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What You Need to Know About Ohio's Medical Marijuana Law, In Effect For Seven Months and Changing Every Day 

A dispensary in Denver, Colorado

A dispensary in Denver, Colorado

On March 23, 2017, a Bedford Heights man flew home from Colorado. He was returning with five grams of marijuana concentrate — "wax," to be vaporized and smoked through your dab rig of choice. TSA agents tipped off the local Southeast Area Law Enforcement narcotics task force after noticing a vial of what looked like heroin. By 6 a.m. the next day, officers were executing a search warrant at his home.

They confiscated the wax and, if this were a typical Ohio petty crime story, the man would have been on his way to a cool $150 fine and a misdemeanor charge in municipal court, to say nothing of interstate transit prosecution. But marijuana laws are changing fast. SEALE officers came back the following day with a promise not to prosecute. They also returned the wax.

That was the first real case of local law enforcement directly interacting with the state's budding new medical marijuana law, which is in that precarious place right now of being "in effect" while not being "fully implemented." Three groups — the Ohio Department of Commerce, the Ohio Board of Pharmacy and the Ohio Medical Board — are sorting out the rules at this very moment. The law should be up and running in full by September 2018.

Between now and then, patients and physicians and business owners and city council members are grappling with amorphous legal language while trying to stay on the crest of this wave, even as the rules continue to be ironed out. It's confusing, but it's exciting. Medical marijuana, of course, promises jobs, tax revenue and a revolution in Ohio health care. Who'd want to miss out?

The real players are already teeing up their pitches, purchasing property, shaking hands with eager municipal leaders and presenting detailed outlooks to the Department of Commerce. Everywhere you look, there's activity; cities are either embracing the industry or hurriedly shutting their doors and instituting bans on medical marijuana businesses.

Eastlake mayor Dennis Morley acknowledges the rush among local municipalities. His city was the first in Northeast Ohio to greenlight a marijuana cultivation business.

Among the fluctuating facets of the medical marijuana law, the state has only 24 cultivation licenses to offer. Six will be awarded in Northeast Ohio; the licenses are divvied up evenly by state quadrant. Each corner of Ohio gets three 25,000-square-foot grow facilities and three 3,000-square-foot grow facilities. The forward-thinking cities get the tax revenue. Morley intends on landing one of the bigger, tier-1 operations, and city council has even sold property to accommodate it. But nothing is certain yet.

If it seems like a convoluted, plodding process so far — remember, we're still a year and a half away from medical marijuana being available for sale in Ohio — it is. That's in stark contrast to the chop-chop deliberations that got the law passed in Columbus.

The House Select Committee on Medical Marijuana began its hearings on House Bill 523, without even a hint of knowing smirk, on April 20 last year. By May 10, the House had approved the bill by a 71-26 vote. On May 25, the Senate gave its approval. Two weeks later, on June 8, Gov. John Kasich signed the legal medical marijuana program into law. The pace of it all was astonishing.

***

The recent and relevant history of legal cannabis in Ohio begins in earnest in 2015, when a group calling itself ResponsibleOhio ushered Issue 3 onto the November ballot. The measure would have legalized medical and recreational marijuana, giving exclusive commercial grow rights to 10 facility operators and investors including, notably, Cincinnati native and 98 Degrees boy-band heartthrob Nick Lachey. Issue 3 failed by a margin of 64 to 36 percent. At the time, recreational marijuana was polling right around the 35-percent mark in Ohio.

In a public statement following the election, ResponsibleOhio executive director Ian James said that his group "made two big mistakes — by self-selecting limited grow site opportunities and making Buddie the face of the campaign." (Voters will recall Buddie as a muscular comic book superhero-type with a frosty nug for a head.) But it was that first part of James' message that voters most strikingly opposed — the word "monopoly" was often used to characterize Issue 3 during the campaign.

In 2016, Ohioans for Medical Marijuana (an offshoot of the national Marijuana Policy Project) mounted a signature-gathering effort aimed at getting its own proposal on the November ballot. It was, you may remember, a presidential election year, promising greater turnout than in the failed Issue 3 bout the year before. The OMM measure would have legalized medical marijuana and allowed private residents with qualified conditions to grow their own plants. The licensing fees for dispensaries ($5,000) and large-scale growers ($50,000) were, in hindsight, much lower than present-day state law.

Before that group could finish its work though, state legislators abruptly announced their own Medical Marijuana Task Force and introduced HB 523. "It's going to be framed in statute, and it's going to have a lot of rules," co-sponsor State Rep. Kirk Schuring said during the announcement, signaling what would become one of the more stringently regulated medical marijuana programs in the U.S.

Within two months, HB 523 was law, and Ohio joined more than two dozen other states and Washington D.C. in its trip into the world of cannabis.

The first order of public interest was the list of qualifying conditions, which includes cancer, Crohn's disease, epilepsy, sickle cell anemia and chronic pain, along with more than a dozen other maladies. Some saw the list as too broad ("chronic pain," for instance, is rather discretionary), while others saw the list as overly restrictive. OMM's 2016 petition also included muscular dystrophy, autism with aggressive or self-injurious behavior, Huntington's disease, cachexia or wasting syndrome and severe and persistent muscle spasms, for instance.

"It's a shame lawmakers couldn't have made history with a vote on a substantive and meaningful medical marijuana bill," said Aaron Marshall, spokesman for Ohioans for Medical Marijuana, on the day the Ohio House approved HB 523. "Today's vote will only bring false hope and empty promises to Ohioans suffering from debilitating conditions who need medical marijuana."

Seven months into HB 523 as law, the process of obtaining medical marijuana is more complicated than it would seem on paper.

Scene spoke with a current Ohio medical marijuana patient, Dan, who asked that his last name not be used. Dan suffers from degenerative joint disease and chronic pain and has been taking opioids for about a decade. He recently began legally purchasing cannabis in Michigan.

He spoke with a physician he met through the Holistic Center in Toledo, the only known doctor currently writing cannabis recommendations in Ohio, who requested a year's worth of medical records proving his qualifying conditions. Dan's regular primary care doctor printed out the records but was not yet prepared to recommend medical marijuana himself. He, like most other physicians in Ohio, is awaiting the go-ahead from both the Ohio Medical Board and his employers, but HB 523 already allows any Ohio physician to recommend medical marijuana right now.

"It's just a matter of having a physician willing to take the — not really risk," Dan says, "but to venture into that area because it's still unknown."

At the Holistic Center, he was provided information about the benefits and risks of cannabis use, the current and evolving laws (keep your medicine locked in your trunk while driving, for instance) and the plant's known interactions with prescription opioids. Medical marijuana, health studies have shown, may increase the effectiveness of opioid medication, decrease the long-term need for those drugs and ameliorate opioids' notorious side effects. That's a big deal in Ohio, which is at the epicenter of the nation's heroin addiction crisis.

"The narcotics they give me make me sick," Dan says. "They give me insomnia, make me nauseous. I like the cannabis at night because it gives me comfort. I'm able to sleep. I don't have any side effects, and I feel fine the next morning." He's been using smaller opioid doses during the day and cutting them out altogether at night since introducing marijuana as medicine.

For Dan, the physician recommendation allowed him to take full advantage of Ohio's new law and to experience a cleaner route to pain relief. He was pointed toward a list of out-of-state dispensaries that currently accept medical marijuana cards from Ohio.

It's a hassle, and many in Ohio aren't even aware that this is fully legal right now. But so far, the three Ohio boards at the helm of this law have been meeting their prescribed timelines. Cultivation license rules are expected by May 6, with processing and dispensary rules and permitting to follow. Inevitably, Dan will be able to purchase his medicine just down the road from his home instead of driving to Michigan.

***

Eastlake became the first Northeast Ohio city to embrace the medical marijuana vanguard. A town hall event on Jan. 31 brought some 100 people to city hall, all seeking information about this entrepreneurial new wave and, according to people who were there, mostly embracing the industry.

"The majority here has reached out with open arms," Mayor Dennis Morley tells Scene. "You know, it's going to bring jobs. We're selling a property appraised at $300,000. We have a building that's an eyesore that Andy's taking down."

Morley is talking about Andy Rayburn, the CEO of Buckeye Relief. And the property that Morley is talking about is a 10-acre former Nike missile launch site on Curtiss Boulevard, unused since the early 2000s when it housed a recreation center.

On March 14, city council unanimously approved the sale of that site to Buckeye Relief. If all goes according to plan, Rayburn says Buckeye Relief will set up a medical marijuana cultivation and processing facility there.

Cultivator licenses are expected to be awarded in September. It's an interesting setup, only because municipalities must enter into formal agreement with an industry that doesn't yet have a functioning legal framework. The only known quantities are what's happened in other states and the broad body of research into health and safety ramifications.

"We went into it with an open mind," Morley says. "I sat down with my police chief and my fire chief, and if they hadn't been on board there wouldn't have been any more discussions. They understand the difference between the medical and the recreational. We've really not found anything that's been negative, from our end as a city."

Rayburn's initial annual payroll is estimated at $1.5 million across 30 jobs. "We fully expect to double, triple or quadruple," he adds. His is one of the "tier-1" 25,000-square-foot facilities, where Buckeye will grow marijuana and then extract its oils and process them for tincture and edible production. The law will not allow patients to smoke marijuana, but rather consume the plant's active cannabinoids through oils (vaping), tinctures, patches or edibles.

Briefly, here's how the cultivation process works — and why Rayburn and others argue that it's best to have these things happening on the same property: Marijuana plants are cultivated in staggered groups that include various varieties or strains. A portion of the plants will be trimmed down to flower, to be sold through dispensaries. Most of the plant will go to extraction and refinement for the end oil product, to be sold for direct consumption through vape pens and for edible processing.

Different strains are grown in different rooms in different, staggered structures. Think lighting levels, air flow, temperature control, "fertigation," pest control. "It's a really, really complicated growing process," Rayburn says. He's traveled to more than 100 cultivation facilities, from Colorado westward, where the markets are more mature, to get a sense of direction.

Rayburn's story begins four years ago with a dear friend caught in the final stages of cancer at Western Reserve Hospice Center. He says his friend told him, "I smoked marijuana last night for the first time, and I slept and I woke up with an appetite and I don't feel miserable for the first time in years."

"That brought tears to my eyes," he says. "That was the moment where I was like, 'Okay, it's time to really look at what's going on here. There's something of real medical value.'"

Rayburn is optimistic; he's assembled a team that includes the author of Colorado's Amendment 64, which set up the country's first voter-approved marijuana program in the U.S., and the former director of the U.S. Secret Service under President Bill Clinton.

"It's been a wild ride, and a fascinating one," Rayburn says. "Five years ago I did not envision myself entering the medical cannabis industry in Ohio, but now we're well on our way."

Richmond Heights' mayor, as it happens, was also at the Eastlake town hall in January to hear Rayburn's plans. He came seeking information about this new wave of industry, and by March his city had gone on to approve legislation that now allows medical marijuana businesses to set up shop in Richmond Heights.

His city and Eastlake may be in a small minority at this point, but local leaders in city councils across the state know that decisions need to be made soon, with such a limited number of licensed operations to go around and the potential that the economic impact might arrive next door instead of your back yard.

"If Parma does not allow the industry, other cities will, and we will lose out on the benefits," council president Sean Brennan said during a March meeting.

Cleveland, among others, seems fine with that. The city instituted a one-year moratorium on medical marijuana permits, lasting through October 2017. By then, the state's 24 cultivation licenses likely will have been granted.

Other Northeast Ohio cities that have approved various degrees of moratoria on medical marijuana businesses include: Lakewood, Lyndhurst, Mayfield Heights and Highland Heights. Many cities in the area have been passing six-month bans and, when the time comes, reassessing and sometimes extending them. The longer they wait, the less the chance they'll land one of the limited licensed operations.

"Once you do a moratorium, you're out of the running for anything," Eastlake mayor Dennis Morley says. "Right now, you're in a time crunch."

***

As the state chugs along its oversight timeline, Ohio residents and entrepreneurs find themselves in a period of uncertainty, if not outright paranoia on some fronts.

The Cleveland Clinic, for instance, has already offered comments to the State Medical Board of Ohio, indicating the need for a process to remove or modify qualifying conditions.

"It is almost certain that the list of conditions for which marijuana can be used will change," Kristen Morris, chief government and community relations officer for the hospital, wrote in January. "And while we expect that we will discover new uses for the plant and its components, we can also expect that evidence will emerge to show that marijuana is not efficacious and may in fact be harmful for some conditions."

The Clinic offered its thoughts during recent Ohio Medical Board public comment periods, which also gave physicians a platform to express their concerns. Based on those anonymous comments, the sentiment among many Ohio doctors isn't very optimistic.

A sampling of submitted remarks: "Thanks, but no thanks. I will not be whoring out my medical license to recommend pot"; "I know two people who developed schizophrenia after taking marijuana. I am unwilling to risk that"; "No study has proven the effectiveness of marijuana to treat any condition. Marijuana has very serious negative longterm side effects. I do not ask patients to go home and drink beer. Why would I prescribe marijuana?"; "I suspect that everybody in Ohio will soon have a diagnosis of fibromyalgia"; and "scrap the whole thing."

There's a smattering of positive responses but, according to a recent Columbus Business First article, fewer than three in 10 Ohio physicians are interested in obtaining the license necessary to recommend medical marijuana for their patients.

For patients like Dan, this presents a problem. What's the use of HB 523 if physicians — the linchpin characters in the legal process — don't participate in realistic numbers? The clunky and confusing rollout hasn't helped to get those numbers churning.

Ohio physicians have actually been able to recommend medical marijuana for their patients since Sept. 8, 2016. It's right there in the Ohio Revised Code, which says a doctor is immune from civil liability, disciplinary action and criminal prosecution for "Recommending that a patient use medical marijuana to treat or alleviate the condition" or "Monitoring a patient's treatment with medical marijuana." But many physicians and patients are in the dark on that detail, which is why the holistic health center in Toledo is such a rarity in granting approval to patients in need and sending them up to Michigan to purchase medicine.

Because the law isn't fully implemented — and won't be until the fall of 2018, most likely — the legal language in the Ohio Revised Code serves as a defensive "bridge" for patients seeking immediate treatment, according to Rob Ryan, the executive director of the Ohio Patient Network. The transition, obviously, isn't an entirely smooth one so far.

"There's a lot of frustration," Ryan tells Scene. "There's a lot of pent-up demand for this — for years."

Senior legislative counsel for the Marijuana Policy Project, Chris Lindsey, wrote on Jan. 3 that Ohio "lawmakers should amend the affirmative defense section of the current law, and make it clear that lawmakers intended for patients to receive immediate legal protections."

To help matters, Ryan drafted an Ohio Medical Marijuana Recommendation form. It's a straightforward document that gives physicians a place to sign their name and agree to the legal ramifications of their recommendation for a patient to use medical marijuana to treat nearly two dozen qualifying conditions. (The form can be found at ohiopatientsnetwork.org.)

Ryan says the form serves three important functions in this interim period: allowing doctors to see patients now, allowing patients to feel more comfortable and protected if and when they use marijuana, and allowing law enforcement to spend its time dealing with actual crimes.

"There are doctors making these recommendations, and there are doctors who are scared because they think they can't," Ryan says. "Doctors have the power to make recommendations today. That's crystal clear. There's no doubt about it."

And while accurate, physicians have expressed their own professional doubt.

Reggie Fields, spokesman for the Ohio State Medical Association, tells Scene: "We're just trying to make sure that physicians across the state of Ohio are aware of the process and are becoming educated about the law and to remind them that it is voluntary. The law as it is written is a little confusing." To wit: Physicians may recommend marijuana, but they must be certified, but there's no certification process yet.

***

Ohio is the 28th state to step into medical marijuana law. Programs vary wildly, from the original program passed in California in 1996 to the current generation of tightly regulated medical marijuana laws and reforms. Some have been praised by advocates; some have been pilloried. Some have seen flourishing success like Colorado, and others have had false starts, like New York, where less than 1 percent of doctors statewide have agreed to be part of the medical marijuana recommendation program.

Some have operated more or less the same since inception; some have changed course. Michigan, for example, approved a fairly progressive medical marijuana program in 2008 that allowed for patients to grow plants at home. But in 2014, the state reorganized its laws and reformed the program wholesale, bringing the entire cultivation and processing worlds under state control.

Ohio, by most accounts, has taken stock of the changes in medical marijuana policy in the past two decades. While the state may have rushed its law to preempt a voter initiative, as many have suggested, the local leaders who will carry this program across the finish line have been ready to make it a success.

"They were substantially more open-minded about the business and they were eager to bring new business into Eastlake," Rayburn says. "The city needs new sources of revenue."

Medical marijuana laws across the U.S. have changed the scope and arc of health care, and the businesses they've spurred have juiced city and state coffers from coast to coast. It's rickety, and even more so in this interim period we find Ohio in right now, but the cities and states that persevere in the process have reaped an ongoing bounty. In 2010, Colorado's medical marijuana program reaped $2.2 million in taxes. The state went on to legalize recreational marijuana in 2012, leading to more than $150 million in 2016 tax revenue.

One major background concern, though, is the federal government, which maintains marijuana as a Schedule-I drug, illegal across the board. U.S. Attorney General Jeff Sessions has no intent of changing that. "States, they can pass the laws they choose," he said earlier this year. "I would just say it does remain a violation of federal law to distribute marijuana throughout any place in the United States, whether a state legalizes it or not."

That hasn't tempered the optimism of people like Serge Chistov, financial partner to the Honest Marijuana Company, based in Colorado, and a self-stylized ganja guru.

"As of right now, the biggest unknown is the policy of the attorney general," he says. "However, based on his most recent outburst and retraction of such statements, we believe the future is to keep the majority of the decision-making regarding marijuana in the states' hands. The administration has been promising that since last year. That said, investment in the cannabis field will continue with optimism — no major change in investment attitude is expected since the administration will continue to leave the power in the state hands of local municipalities."

And despite false starts, local municipalities around Northeast Ohio are ready to embrace the future.

"From what I've learned about it — how it's helping these people who are having seizures, and things like that — I'm just amazed," Eastlake's Mayor Morley says. "The law, through the legislation and all that, it's going to be what it is. I'm not going to say there won't be any hiccups, but we'll work through anything on our end."

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