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Medicinal Marijuana’s Next Steps: How Texas Can Be More Business-Friendly

Expanding diagnoses and changes to concentration and distribution regulations would allow the industry to grow and reflect public opinion.
Courtesy: iStock

Dr. Lisa Gardner has made it her mission to spread the word about the benefits of medicinal marijuana. The Fort Worth physician worked for years as a traditional OBGYN but became disillusioned by the industry and dependence on pharmaceuticals and wanted to move into more preventative and holistic care.

“I felt very empty. Wow, I did 20 years of this? This is it?” she thought. “This is just writing Xanax and Ambien and doing pap smears, then it’s see you in a year.” She decided to switch gears, and today she owns a preventative medicine practice and a business that offers CBD products and is a drop-off location for Texas Original Compassionate Cultivation (TXOG), one of the few medicinal cannabis legal dispensaries in Texas.
She wants medical cannabis to be normalized and professionalized and for providers and patients to be aware of its effectiveness and application.

As of September 1, all cancer patients and those with PTSD are eligible to be prescribed medicinal cannabis. Advocates say as many as two million Texans are now eligible, but many are unaware of the changes in the law as well as the potential for medicinal marijuana, Gardner says.

She continues to spread the word and advocate for the continued expansion of diagnoses, particularly those with chronic pain. She has patients with chronic pain who have cannabis products shipped from Colorado or who travel to Oklahoma to access medicinal cannabis for chronic pain. One in ten Oklahomans has a medicinal marijuana card that allows them to purchase it. These patients could spend their money and generate tax revenue in Texas if laws changed.

Courtesy: Dr. Lisa Gardner

Anxiety is another diagnosis Gardner would like to see added to the list. “Anxiety is what I see all day long,” she says. “They don’t want to be on Prozac. They don’t want to be on Xanax or Ambien. They’re looking for an alternative.”

Advocates are pushing to change the diagnosis rules and the amount of THC in the medicine. To limit how much of the active ingredient people take, Texas law says that any cannabis products can only contain 1 percent THC. But the law doesn’t specify how much THC physicians can prescribe. Many veterans who have PTSD are prescribed around 100 mg of THC, which means they have to consume 10 grams of total medicine. That means 10 grams of gummies or oil can cause stomach trouble when consumed in that volume.

“It’s an arbitrary threshold that serves zero real purpose,” says Morris Denton, CEO of TXOG of the 1 percent cap. “Other than forcing patients to consume a lot of byproducts to get to the targeted prescribed dose.”

Another anti-free market practice that hampers the medical cannabis industry is the rule that dispensaries like TXOG are only allowed to store the product in one location but still have to deliver the medicine to the entire state. The rule is a logistical nightmare for distributors. All products must be kept in one location, and drivers deliver them to drop-off zones all over the state. Every day, TXOG staff has to pick up and drive back whatever isn’t picked up. Because it is a schedule 1 drug, the dispensary employees have to maintain chain of control, which can’t be delivered via the mail or FedEx. If a dispensary wants to open a brick-and-mortar dispensary for patients to visit, they have to remove all medicine at the end of the day and drive it back to the warehouse.

Dispensaries can’t afford to go all over the state every day and often do weekly drop-offs to remote locations. If the patient cannot pick up their medicine on the day of the drop-off, they are forced to wait until the next drop-off, which may be a week later. In a world of Amazon and prescription delivery and a pharmacy on every corner, these regulations are a significant hurdle for regular delivery and a functioning business model. “The inability to store inventory close to our patients is punitive to our patients,” Denton says. “This medicine is life-saving and life-changing, and if they run low, it can have a massive impact on their health.”

Advocates are bullish on the 2023 legislative session, and Morris thinks medicinal cannabis will be a significant campaign issue. His work with legislators on both sides of the aisle have shown progress and acceptance on the issue. Unfortunately, the executive branch of the state government isn’t entirely as on board at this point, and they have much influence over the legislative agenda.

Some legislators have reason to be wary. Oklahoma’s overwhelming approval of a very lax medicinal marijuana law has led to more than 9,000 grow operations around the state. Massive California has 3,000 fewer, and Pennsylvania has just 13 growers. It only costs a few thousand dollars to obtain a dispensary license. But in addition to those following the rules, there are plenty of unlicensed growers and sellers, stressing the understaffed enforcement agencies.

Oklahoma’s law says that the majority owner of the grow operation must live in Oklahoma, meaning there are hundreds of “ghost” owners that live in Oklahoma while other groups run the operation. Often, the marijuana grown in these operations ends up out of state or on the illicit market.

But down in Texas, there are only three growing organizations, despite most Texans being in favor of some level of legalization. Opponents of medicinal marijuana expansion often speak about the increased threat to public safety and marijuana use leading to other more dangerous drugs, but even executive leaders in Texas may be changing their tune to match up with popular opinion. Governor Abbott now opposes jailing people for marijuana possession, which could be a sign of future indifference, if not acceptance.

TXOG focuses on educating patients and physicians via forums and webinars. They teach physicians about the benefits of medicinal marijuana, who is eligible, and how they can sign up for Texas’ Compassionate Use Registry, which allows them to prescribe the drug.

The next legislative session will give Texas a chance to prove that it is as business-friendly as it touts itself to be, and folks like Morris and Gardner are doing everything they can to spread the word. “We have patients as young as two months and as old as 98,” Morris says. “Our medicine knows no demographic and knows no political affiliation. It just knows that it can help people.”


Will Maddox

Will Maddox

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Will is the senior writer for D CEO magazine and the editor of D CEO Healthcare. He's written about healthcare…