About one-quarter of the state's 56 licensed dispensaries are now open. While the owners face challenges in figuring out how they can or can't advertise and adapt to continually changing regulations, lots of potential candidates for using medical marijuana just want to know the basics of how to get a card, where to find dispensaries and how much the products will cost.
That means small-business owners learning about the industry are also faced with a new type of customer: the first-time cannabis user. Businesses can't just be focused on the bottom line, they have to focus on educating consumers, as well.
"With this program still being so new in Ohio, there is a bit of a learning curve for patients as they try to navigate the process of purchasing medical marijuana and picking the right product," said Thomas Rosenberger, executive director of the National Cannabis Industry Association of Ohio.
"So as dispensaries open up across the state, we're seeing them position themselves not only as a place to purchase medical marijuana, but also as an educational resource for patients," Rosenberger said.
"Right now we have a concentration of dispensaries open in the northern and eastern parts of the state, and none in the southwestern part of the state," he said. "Over the next several months, though, we're going to see more and more dispensaries open and more and more patients will have easy access to one."
So far, nearly 450 physicians have signed up to recommend medical marijuana in the first 12 months the state medical board has been approving doctors for the program. However, only about a quarter of them are actively prescribing medical marijuana cards that are needed to purchase products.
Kate Nelson, chief operating officer of Greenleaf Apothecaries, said two of the company's five botanist dispensaries are now open in Canton and Wickliffe. The Cleveland location, on Lakeside Avenue, which recently passed the state inspection, is expected to open in April.
"Our ultimate goal is to bring education, whether it's to patients or members of the community," Nelson said.
Between mid-January and mid-March, there were about $1.85 million worth of marijuana sales statewide, about 245 pounds of the cannabis flower. Right now, it's only sold in bud form. Dispensaries also sell grinders and vaporizers. Processed products will be available soon. Ohio law permits patients to medicate with oils or plant material for vaping, patches and creams for transdermal application, as well as with tinctures and edibles for consumption.
Nelson, who studied medical marijuana in college, said she's gratified when she hears from people who tried the product for the first time and tell her they're finally able to sleep well, they're now pain-free, or their appetite increased instead of feeling nauseous from chemotherapy treatments.
"We don't know that it can help everyone who has one of the 21 qualifying conditions, but we want to be available to provide an alternative so that they have the opportunity to alleviate the symptoms they're suffering from," Nelson said.
The learning curve is stiff. Most people start with an online search for physician referral clinics. Then they make an appointment with a doctor whose goal is talk about a patient's qualifying condition and how to use medical marijuana and minimize any possible adverse effects.
"We're the first to educate new patients about the process," said Lenny Berry, co-owner of Lakewood Medical Clinic and Maple Heights Medical Clinic. "We teach them how cannabis might help them with their condition and how to properly dose it. Doctors talk to them about how it might interact with other medications that they're taking."
Berry said most conferences are trade show-based, but he plans to host a patient-and-caregivers-focused conference July 13 in Independence.
"It's going to focus on the health of the patients and how cannabis might help them," Berry said. "We want participants to leave feeling knowledgeable and encouraged."
Of more than 20,000 patients registered so far with the state board of pharmacy, data at the medical marijuana advisory committee show most are seeking medical marijuana for chronic or severe pain. Also, so far only about a quarter of the patients have used their cards.
Robneeka Robinson, who suffers from fibromyalgia and Post Traumatic Stress Disorder, said she got a medical marijuana card two months ago, but she has yet to use it.
She's concerned about the process. Even though she's heard basic information from a physician referral clinic, she wonders what the buying experience will be like at a dispensary and how she'll be treated.
"The reason I want to try it is because I suffer from real pain. But because of the opioid addiction, doctors are hesitant to make certain prescriptions," she said. "And people like me who really need the medication can't get it. They give me ibuprofen and anti-inflammatory medication, but nothing for pain."
Robert Hawkins, 72, of Cleveland, is a Vietnam vet who said he is glad he got a card after his recent hip replacement. He also suffers from glaucoma.
"Since I've been taking medical marijuana the pressure in my eyes has reduced to where I don't have to take the eye drops anymore," he said. "I'm looking forward to when the processors start putting out products. I want to try ointments for my arthritis.
"I want to live the rest of my life at a pain level of maybe 2 on a scale of 1 to 10," Hawkins said. "I'm hoping that medical marijuana will help me."
The current dosage landscape
Patients are allowed up to 8-ounces of Tier 1 plant material every 90 days. Tier 1 plant material refers to less-potent medical marijuana that contains up to a 23 percent concentration of THC. Tier 2 plant material has a higher potency and refers to anything greater than 23 percent of the main psychoactive component in the cannabis plant.
While patients have a year to use their medical marijuana card, if someone waits until the fourth month to make a purchase, the recommended quantity allowed in the first 90 days will no longer be available.
"Patients don't understand that if you don't use it, you lose it," she said. "The 90-day supply starts to go down as soon as a marijuana card is issued."
Patients also can designate up to two caregivers who can buy and administer the cannabis. Caregivers must be at least 21 years old and are limited to two patients.
So far, patients said they are surprised about the purchase process that includes only being able to use cash.
Nelson said it's the reason each of the Botanist locations has ATM machines. Terrasana, in Garfield Heights and Columbus, offers Hypur for electronic payments. They plan to open a third location in Fremont sometime this month.
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