These were a few key findings in a Dayton Daily News investigation of how Ohio’s medical marijuana program monitors and regulates medical marijuana patients, dispensaries and physicians licensed to recommend medical marijuana to patients.
The Dayton Daily News investigated oversight of the state’s medical marijuana program as state lawmakers and others propose overhauling how it’s managed, as well as expanding it — possibly to include recreational use.
“Ohio’s medical marijuana program isn’t perfect, but it works,” said Tom Haren, spokesperson of the Coalition to Regulate Marijuana Like Alcohol. “It shows Ohio can safely regulate the possession and sale of marijuana products.”
Critics of the state’s medical marijuana program voice concerns over the efficacy of cannabis as a treatment option and the regulation of products.
The Dayton Daily News obtained hundreds of documents from a few state agencies to gather details about how regulation works in the medical marijuana program.
Three agencies oversee program
Medical marijuana was legalized in Ohio in 2016, and state officials created the Ohio Medical Marijuana Control Program to oversee it.
The Ohio Department of Commerce, State of Ohio Board of Pharmacy and State of Ohio Medical Board all play their own roles in the operation of the state’s medical marijuana program.
The state’s commerce department is responsible for looking after cultivators, processors and testing laboratories, while the pharmacy board oversees marijuana retail dispensaries, the registration of medical marijuana patients and caregivers and the approval of new forms of medical marijuana.
The medical board certifies physicians who can recommend medical marijuana to patients, and this board can also add to the list of qualifying conditions.
Ohio’s Medical Marijuana Control Program has issued nearly 90 operation certificates to dispensaries across the state since its start. Less than 10 of these dispensaries are in Montgomery, Warren and Greene counties. Neighboring Butler County contains five dispensaries, and Clark County is home to two.
The state’s program has seen the sale of 168,045 pounds of plant material — totaling $1.33 billion — as of April this year.
Dispensaries themselves have seen few sanctions since the birth of the state’s medical marijuana program, but the pharmacy board has completed a slew of investigations against dispensary employees, our investigation found.
Employees of medical marijuana dispensaries are granted their own licensing through the state. This license is necessary to obtain and maintain employment at one of Ohio’s dispensaries.
Roughly 20 dispensary employees across the state have been sanctioned in a way that impacted their employee license through the program since 2020.
The most common citation among the state’s dispensaries over the past few years was related to dispensaries with provisional licenses not being operational within 270 days of receiving their license. Dispensaries in Riverside and Beavercreek were fined due to this violation, per medical marijuana control program records.
Provisional licenses are temporary licenses issued to dispensary applicants. Provisional licensees are authorized to begin the process of establishing a dispensary.
In another case in 2020, a Springfield dispensary employee had his key employee license and support employee license revoked following a state investigation. The dispensary where he worked — Terrasana Labs, a dispensary of company Cannamed Therapeutics — settled with the state pharmacy board and agreed to pay $100,000 in fines.
Dayton Daily News reached out to Terrasana Labs and Cannamed Therapeutics for comment but the companies did not respond.
The investigation started after the dispensary ran an internal audit and found a discrepancy in its data in the statewide system that tracks medical inventory, seed to sale. The company contacted the state in May 2020, with an investigator running an inspection of the dispensary the following month.
The inspection found that an employee was reconciling inventory discrepancies after errors in dispensing. This involved the worker manipulating sales of medical marijuana in his reports submitted through the tracking system, according to pharmacy board records.
The employee made several sales to patients between February 2020 to April 2020 where the products sold to them differed from what was logged into the tracking system. He told state investigators that this was done “in an effort to correct” mistakes made in dispensing.
The state pharmacy board found that this employee “engaged in conduct that has a casual connection” to a “substantial discrepancy in a Board audit of medical marijuana.”
Physicians cannot legally prescribe medical cannabis, but with certification through the medical marijuana program they can recommend it to patients who have qualifying conditions.
Physicians who apply for the licensing needed to recommend medical marijuana are required by law to complete at least two hours of continuing medical education that will assist in diagnosing qualifying conditions, treating those conditions with medical marijuana and possible drug interactions.
A total of 660 physicians have been issued certificates to recommend medical marijuana since the program’s start. Roughly 220 were listed as active in early June. Out of the more than 200 current certified physicians statewide, 26 call the Miami Valley home.
Under the state program, physicians have given more than 700,000 recommendations of medical marijuana to Ohioans. Patients can receive more than one recommendation, resulting in more than 355,000 registered patients in the state since the program’s birth.
The Dayton Daily News investigation found that no physicians have had their certification to recommend medical marijuana to patients revoked since the program’s start.
A total of 11 physicians — none from the Miami Valley — had their applications for certificates to recommend marijuana denied by the state, however.
In all instances, the physicians had “prior disciplinary history… based in whole or in part on inappropriate prescribing, personally furnishing, dispensing, diverting, administering, supplying or selling a controlled substance or other dangerous drug,” according to a list provided by the state medical board.
Roughly 3% of Ohio’s population is registered in the state’s medical marijuana program. This includes adults and minors who have parent or guardian permission, according to the Medical Marijuana Control Program.
Of the state’s more than 362,000 registered patients, 21,719 are veterans, 22,786 have indigent status and more than 1,316 are faced with a terminal diagnosis, according to program data as of April.
Jonathan Wright, of Montgomery County, said he registered as a patient of Ohio’s program after moving back to the area from Colorado.
He wanted to enroll in Ohio’s program because he was diagnosed with blood cancer and was looking for a sleep aid and something to help him eat. He said he’s struggled with stomach issues all his life and has been on multiple medications to alleviate discomfort.
“I used to think there was a ‘pill for every ill,’” Wright said. “But there were so many side effects.”
He had his virtual consultation at the start of the pandemic, where he sat in his car and talked to a doctor about his health conditions and what symptoms he was hoping to improve. Wright said his doctor walked him through eligibility, what steps he’d need to take to get a card, and even which strains of cannabis would suit him best.
“It was really like going to any other doctor’s appointment,” he said. “And with dispensaries... it’s like a pharmacy, only much better.”
A patient’s registration in the program is valid for one year and must be renewed to continue in the program.
Under current Ohio medical marijuana law, the state pharmacy board is charged with investigating allegations against registered patients and has the authority to revoke, suspend, restrict or refuse to renew their registration.
According to the Ohio Board of Pharmacy, 21 patients have had their registration revoked or suspended since the program’s start.
Reasons for sanctions against patients’ registration vary. Someone registered in the program, for example, can be sanctioned for having more than a 90-day supply of medical marijuana in a 90-day period. Others can have their registration revoked for being found to mislead or falsify their application for the program.
Patients can also surrender their medical marijuana cards — something they’re required to do if their eligible diagnosis is lifted.
Qualifying conditions for Ohio’s medical marijuana program are vast, including HIV/AIDS, Alzheimer’s disease, cancer, Crohn’s disease, epilepsy and other seizure disorder, fibromyalgia, glaucoma, multiple sclerosis, post-traumatic stress disorder, sickle cell anemia, terminal illnesses and more.
The list could also expand to include conditions like autism spectrum disorder and even opioid use disorder, if pending Ohio legislation passes.