Insights from Medical Marijuana Program Implementation

As Bob Dylan once said, “The times they are a-changing.” According to a 1969 Gallup Poll, 12 percent of Americans supported legalizing marijuana. Fast forward to 2018: 30 states and the District of Columbia (D.C.) have legalized medical marijuana to treat chronic pain, nausea, seizures and other symptoms of serious medical conditions. Additionally, an October 2017 Gallup Poll shows 64 percent of Americans support legalizing marijuana for medical or adult use. The shift in public opinion and the medical community’s recognition of therapeutic uses for marijuana show that Bob Dylan’s words couldn’t be truer today.

Mirroring public opinion, nearly every state legislature in the United States has debated the issue.

Through our experience with five state medical marijuana programs, North Highland has learned that the decision to legalize medical marijuana is the beginning of a complex journey to realizing the intended benefits of the program. With 16 additional states currently exploring medical marijuana legalization, it’s important to build a program that fits the specific needs and attributes of patients, protects health and safety, and is administered with fairness and transparency.

When standing up a medical marijuana program, states grapple with building an administrative infrastructure around a complex web that includes growers, processors, distributors, doctors, patients, caregivers and regulators. We’ve noted the following common program characteristics across the medical marijuana landscape:

  • Rigorous regulatory oversight and compliance roles
  • Transparent and defensible licensing standards for growers, product providers, patients, etc.
  • The selection and licensing process can be litigious
  • Consistent communication with stakeholders creating a shared program understanding
  • Lucrative business opportunities lead to high stakes

A successful medical marijuana program takes these core aspects into account for program design and integrates them into the model for serving patient and caregiver needs, regulating grower, processor and dispensary services, and managing stakeholder education and communication. With these focus areas in mind, what are the top considerations that states should take into account?

Key consideration 1: Customer needs

In medical marijuana programs, the customers are both patients and caregivers who are dealing with numerous challenges associated with the patients’ medical condition(s). Patients must typically navigate multiple steps to qualify for the program, much less actually acquire medical marijuana. Both state regulators and businesses need to pay keen attention to ensure patients’ unique needs are met and not burdened with unnecessary complexities. Medical marijuana programs must therefore address patient/customer registration, business compliance, and accurate tracking of program outcomes to provide patients with access to medication while avoiding fraud and abuse.

Key consideration 2: Services regulation

Another key aspect of medical marijuana programs is regulating the services provided at the dispensary where the patient may acquire medicine. Medical dispensaries should address the many needs a patient may have, ranging from privacy to supporting sensitive discussions about their condition, to physical comforts to accommodate the ailments they are experiencing. In addition, many patients of medical marijuana programs have financial challenges affording the often-expensive medicine, and many dispensaries have established programs to assist patients when needs exist.

Key consideration 3: Stakeholder communications

Stakeholder communication for medical marijuana programs is the third key aspect and seeks to engage many stakeholders beyond just the patients. It is critical that healthcare practitioners understand the potential benefits as well as the administrative requirements for themselves and their patients. Families and caregivers are also unique constituents that require targeted communication and education because many patients need assistance in deciding whether medical marijuana could be an option, as well as help in coordinating the logistics of acquiring the product. Patients may also have other medications to factor in as well as determining what may provide the most benefit for their specific condition.

While every state’s journey to medical marijuana program design and implementation will vary, leaders can commonly expect strict regulation and compliance roles, a highly scrutinized licensure and selection process, and a lucrative market. Our approach to program design and implementation can be tailored effectively to an individual state’s needs by incorporating the appropriate requirements and stakeholder engagement from application development and licensure through to ongoing operations.

Our experience with helping states stand up their medical marijuana programs allows us to draw on lessons learned to develop an administrative structure around patient service, grower, processor and dispensary regulation, and stakeholder engagement that ensures that the program implementation is fair, accountable, and transparent. We encourage state agencies with oversight of medical marijuana programs to thoughtfully consider the unique needs of the program when establishing the application development and evaluation process, response to applications, and post-implementation operations.  Early program successes and failures serve as invaluable learnings for states embarking on their state medical marijuana program implementation journeys.