Last year, Chelsie Warren quit her job as a bus driver so she’d be free to sign up as one of Utah’s first cannabis patient cardholders and qualify for the plant-based treatment that soothes her chronic back pain.
She’s found a new job since then and doesn’t regret the trade-off.
But the Garland resident is disappointed she has to drive 40 minutes to the nearest cannabis pharmacy — which is often sold out of the gummies that provide her relief and sometimes also out of the raw flower she uses as a backup. She’s traveled outside Utah, where she says dispensaries are better-stocked and prices are lower, several times.
“It’s just been so much easier for me to go out of state,” she said, “and purchase so much more for cheaper.”
With the advent of 2021, though, she and other Utah cannabis patients lost the legal ability to cross state lines and buy their medicine in Colorado or Nevada, as many of them have been doing for months. State lawmakers put this sunset date on out-of-state purchases in anticipation that, by this point, Utah’s medical cannabis program would be robust enough to serve its own patient population.
But nearly a year since legal cannabis sales began in Utah, only half the state’s 14 approved marijuana pharmacies have opened, and the retailers that are up and running have often struggled to keep their shelves full.
Cannabis advocate Desiree Hennessy said she’s trying to figure out how to bridge the gap for patients in rural Utah who can’t easily travel to one of the Wasatch Front pharmacies and are now legally prohibited from accessing cannabis treatment anywhere else.
“These patients are without medication,” she said. “They’re watching the rest of the state move forward and they’re stuck in limbo patiently waiting — or impatiently waiting.”
Members of the Utah’s cannabis industry say the state’s nascent program is doing well overall, especially considering that it had to contend with a pandemic and associated economic turmoil in its inaugural year.
Still, because some physicians remain hesitant about recommending the federally illegal substance, it can be challenging for patients to get the necessary medical authorization for a cannabis card. On top of that, half the state’s cultivators harvested next to nothing through much of 2020, and resulting product shortages drove up the costs for patients.
And a recent investigation by State Auditor John Dougall cast a shadow over the program, raising concerns about how the Utah Department of Agriculture and Food doled out eight lucrative grower licenses in 2019.
Officials and advocates are expecting progress on several of these problems in coming months as cultivators ramp up production, more pharmacies open and state legislators strengthen cannabis laws in the upcoming 2021 session. In the meantime, Warren says she can be patient with the program, as long as its leaders show they’re listening to patients.
“I can understand that it takes time to have a program like this run smoothly,” she said. “But I also feel like if they’re not more giving on the state side or [Utah Department of Agriculture and Food] side, then we’re not going to make it that far.”
Planning for the future
Utah has issued licenses to operate pharmacies in Cedar City and St. George, but with neither open yet, the state’s southernmost cannabis retailer so far is in Provo — hours away from patients in many corners of Utah.
A legal loophole has limited the state’s ability to put pressure on these two businesses and the five other cannabis pharmacies that still haven’t launched since landing a retail license in January 2020.
Senate Majority Leader Evan Vickers, a lawmaker who’s worked with advocates to build Utah’s cannabis program, said legislators will likely tackle this issue in the 2021 session by setting a hard deadline of April 15. If the pharmacies miss the date, they’d risk losing their license, the Cedar City Republican said.
The seven pharmacies are aware of this forthcoming proposal and are already working toward opening before April, said Richard Oborn, who directs the Center for Medical Cannabis at the Utah Department of Health.
Additional relief for rural and southern Utahns could come as pharmacies roll out their home delivery services this year, Oborn added.
Chris Jeffery, CEO of WholesomeCo, said his company was began transporting cannabis products to patient doorsteps last week and anticipates the service will be available to 99% of the state’s patients by July.
“Our goal with delivery is to reach those underserved markets,” he said. “In a town like Vernal, it’s challenging for that patient to come to Salt Lake and get their cannabis on a regular basis. I think when you speak to the overall market growth, we’re doing our part by launching delivery.”
Hennessy isn’t sure how soon home delivery will make a difference for rural residents, saying that the service will likely start in the population centers and expand out from there. Acting during the legislative session is the quickest way the state could aid patients who can no longer buy cannabis outside Utah, she said.
Vickers said he recognizes the challenges created by the Jan. 1 shift but isn’t sure how lawmakers might address it in the package of cannabis-related legislation they plan to consider. The concern recently came to his attention, and he said he’ll be meeting in coming days with advocates and state regulators to talk about it.
On the other hand, state lawmakers have landed on a potential solution for people struggling to find medical providers who are willing or able to admit them to the cannabis program.
Many of these patients over the past year have gained access to pharmacies via recommendation letters that doctors could write without undergoing the training necessary to become a “qualified medical provider” in the state’s cannabis program. But these letters — created as a temporary fix while the state was smoothing out its patient enrollment process — expired Jan. 1 and left medical cannabis users locked out of the pharmacies unless they can obtain patient cards with the permission of a qualified provider.
Vickers said he hopes a new legislative proposal will help some of these patients by giving doctors the freedom to refer up to 15 patients for cannabis cards even if they don’t want to enroll as a qualified medical provider.
Despite the growing pains, the state senator believes the cannabis program forged in 2018 as a compromise between advocates, religious leaders and government officials has been an overall success.
“We’ve got some growers doing great and some that aren’t doing so great. We’ve got some pharmacies doing great and some that aren’t so great,” he said. “So, far from perfect, but I think we’ve done a pretty good job so far.”
Warren said the cost differences between cannabis products in Utah and elsewhere are striking. Vape cartridges that cost $60 on Utah shelves are a third of that price in Oregon, she said. And while she has shelled out $35 to $55 for a package of gummies in the Beehive State, she found them for $12 elsewhere.
In an October survey of Utah patients, nearly 60% said they continue to consider buying cannabis from the black market or outside the state, with most of those respondents saying cost was the main reason.
Oborn argues Utah’s prices are comparable to those in other medical-only states such as Pennsylvania and West Virginia and notes that Utah charges a $3-per-transaction fee that’s designed only to cover the costs of its cannabis program. But he acknowledges that cannabis in Utah is more expensive than in neighboring recreational marijuana states and that product shortages here have inflated costs.
Critics, even some from inside the industry, have faulted several cannabis growers for dragging their feet and contributing little to the state’s emerging program so far. A recent Tribune analysis found that four of the state’s eight growers accounted for nearly all the cannabis harvested through December.
The Utah Department of Agriculture and Food recently reviewed whether the cultivators have met their commitments to the state, but during an hourlong meeting last month, the head of the agency’s cannabis program ultimately recommended renewing all eight licenses.
The state’s cultivation oversight board voted to extend these $100,000-per-year licenses with cursory discussion and no dissent.
The meeting also skipped over the recent audit that raised questions about how the state originally awarded the grower licenses — even though the agriculture agency previously pointed to the license renewal process as a venue for addressing concerns identified by auditors.
However, Hennessy argued that stripping licenses from low-producing growers and transferring them to other companies would only restart the clock and risk further setbacks to the cannabis program.
“Maybe it’s a delayed process and it’s taking longer than we wanted,” she said. “But we’re not adding another year to it, expecting somebody [else] to start growing.”
Several cannabis growers suggested they’re on the verge of major harvests or expansions that will enable them to ramp up their farming operations. Zion Cultivars, which had grown only 160 pounds of cured cannabis biomass as of mid-December, harvested another 2,000 pounds or so toward the year’s end and was about to begin a growing rotation that will create a fresh supply of cannabis every couple of weeks, a company representative said during the relicensing meeting.
And while Wholesome Ag had grown only about 80 pounds of cannabis biomass by December’s meeting, it expects to be ramping up soon to about 400 pounds per month, according to Jeffery.
The company’s progress last year was delayed in part because of challenges finding the right location, he said, with some local governments wary of letting the new and often stigmatized cannabis industry establish a presence in their cities and counties.
But growers have also tailored their expansion plans to the size of Utah’s patient community, he said, keeping in mind that a full-throttle approach could be financially calamitous.
“If every operator built [the maximum] 100,000 square feet of cultivation overnight, there would be way too much product in the market,” he said. “And the operators would be out of business overnight.”
Along with Zion Cultivars and Wholesome Ag, Harvest of Utah and Standard Wellness of Utah produced scarcely any cannabis during the program’s first year but promised to scale up in the months to come.
Seth Gomm of Zion Cultivars said he’s worked on cannabis programs in other states and is largely impressed with the industry’s progress in Utah in the year since the first cannabis pharmacy opened in Salt Lake City.
“It’s not without some bumpy spots,” he said. “But I’m happy to be here and happy to be operating in this space.”