![* Patients in these states do not have access to medical marijuana. (Chart by Katishi Maake and Jake Eisenberg. Data source: ProCon.org)](./images/21420-chart.jpg)
ANNAPOLIS (Oct. 13, 2016)—While Maryland is on pace to have one of the slowest rollouts of medical marijuana in the country, patients across the state must skirt the law if they want to treat themselves.
It has been more than 900 days since former Gov. Martin O'Malley signed the bill legalizing medical marijuana in the state.
Dispensaries are anticipated to open by next summer, but legal fights with the Natalie M. LaPrade Maryland Medical Cannabis Commission over licenses to grow the plant has many concerned that access will keep patients waiting longer.
One company that applied for a growing license but was denied has filed suit against the commission, with two others planning to do so, all saying the licensing process was unfair and improper.
And the Legislative Black Caucus, concerned about a lack of minority ownership among preliminary licensees, plans to introduce emergency legislation in the next General Assembly session calling for the commission to restart the process.
While state officials grapple with who should grow, process and sell the drug, some Maryland patients are suffering—or medicating themselves outside the law.
"I was 26 years old before I tried pot for the first time, and it was strictly as pain management," said Rachel Perry-Crook, executive director of Maryland NORML, an organization that promotes marijuana legalization.
Perry-Crook, now 30, said she has used marijuana for four years to help alleviate pain from a number of different ailments, including undergoing four back surgeries and a spinal fusion. She has a connective tissue disorder known as Ehlers-Danlos syndrome, she said, that causes hypermobility, leaving her body in constant pain.
She said she turned to marijuana after years of taking a prescription opioid medication meant to treat severe pain.
"I was taking Dilaudid for years—very high dosages of Dilaudid to the point where it would put a lot of people in a coma," Perry-Crook told the University of Maryland's Capital News Service. "I looked at myself one day and I realized I was going to turn into a junkie if I didn't find something else to manage my pain."
Pushback against the commission
The state granted pre-approval to 15 processors and 15 growers in August.
Medical cannabis producer Green Thumb Industries-Maryland, based in Prince George's County, filed a lawsuit against the commission on Sept. 19. The company said it was on the list of 15 pre-approved growers in July, then subsequently and unfairly removed when the ranking process was changed to factor in the geographic diversity of the applicants.
"The path we're pursuing now is a last resort; we feel like we've exhausted all other remedies," Pete Kadens, CEO of GTI-Maryland, said during a press conference late last month. "The last thing we want to do … is further distress sick patients."
A little more than a week later, another rejected grower, Maryland Cultivation and Processing, petitioned to join the lawsuit, which was filed in the Baltimore City Circuit Court.
Additionally, members of the state's Legislative Black Caucus, among others, have also taken issue with the lack of racial diversity among the 30 pre-approved processors and growers.
"We are not going to let anybody get licenses under the scenario that exists now," state Delegate Cheryl Glenn, D-Baltimore said during a Legislative Black Caucus meeting on Oct. 6.
Alternative Medicine Maryland, which is majority African-American owned, was also denied a license by the commission. The group will file a lawsuit in the coming weeks demanding the commission stop the licensing process and mandate racial diversity, according to John Pica, an attorney for the group.
"Sometimes I wonder if our application was even reviewed," Pica said. "African-American companies have been stiff-armed in this industry."
Some industry advocates are concerned that the legal battles, though valid, will mean sick patients are left waiting for even longer.
"We are very concerned with the lack of diversity that is in the current pre-approvals," said Kate Bell, legislative counsel with the Marijuana Policy Project, a cannabis advocacy group. "But we have to remember that—fundamentally—this is about protecting sick patients."
Where Maryland stands
On April 14, 2014, Maryland joined the 25 states and Washington, D.C., to legalize medical marijuana. Of the three states that passed the legislation in 2014, Maryland is the only one where patients do not yet have legal access to cannabis.
The commission plans to administer patient cards six months prior to the anticipated opening of dispensaries, according to its website.
Mike Liszewski, government affairs director for Americans for Safe Access, said Maryland is taking longer than most states to bring medical marijuana to its patients. While he predicts patients will be able to receive legal medicine by mid to late 2017, he said additional lawsuits and injunctions could push that back further.
Hawaii's June 2000 medical marijuana law allowed patients to use and cultivate the plant with a doctor's prescription. The state approved an amendment in July 2015 that allowed dispensaries to open in July 2016—only one year later, according to the Hawaii Department of Health's website.
States such as Nevada and Vermont also did not have dispensaries available from the onset but did allow patients with registry cards to legally grow marijuana for treatment.
"If patients were allowed to cultivate their own medicine (in Maryland), you wouldn't have patients waiting and suffering," Liszewski said. "Our organization is trying to get to a solution that has the dispensaries opening up as soon as possible."
A 2011 amendment to Vermont's 2004 medical marijuana legislation established dispensaries that are permitted to both cultivate and distribute the drug. In Maryland, growers and dispensaries must be separate businesses, an extra layer of bureaucracy.
The 30 pre-approved growers and processors are in the second stage of the licensing process where they must undergo background checks, inspections and prove financial competency.
Preliminary, or stage one, approval of dispensaries is forthcoming, according to the commission.
Liszewski said removing statutory and regulatory caps that restrict the number of growers and processors permitted under law could alleviate the grievances regarding geographic diversity and promote greater competition within the industry.
Perry-Crook says the legislature needs to diversify the pool of applicants and review county-level zoning provisions that do not allow growing, processing or vending in commercial areas. She said these provisions restrict patients' access to marijuana since they may have to travel farther receive it.
"The supply is not going to meet the demand with how things are laid out right now," Perry-Crook said.