Only 59 patients have applied and been approved for the District’s medical marijuana program since it finally launched four months ago. As currently set up and based on the participation rate, it is an unsustainable business model.
On Monday the owner of Capital City Care testified at a D.C. Council health committee public hearing that his medical marijuana business, like two other dispensaries in operation, is losing money and more patients are needed to keep the doors open. His was the first of three distribution centers that opened in the nation’s capital, of a maximum eight allowed. The storefront dispensary, in a converted townhouse on North Capitol Street, N.W., enjoys a view of the U.S. Capitol from its doorstep.
An owner of one of the separate cultivation centers licensed to grow medical marijuana indicated, “all we have been doing is bleeding cash.”
Officials had predicted that 800 patients would sign up, with subsequent increases of 50 percent in each of five subsequent years. Some thought those projections were modest.
Unless enterprise conditions change and the surprisingly low level of patient participation increases, the entire medical marijuana program may go up in smoke.
It took 15 years for D.C.’s voter-authorized medical marijuana program to go into effect. Following approval of a ballot initiative in 1998 with 69 percent support, Congress banned implementation for nine successive years utilizing oversight authority over District legislation. When the prohibition was lifted in 2009, it took the city government more than three years to establish regulations.
D.C. officials instituted the nation’s most restrictive rules compared to the 20 states that have enacted laws legalizing medical marijuana programs. Home cultivation, approved by voters as part of Initiative 59, was not included.
Access is restricted to D.C. residents diagnosed with HIV or AIDS, cancer, glaucoma or suffering from a condition causing severe muscle spasms, such as multiple sclerosis. Potential patients must present a recommendation from an authorized doctor licensed and practicing in the city for approval by the D.C. Department of Health. Fewer than 70 doctors have so far indicated interest in participating. The regulations prohibit identifying doctors able to prescribe marijuana.
Expanded access advocates suggest adding medical conditions that would qualify for treatment. Included among these recommended ailments are epilepsy, post-traumatic stress disorder, Crohn’s disease, digestive ailments and migraine headaches. Of note, epilepsy is a qualifying condition in 17 of the states with medical marijuana programs.
Some proponents urge further expansion to additional pain-causing illnesses. Others worry that abandoning the city’s cautious regulatory approach and introducing lax eligibility policies might stir a quiet federal beast and provoke prosecutions.
Deterrents to participation also include a cumbersome application process and a requirement that doctors, patients and city-sanctioned growers and distributors sign an acknowledgement that the activity is in violation of federal law.
D.C. Council Committee on Health Chair Yvette Alexander voiced an important observation regarding the low participation level at a public hearing this week. She noted that despite a significant HIV and AIDS rate, for example, the number of those affected signing up is low, accounting for slightly more than half of the 59 participants.
Whatever the cause of low participation numbers, it is not clear that expansion of qualifying ailments and medical conditions would sufficiently increase participation numbers. Is market need fulfilled by illegal product acquisition? Was patient interest grossly miscalculated? Is the city’s culture too risk-averse for an activity that is in violation of federal law? Is registration with the government a unique obstacle in a town accustomed to diligent privacy protection?
The program’s future could also be complicated by D.C. Council or District voter approval of decriminalization or full legalization and home cultivation. Legislation has been introduced and potential ballot efforts have been announced for both propositions.
Consideration must be given to the possibility that actual patient demand may not prove sufficient to sustain a robust number of commercial business operations.