When Compassion Equals a Pilot Program

Despite a credible amount of hard research and anecdotal evidence from patients, on Friday, January 29, Illinois Governor Bruce Rauner’s administration announced that it will not expand the list of qualifying conditions for the state’s struggling medical cannabis program.

Proposed Conditions

Illinois’ Medical Cannabis Advisory Board had recommended that eight conditions be added to those that qualify for legal medical cannabis, including autism, Irritable Bowel Syndrome, Post Traumatic Stress Disorder, osteoarthritis, and several pain-related conditions. It responded to the governor’s negative decision by issuing a statement that labeled it “a gross injustice to patients.”

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Chairperson of the Medical Cannabis Advisory Board, Dr. Leslie Mendoza Temple, said in response to the announcement from the state:

“I’m deeply disappointed. But I’m not surprised. The governor’s office hasn’t shown much support for this pilot program, and it shows in this blanket rejection again.”

Journalists and the mainstream media continue to cite the number of states in the U.S. where medical cannabis programs exist—regardless of how stimied or ineffective they may be.

The Land of Lincoln is to be praised for things like the fact that, at 39, it covers more conditions than any other state, and that it includes ailments typically neglected in state laws, even in many progressive states, such as Tourette’s Syndrome and dystonia.

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Illinois governor Bruce Rauner

There are currently about 23 dispensaries operating in Illinois, with another dozen slated to open by March.  While the pool of retail outlets for safe access continues to grow, with literally hundreds of millions of dollars being invested in cultivation and processing facilities and dispensaries, cannabis business owners in Illinois are complaining that there are too few patients to sustain the business of the current number of outlets, let alone a growing network of revenue-hungry retail stores that require a sufficient number of daily customers to stay in business.

Many desperate patients are probably thankful that the state has any program whatsoever. However, the forces that govern Illinois have the relatively open goal of dismantling the program, regardless of its effectiveness or the number of patients that it either does, or could, assist.

According to Debra Borchardt, when writing for Forbes:

“The clock is ticking for the Illinois medical marijuana program. A low number of approved patients could force some marijuana businesses to close just as the program is getting underway.”

The Problems

The greatest problem obviously lies in the state’s opposition to its own law. Republican Governor Rauner openly opposes anything cannabis. Officially, his state’s medical pot program is a grand experiment conducted at the expense of sick patients who, finally granted legal, safe access to medical cannabis in the state, may very likely lose that access in the near future.

This is despite the overwhelming approval of medical cannabis among the citizens of the state. Sixty-nine percent of voters support expansion of the program, while 73 percent believe that the benefits of medical cannabis outweigh the risks.

Too Few Participants?

The proof of this opposition? This isn’t the Rauner administration’s first oppositional move toward the state’s medical cannabis program. A year ago, the highly contested governor punted on expanding the list of qualifying conditions, which then included neuropathy, a condition that afflicts millions of patients.

Also, despite the fact that the state covers more conditions than any other, it has admitted only 4,400 patients to the program as of the end of 2015 (more than 29,000 had begun the application process at that time). This is despite predictions from regulators that the pilot program will include “tens of thousands” of patients by the end of its four-year run.

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Dr. Leslie Mendoza Temple, Chairperson of the Illinois Medical Cannabis Advisory Board

In its defense, the Illinois program began accepting applications only as recently as September 2015. The stark reality of the situation, however, is that businesses have already begun to complain that the program, from a business perspective, is generating too small a volume of business to sustain.

This is making many in the medical cannabis industry who have invested in Illinois, from venture capitalists to dispensary managers to those providing security for the transport of money and flowers, nervous that the program may collapse under the neglect and mismanagement of the state.

Said a dispensary operator in Chicago, Joseph Friedman:

“If this is the trend, with one to three patients a day, we’ll go out of business.”

Owners and investors in cultivation facilities and other medical cannabis businesses in the state say they require 20,000 to 30,000 customers—all within the next six to 12 months—to stabilize the market and allow them to sustain their businesses.

At the current pace of roughly 1,100 new patients per month, those managing the state’s program will need to increase their acceptance rate for applications, possibly being less strict in their approval of prospective patients. Business owners claim that “unnecessarily tight restrictions” are either dissuading patients from submitting an application or preventing them from being accepted if they do.

More Inclusive Approach Needed

Allowing more patients to enter the program would obviously be good for not only the patients themselves, but also the businesses that have invested heavily in the emerging medical cannabis infrastructure of the state.

While most of these business entities are acutely aware of the relatively high risk of entering a business segment that is illegal at the federal level, they also may not have anticipated a state government that would so cavalierly subvert the will of its own citizens, especially that most frail slice of society that is comprised of very ill children and seniors.

Dispensary owners are stressing that, unless the state begins approving patients at a more rapid rate, the result will be a growing number of dispensaries fighting over a relatively small population of patients—and patient dollars. “As they open, we’re going to be sharing a finite number of patients because it’s not growing the way anyone expected,” said Friedman.

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A dispensary in Illinois

Put simply, the industrial-scale cultivation and processing facilities within the state are owned and operated by for-profit businesses that, if they don’t get enough foot traffic through the doors of dispensary outlets to move their product, won’t be able to justify or sustain a viable business. The result of this could be investors that pull out before incurring losses or businesses that choose to focus on more lucrative or dependable states, like California, Oregon, and Washington.

It could be argued that conservative forces within Illinois are practicing obstructionism, purposefully dragging their heels and even blatantly opposing the success of the state’s program that, in the end, is intended to provide sick patients, with conditions like cancer and dystonia, with access to laboratory tested, high-quality cannabis medicine.

Commercial concerns within the state that invested hundreds of millions of dollars into their businesses are justifiably concerned that the state may allow its medical cannabis program to atrophy and literally die on the vine.

Feel the Pain

Keen readers will note how four of the eight conditions recently rejected by the Governor relate to pain. One of the chief goals of adding these conditions to those covered in the state was an effort to deal with the opiate epidemic that is sweeping the nation.

Temple, of the Medical Cannabis Advisory Board, in an interview with WTTW, a Chicago PBS affiliate, stressed that pain is difficult to treat and that many conventional pharmaceutical drugs are bad in two ways: 1) They aren’t an effective analgesic (pain killer), especially over time, and 2) They are highly addictive.

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A nice, plump outdoor, backyard plant in Toronto, Ontario (circa 2008)

“If we look at the number of narcotic pain killer deaths that have occurred in this country, we are facing an epidemic of people dying from overdoses because their pain isn’t adequately managed,” said Temple.

The sometimes outspoken doctor explained how patients using opioids and narcotics can slip into respiratory depression and literally die, something that happens all too commonly. “We’re seeing more of that mortality grow,” said Temple. She explained how states that have adopted comprehensive medical cannabis laws are experiencing 25 percent fewer opiate overdoses.

In the end, the Illinois program could be terminated as early as 2017 by nothing more than swipe of the pen from conservative governor Rauner. Instead of incurring the political backlash and wrath of angry patients and progressives, the current administration may be trying to subtly sabotage the program through long-term mismanagement and a deprivation of resources.

If Illinois conservatives and Rauner can point toward slumping numbers, they may try to defeat the program by claiming it is unpopular or even unnecessary. While nothing is certain, the next 12-24 months will prove stressful for the state’s qualifying patients, caretakers, and legalization advocates, all of whom will live in fear that patient access to laboratory tested, high-quality medicine may soon be a thing of the past.

Illinois Qualifying Conditions

The state of Illinois currently allows the following 39 conditions (although it is being extremely picky about those it allows into the program):

  1. Cancer
  2. Glaucoma
  3. HIV/AIDS
  4. Hepatitis C
  5. Amyotrophic Lateral Sclerosis (ALS)
  6. Crohn’s disease
  7. Alzheimer disease
  8. Cachexia/wasting syndrome
  9. Muscular dystrophy
  10. Severe fibromyalgia
  11. Spinal cord disease (including, but not limited to, arachnoiditis)
  12. Tarlov cysts
  13. Hydromyelia
  14. Syringomyelia
  15. Rheumatoid arthritis (RA)
  16. Fibrous Dysplasia
  17. Spinal cord injury
  18. Traumatic brain injury (TBI) and post-concussion syndrome
  19. Multiple Sclerosis
  20. Arnold-Chiari malformation and Syringomelia
  21. Spinocerebellar Ataxia (SCA)
  22. Parkinson’s disease
  23. Tourette’s syndrome
  24. Myoclonus
  25. Dystonia
  26. Reflex Sympathetic Dystrophy
  27. RSD (Complex Regional Pain Syndromes Type I)
  28. Causalgia
  29. CRPS (Complex Regional Pain Syndromes Type II)
  30. Neurofibromatosis
  31. Chronic Inflammatory Demyelinating Polyneuropathy
  32. Sjogren’s syndrome
  33. Lupus
  34. Interstitial Cystitis
  35. Myasthenia Gravis
  36. Hydrocephalus
  37. Nail-patella syndrome
  38. Residual limb pain
  39. Seizures (including those characteristic of epilepsy)

Gooey Rabinski is a technical writer and instructional designer who has contributed feature articles to magazines such as High Times, SKUNK, Heads, Weed World, Cannabis HBK11RenderHealth Journal, Green Thumb, and Treating Yourself. He is the author of Understanding Medical Marijuana, available on Amazon Kindle, and a contributing writer at Whaxy.com.

His marijuana-related freelance photos, spanning back more than a decade, are available on Instagram and Flickr. He tweets from @GooeyRabinski.

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