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What Happens to Medical Markets When Recreational Cannabis Is Legalized? 

medical cannabis
Written by Alexandra Hicks

Cannabis sales in the US and Canada continue to be robust overall, thanks to the continued explosion of recreational sales. But as adult-use recreational sales are increasing, medical cannabis totals are in a free-fall that began last year.

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Overall Cannabis Industry Sales and Projections 

In the US, both the medical and recreational markets combined are expected to reach $33 billion by the end of 2022, and upwards of $52.6 billion by 2026 if figures remain consistent. This is largely due to the continued growth of adult-use markets. Both sectors have been trending upward over the last few years, but in 2021, recreational use markets grow 43% while medical markets showed only 34% growth. Despite this, some experts believe this health-related side of the industry remains strong, while others worry the US medical market will fizzle out when cannabis becomes federally legal.  

Now, these numbers represent an average. Numerous states have struggling medical programs due to a lack of access, product variety, affordability, and safety standards. Some states, like Louisiana and Minnesota, are trying to expand participation in their programs by developing new regulations that would make it easier for patients to get their medicine. Other states, like Iowa and Georgia, seem incapable of coming up with reasonable solutions for the accessibility issues. In contrast, there is such a huge product variety in the recreational sector, and so much competition that prices remain relatively low in established markets. All this as widened the divide between medical and recreational sales.  

In Arizona, for example, the Department of Revenue reported that medical cannabis sales have been on a steady decline for six consecutive months now, while adult-use retail sales have seen a $3 million dollar increase in just the last 30 days. The total numbers are roughly $80 million per month compared to $47 million. Overall, these last few months have been among the best ever for Arizona recreational sales, and the worst for medical. Many states have experienced similar trends.  

Benefits and Disadvantages 

It’s hard to say exactly what the future holds for medical cannabis, but if we continue to see downward trends like what is currently going on in in Arizona, then what can consumers expect? As with anything, there will some benefits and disadvantages when transitioning from a more medical market to a recreational one. Let’s start with some of the downsides, so we can end the section on a positive note.  

One of the primary concerns that comes up when analyzing the recreational cannabis takeover, is the influx of higher and higher potency products with little to no research backing up their safety and effectiveness. While “high-potency” may sound like a win, it’s hardly so when that’s the only thing available. Recreationally… sure, why not? But from a therapeutic standpoint, it’s very limiting because many people who use cannabis medicinally are not trying to get “stoned”, they’re trying to get well, and you do this by using high quality products and starting with the lowest dose possible.  

“There is still much to learn about how the different cannabinoids in marijuana can be useful in treating various conditions,” said Brent Zettl, CEO of CanniMed in Saskatoon, Canada. “And my company plans to participate in studies to slice through and get to the real meat of it. The recreational market, on the other hand, is unlikely to be as interested in research. The recreational purpose, getting high, is an overdose response,” Zettl added. “Functional treatment is usually 10% of that. People who want to use it as a medicine take just enough to manage their symptoms and get on with their day. They don’t want to get stoned.” 

Now, on to the positives. Despite many unpredictable changes that may arise as the industry grows, on the whole, legalization is a good thing. First and foremost, it indicates a growing acceptance of cannabis use in general, which means that patients don’t have to experience the stigma they once did for simply using a substance that helps alleviate their medical issues, and a relatively mild substance compared to most pharmaceuticals.  

Furthermore, it will alleviate the burden that doctors feel in regards to prescribing cannabis, or even discussing it with their patients. As it currently stands in illegal states, doctors can face disciplinary action for merely suggesting cannabis products to their patients, which prevents many from utilizing what may be a safer and more effective alternative to what they’re already taking. Even states with medical cannabis programs have their issues, with recreational users posing as patients in order to gain access to legal marijuana – I would know, I did this for years before cannabis was recreationally legal.  

“Legalization will remove the gatekeeper burden from doctors, as recreational users posing as patients move to the consumer side, getting rid of that grey area,” says President of Bedrocan Canada, Marc Wayne. He also believes that this side of the industry is “unlikely to lose legitimate medical users”, even if recreational purchases are more convenient. The common belief is that the recreational market will fail to provide products of equal quality and consistency when compared to established medical companies.  

Additionally, legalization will likely lower prices across the board. We see this in legal markets – especially well-established ones or those that are experiencing oversupply, such as California, Colorado, Oregon, and Washington. Not only that, but if cannabis and all of its compounds are federally legal, eligible patients may be able to get their prescriptions covered under their medical insurance policies. This is already a thing in Canada, where consumers can write off medical cannabis purchases as “eligible medical expenses”.  

Information and accessibility should also improve for medical users post-legalization. A new startup that forms to serve the recreational market may not have the same expertise, especially when it comes to what dosages and compounds can be used to treat specific ailments. “If you are looking to alleviate ailments or symptoms, and you don’t know about dosages, you need the security blanket of speaking to someone who is knowledgeable on the subject,” said Denis Arsenault, CEO of OrganiGram in Moncton. 

“We have become very knowledgeable on medical marijuana and it only makes sense that this resource continue to be utilized,” Arsenault continued. “Buying marijuana at the corner store might be good for a person who has already learned how to self-medicate and knows which strains work for them, but others need knowledge from a place other than a street corner or the Internet.” 

Is It Worth Getting a Medical Card in a Legal State?

Yes, there are a handful of benefits to getting a medical card, even if you live in a state where adult-use cannabis is legal. A medical cannabis card (or medical cannabis recommendation, as they’re often referred to), are state-issued identification documents that confirm the person carrying them has a medical condition that enables them to legally purchase, possess, and use cannabis. As regulations change and recreational markets explode, the idea of paying for a medical card may seem obsolete, but there are some benefits carrying one still.  

Take California, for instance, where cannabis is in fact completely legal, but as a recreational customer, you’re stuck paying up to 45% in recreational, cultivation, excise, and local taxes. Plus, your purchases are limited to one ounce of flower and eight grams of concentrate. Patients with a doctor’s recommendation can possess up to 8 ounces, or 226.8 grams, of dried cannabis or concentrates, and they’re exempt from paying all the extra taxes.  

The qualifying conditions vary from state to state, and can also be at the discretion of the recommending physician. Ordinarily, the card will be valid for up to 12 months, at which point you will need to schedule a follow-up appointment for another evaluation. It used to be that you had to do a lot of searching and often, quite a bit of driving, to find a “marijuana doctor” who was willing to write these recommendations, but now, everything can be done remotely. 

Final Thoughts

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About the author

Alexandra Hicks

Managing editor at Cannadelics and U.S based journalist, helping spread the word about the many benefits of using cannabis and psychedelics.