The cannabis experts of Salt Baked City on patient access, home cultivation rights and the pros and cons of the legal marijuana market 

• Courtesy Photo
• Mindy Madeo

The Grass is Greener
The pros and cons of legal dispensaries versus your black-market plug
By Mindy Madeo

The following article originally appeared in Salt Baked City and is excerpted, in part, below. For the full text, visit saltbakedcity.com

Utah's medical cannabis program has been running for close to three years now. Despite having more than 60,000 active card holders, many of Utah's cannabis consumers still don't have a medical card and choose not to participate in our medical program.

I wanted to explore the reasons why and see how we might make our medical program serve all Utahns.

Legalities
The most obvious reason to get a card and purchase medical cannabis products would be to protect yourself legally. A medical card may protect you from possession or DUI charges if you have cannabis products on your person or in your car or home.

A med card may also protect you during workplace drug testing. Many drug-testing centers will conclude you passed a drug test even if you test positive for cannabis as long as you have a provider recommendation to explain the positive result.

Med cards have helped those on parole and those with prior drug charges to be able to consume openly and legally. Med cards may also be important in situations where a former partner may be trying to use your cannabis consumption against you in matters of litigation and custody disagreements.

Safety
Products purchased from the medical program are batch tested by a state-approved lab for heavy metals, residual solvents, pesticides, microbes and fungi. And Utah is recently the first state in the nation to require testing for unintended synthetic byproducts.

Utah cannabis testing is not perfect, and I hope we get more comprehensive testing and additional labs to validate and interpret results. But I will always recommend a product batch-tested in the Utah medical program over any untested cannabis product.

A study published in 2022 analyzed 516 CBD-based edible and topical products in the U.S. market. Sixty percent were mislabeled, containing more or less cannabinoids, and they also detected the presence of lead, mercury, arsenic, cadmium, phthalates and other heavy metals.

A local group was curious how safe illicit vape carts might test, so they sent a popular illicit vape cart out of state to get third-party testing, and it came back positive for having high levels of two different pesticides not considered safe for human consumption. Lung injuries associated with vaping products reached a peak in 2019 and 2020, when irreversible lung damage was attributed to Vitamin E acetate in THC-containing vape carts.

In response, the Centers for Disease Control and Prevention and FDA recommended that people not use THC-containing e-cigarette or vaping products, particularly from informal sources like friends, family or in-person and online dealers.

Today, most illicit drugs carry the risk of added, dangerous contaminants like fentanyl. While it's quite unlikely that fentanyl would be added to cannabis products intentionally, there have been cases where accidental cross-contamination of the very potent fentanyl has been reported.

But the thing you should be most concerned with is flower sprayed with compounds to make effects stronger. We see illicit cannabis flower being sprayed with things like lab-synthesized cannabinoids and even potentially dangerous synthetics like spice.

Cost
Cost is one of the biggest reasons patients don't utilize the Utah cannabis program. There is the issue that a visit to a cannabis specialty clinic to see a QMP can cost up to $500 per year.

We are seeing the price decrease over time, but it's still quite unaffordable for many. Shopping around and using an LMP can save you quite a bit of money.

As legislators continue to refine our program, we might see restrictions loosening on allowing recommendations to be valid longer, with less paperwork, more user-friendly software interfaces, telehealth restrictions lifted, expanding state-run insurance coverage to include cannabis visits and other measures to lower the price to access our medical cannabis program.

Using recent state data from a cost comparison study, I compared the different ways Utahns might access cannabis. Due to competition among cannabis pharmacies and an increased product supply, the costs on average have continually lowered over time.

Of course, we found illicit cannabis products to be the least expensive, which makes sense since the local dealer isn't paying for safety testing, labeling, taxes, adminstrative costs or government fees.

Advice
The best advice I have for patients is to shop around. Become familiar with all accessible Utah medical cannabis pharmacies and feel free to visit them all. Look for coupons and sales, but remember that those are temporary. More importantly, notice who has lower prices on the products you love without the gimmicks.

If you have a favorite pharmacy, sign up for their rewards programs and text clubs to learn about discounts. Ask for senior, veterans and low-income discounts at your pharmacies.

The lowest-price products may be costing you more in the long run. If they are not as effective, you may consume more. And lastly, work on your tolerance if you believe it's high. Less is more when it comes to medical cannabis dosing and often a lower amount will be much more effective after you take a tolerance break and learn to consume more consciously.

• Courtesy Photo
• J.D. Lauritzen

Growing Your Own
Utah's "Leafy Lawyer" on the rights and laws around home cannabis cultivation.
By J.D. Lauritzen

The following article originally appeared in Salt Baked City and is excerpted, in part, below. For the full text, visit saltbakedcity.com

A lot of conversations have occurred in the Utah medical cannabis program around the topic of patient "access," which can take on many forms depending on who you ask.

For some, access might mean actual, physical access to brick-and-mortar pharmacy storefronts. For others, it might mean access to home delivery services or more diverse product offerings/supply.

Access could also mean the ability to even participate in the program itself, especially where the costs associated with being a valid medical cannabis cardholder can be a barrier to entry for many. Although these points of "access" are undoubtedly important, and are ones that we should strive to protect and continue expanding upon, one topic that deserves more attention is the right to home cultivation.

Why Home Cultivation Is Important
With home cultivation laws being enacted in more than 20 states, it should go without saying that home cultivation has been regarded in many jurisdictions as a fundamental right for cannabis users. Indeed, home cultivation has been an integral part of legalized cannabis in the U.S. since the very beginning.

In 1996, California voters passed Proposition 215, which enacted the country's first medical cannabis laws. Among other things, Prop 215 authorized those individuals with a valid doctor's recommendation to possess and cultivate cannabis for personal medical use.

Since the passage of Prop 215, 22 other states, the District of Columbia and two U.S. territories have adopted laws allowing for home cultivation. However, this leaves 17 states with medical cannabis programs that have not yet granted patients home-cultivation rights. There is even one state, New Jersey, that does not allow any form of home cultivation despite it having enacted adult-use cannabis laws.

According to research from 2021, approximately 3.6 million Americans legally use cannabis to treat one or more medical conditions. Despite this prevalence, private insurance is unlikely to cover the costs of medical cannabis treatments (which can be quite cost prohibitive, as many reading this article can attest to).

The cost of medical cannabis only becomes more burdensome when it is combined with the fact that certain patients with serious medical conditions have not only other medical expenses to contend with, but they often also experience a reduced ability to work and make a living. The reality, then, is that many of these patients are priced completely out of the market, or they are forced to return to the traditional market or turn to products that, while legal, contain cannabinoids or other substances that need more research before it can be determined that they are safe to consume.

To ensure access to their medicine, home cultivation of cannabis is the only real option for many patients.

Second, home cultivation improves access for those who live further away from a brick-and-mortar pharmacy or dispensary location. In Utah, for instance, until the 15th pharmacy location opened recently in Price, the entire eastern and southeastern parts of the state had no reasonable access to a brick-and-mortar pharmacy.

Some may say that home delivery could solve the distance issue, which is at least partly true. However, again, this presumes that a patient even has the financial wherewithal to afford the cannabis sold at pharmacies.

Dispelling the Myths Around Home Cultivation
The first myth that many throw up as opposition to home cultivation is that granting people the right to cultivate their own cannabis will fuel the traditional market. Nothing could be further from the truth, however.

Allowing an adult to cultivate between six and 12 plants in the security of their own home will not lead to a spike in traditional market sales. Nevertheless, even if a few people decided to grow for the purposes of selling into the traditional market, this would have a negligible impact on cannabis supply in a given state and also would not materially contribute to any crime around illegal cannabis distribution.

Some opponents of home cultivation also cite that by allowing people to grow their cannabis, the government is only increasing the dangers/resource consumption that surround cannabis cultivation.

However, fears over electricity use, fires or other potential hazards are overblown and have not been shown in any real significance. Likewise, fears that allowing home cultivation will lead to everyone growing their own cannabis—which opponents say will lead to decreased taxes/fees recouped from cannabis—are also overstated.

One need look no further than the record money being pulled in by those markets that currently allow for home cultivation. For example, Colorado was projected to eclipse $1.8 billion in legal sales in 2022, with many millions of that money going to taxes.

With figures like this common across the country, it is safe to say that home cultivation is not negatively impacting cannabis sales and tax receipts. The same is true for any land use issues that opponents try to raise.

The simple fact is that a majority of people will continue to obtain cannabis through a pharmacy or dispensary and only a minority will try their hand at home cultivation. As any seasoned grower will tell you, growing cannabis is not as easy as you might think.

Why Utah Should Consider Home Cultivation
Ultimately, allowing home cultivation for Utah patients is a good way to solve the access question (at least partly). It helps to address the cost issue, the rural vs. urban issue, the availability of certain cultivars/product issue, any questions over what substances are or are not in a given product and a portion of the social justice issues that are tied to the continued jailing of persons for cannabis cultivation.

Regardless of the path that Utah takes toward home cultivation, there is little doubt that adopting home cultivation rights will benefit all Utah medical-cannabis patients.