Advocates and regulators push to reform medical cannabis in order to save it

The opening of the adult recreational cannabis market in Vermont last October is prompting the state Cannabis Control Board and others to propose reforming the medical cannabis program.

Vermont has allowed patients and caregivers to possess and cultivate cannabis since 2004. The first medical cannabis dispensaries received licenses in 2012. There are now five medical dispensaries.

Since the state legalized personal possession of cannabis in 2018, it has seen a significant decline in the number of patients who have medical cannabis cards, from 5,662 in June of that year to 3,745 this month, according to the Cannabis Control Board.

With the opening of the adult recreational market, according to board chair James Pepper, it is time to revisit the medical program to make sure it remains viable.

“We certainly believe it is necessary,” Pepper said, pointing to advantages the medical cannabis program offers patients that are not available in the adult regulated market. 

According to Pepper, the Cannabis Control Board would like the Legislature to increase the number of medical conditions that qualify people to use medical cannabis and remove the requirement that those with post-traumatic stress disorder, or PTSD, undergo counseling while they use cannabis.

“Just putting every single person with PTSD under this umbrella of needing a counselor and needing to be in therapy and needing two signatures to get their medical card, all of that is just a barrier to access,” said Amelia Grace, co-founder of the Green Mountain Patients Alliance, which is advocating for reforms to the medical cannabis system. Grace, who lives in Berlin, said she herself has PTSD.

“Talk therapy does not always work for everybody,” said Jessilyn Dolan, another co-founder of the Green Mountain Patients Alliance and the founder of the Vermont Cannabis Nurses Association. She specializes in opioid use disorder and mental health comorbidities.

Dolan and Grace have found an ally in Rep. Tanya Vyhovsky, P/D-Essex, who is set to join the state Senate this week and is working on legislation to reform medical cannabis. 

“I work with people with PTSD every day and if that person isn’t ready to be in counseling and ready to do the work, (therapy is) not going to be effective or helpful,” said Vyhovsky, who is also a social worker. “If in the meantime, cannabis helps alleviate flashbacks and debilitating symptoms, for me it’s about harm reduction.”

Pepper also supports increasing the number of plants patients are allowed to grow from two mature and seven immature plants to six mature and 12 immature plants and allowing caregivers to have two patients.

Currently, caregivers can grow cannabis for just one patient. 

“There’s some really good caregivers out there, but they’re limited in who they can serve,” Pepper said. 

He said he also would like the Legislature to eliminate the requirement that patients with incurable conditions such as HIV, Parkinson’s and multiple sclerosis get a letter from their doctor every year attesting to the fact they still have an incurable condition. 

“Nothing is ever going to rewrite my DNA,” said Grace, who said she has Ehlers-Danlos syndrome, a rare genetic condition that affects connective tissue. “I am never not going to have it.”

Grace said she also has Crohn’s disease. She said she uses cannabis to treat both conditions, as well as mental health conditions. She said a caregiver grows cannabis for her in her home, and sometimes a grower donates cannabis to her. 

The Cannabis Control Board also would like to reduce the fee for starting a medical dispensary, which is currently $25,000, compared to $10,000 for an adult recreational retail shop. 

Pepper also would like to see the Legislature allow third-party testing of medical cannabis. Currently, medical dispensaries test their own cannabis. 

According to Pepper, there are benefits to using medical dispensaries. Patients can receive delivery of cannabis at their homes. There is no cap on the concentration of tetrahydrocannabinol, or THC, in solid cannabis concentrates in the medical market, unlike the adult recreational market. Medical dispensaries offer a reservation system.

“You can be the only person in there at any given time,” Pepper said. “The stigma of using cannabis still exists.”

Finally, medical cannabis is not taxed, whereas adult recreational cannabis is taxed at 20%.