The fact that 94 percent of all Arizona cardholders have attested to having chronic pain suggests that, for many, their "pain" might be more accurately described as a lack of chronic.
Yet while the passage of Proposition 207 means that anyone who wants to shop at a state-authorized dispensary won't need a medical card, the doctors who issue those cards aren't necessarily going anywhere.
Dr. Elaine Burns, the medical director of Southwest Medical Marijuana Physician’s Group, said she expects to see a drop-off from people who were simply interested in recreational use or want to avoid the hassle of a doctor visit, but she's confident that there will still be medical-marijuana patients. The trick will be making sure they know the medical marijuana system is still operating.
"The medical marijuana program is alive and well, and if you have a medical condition you need medical guidance," said Burns, a naturopathic doctor who's been in the medical marijuana business since 2011.
While Prop 207 will allow anyone 21 years old and over to purchase marijuana products at a dispensary, recreational buyers will have to pay a 16 percent state tax on all purchases. Accredited medical patients do not pay the tax. Burns and other doctors have calculated that if patients spend more than $80 on cannabis products each month, the $250 for a card becomes worthwhile.
"That pays for the card and then some," said Michael Jusino, brand manager at The Marjiuana Doctor, which operates five Arizona clinics. He said they've seen a slight downtick in new patients since Prop 207 passed, but new people have still been coming in.
Other advantages to a medical card include greater legal protections for patients and access to higher potency products.
The bigger issue for doctors has been the state changing regulations so that medical marijuana cards only need to be renewed every two years, instead of annually. Burns said that, in combination with the pandemic, has meant she's had to close down two of her three locations and lay off six people.
Kyle Wagner, the owner of Valley Evaluations Center in Litchfield Park, said his business has been cut in half and he's had to lay off two office workers as a result.
"We grew every year up until this year," he said.
Wagner has yet to see any changes that he attributes to Prop 207. He doubts that the state's 280,000 current patients will just go away.
"In short," he said, "we're just waiting to see what happens."
The number of medical marijuana patients registered with the Arizona Department of Health Services has grown by an average of about 33,000 patients per year in the past four years. But as of September 2020, the program already has more than 60,000 more patients than it did last year. That's partially due to less turnover since the extended, two-year card expiration went into effect in August 2019. In Colorado, after recreational marijuana was legalized in 2012, the number of medical patients continued to increase. While the number eventually dropped by around a quarter, it's stayed steady at around 88,000 patients.
There's little doubt some of the 94 percent of chronic pain sufferers are actually using cannabis for pain treatment. And the remaining 6 percent of patients report serious conditions including cancer, post-traumatic stress disorder, and glaucoma.
Doctors with experience prescribing medical marijuana can figure out the correct dosages and methods for different conditions in ways that recreational marijuana providers cannot, she said.
"You don't go to Total Wine [& More] to get something for a medical condition," Burns said, differentiating her clinic from those set up just to pump out medical marijuana cards.
She gave the example of how even innocuous cannabidiol, or CBD, can delay metabolism of opioid-based painkillers and other medications, causing issues if a medical professional does not evaluate its use alongside other treatments.
If the number of patients drops, Burns said she could try to focus on referrals from surgeons looking for pain management options or perhaps go back to her non-medical marijuana practice.
"Being in this business is not for the faint of heart," she said.