal protections for patients, caregivers, and physicians and created a distribution system. Registered patients and their designated caregivers are allowed to obtain and possess a 30-day supply of cannabis, but personal cultivation is prohibited. There are no explicit qualifying conditions in Maryland under HB 881; instead, physicians must apply for permission to write recommendations for conditions they specify, though the Commission may add conditions through rulemaking. In 2016, HB 104 was passed which expanded the type of healthcare practitioners that could recommend cannabis. In 2017, certain dispensaries began distributing medicine, but quickly ran into supply shortages.

After nearly 4 years of waiting, patients in Maryland finally had access to medicine through a total of 21 dispensaries in December 2017. Maryland has been thoughtful in their adoption of consumer safety and provider requirements, earning them a perfect score in this category, but still needs to provide civil protections for patients including parental rights, employment protections, and organ transplants. While Maryland’s affirmative defense provision has been used in limited instances to protect patients growing their own medicine, the state should explicitly provide for patients and caregivers to grow their own medicine.

Opioid Response

For the first time in 10 years, the opioid overdose rate in Maryland has declined. Despite this, the number of drug- and alcohol-related intoxication deaths occurring in Maryland increased in 2017 for the seventh year in a row, reaching an all-time high of 2,282 deaths. In a report, Maryland regulators found that there is “mounting anecdotal evidence “ that cannabis may “offer an effective tool for lowering” opioid cravings and addressing withdrawal symptoms. Maryland needs to improve the efficiency of its program in getting patients certified, as well as increasing doctor education on opioids and cannabis.

Patient Feedback

Some patients reported having to use the black market despite Maryland having a medical cannabis program because the prices are too high and the dispensaries are too far from their homes. They contend that medical cannabis is still more expensive than doctor prescribed opioids, and costs around the same as the black market products. Patients expressed the desire for insurance companies to get involved to help cover the costs of medical cannabis products. Many patients also urge Maryland legislators to allow firefighters and state workers to use medical cannabis.