More than a third of U.S. states have legalized adult-use cannabis, and the Maryland cannabis industry is watching closely for a road map of what to do—and what to do differently—when adult (also known as recreational) cannabis use for people over the age of 21 arrives in the Old Line State. Medical cannabis was legalized in the state in 2014.
In addition to learning from its neighbors—Virginia legalized adult use in 2021 and is in the midst of the regulatory process, while the District of Columbia legalized recreational cannabis for adults over 21 in 2014 but lacks a regulated retail market due to its lack of statehood—Maryland can draw on its own experience during the legalization and regulatory process for medical cannabis.
While legislation forming the Medical Cannabis Commission, tasked with ironing out regulations and awarding licenses, passed in 2014, the first medical dispensaries in the state didn’t open their doors until late 2017. After Maryland’s medical cannabis industry launched to criticism about the lack of diversity among the business owners awarded a limited number of initial licenses, Governor Larry Hogan ordered a diversity study that resulted in making 20 additional licenses available with consideration of racial and ethnic diversity during application approvals.
The Maryland Minority Cannabis Business Association (MMCBA), established in 2021 by veteran lobbyists Michael Arrington, a Democrat and former state delegate, and John Kane, an entrepreneur and former Maryland Republican Party chairman, sees the eventual adult-use cannabis regulatory process as an opportunity for the state to correct disparities in the initial medical cannabis license rollout. Through the association, they hope to advocate for policies that level the playing field.
“I look at it as being a once-in-a-lifetime chance to bring some parity to help fund health care needs and help cities—Baltimore City in particular—where they’ve just been devastated by the so-called ‘War on Drugs,’” Kane says of the equitable distribution of adult-use cannabis licenses. “And if they can reverse some of that, then I think that’s a good thing.”
With a mission to ensure minority business owners interested in entering the cannabis industry have professional representation and advocacy for creating and enforcing sensible and equitable legislative policies, Kane and Arrington studied challenges minority-owned cannabis businesses faced in states where adult use was already legal.
“We asked, ‘What are the three things that are limiting the ability of minorities to be successful?’ Because in all 16 states with an adult use industry at the time, the majority of minority-owned cannabis firms failed,” Kane explains. Through their research, the MMCBA found a lack of advocacy, lack of education about the cannabis business industry, and lack of capital to be the main barriers to success.
When adult-use cannabis comes to Maryland, the MMCBA plans to address these three areas through professional development programming for members and providing connections to potential investors. With the membership funds, Kane and Arrington will lobby for more equitable policies.
“Our targeted member is a husband and wife who own a couple of tire stores and want to get into cannabis, maybe they want to get into retail or into the grow side,” Kane explains. “Members would get to participate in bootcamps—two-to-three-day events bringing in experts on subjects like submitting responses to RFPs for licensing, how to set up the organization from a tax structure, legal and real estate considerations—all the things where, if you get one wrong, it can kill you.”
With access to comprehensive resources and funding, Kane hopes that minority owners granted licenses for the adult use program have the tools they need to succeed.
Members of the local cannabis industry praise the medical program the state has built for its focus on patient education and relatively low barriers to access.
“Maryland has at its core a really great medical program,” says Wendy Bronfein, co-founder, chief brand officer, and director of public policy at Curio Wellness. “It was created with respect for the patient-provider relationship and without a lot of hoop-jumping for participation for patients and providers to get access to this therapeutic product.”
Maryland’s largest medical cannabis brand, Curio Wellness, opened a $7-million, 34,000-square-foot, product-research, development, and manufacturing facility in co*ckeysville last year and employs 250 people across its growing, processing, and retail businesses.
Bronfein says that how state regulators balance an eventual adult-use cannabis program while strengthening and sustaining the existing medical cannabis program is critical to the success of both industries.
“We know a lot more today than we did in 2014,” Bronfein says.
“Policy makers need to look at strengthening and improving medical while developing what adult use looks like. If we’ve had five years of a strong medical program and people say they want adult use, let’s not let our fears of a stigmatized product create unnecessary barriers,” she continues. “It’s really common in this industry to have a lot of unnecessary rules that make people feel better about the legalization of something that has been stigmatized for so long and was illegal. It doesn’t make for safer product—it just increases cost.”
In a market with both medical and adult use programs, Bronfein explains, medical cannabis would be differentiated from adult use by remaining untaxed and offering a deeper breadth of products in terms of potency, specialized dosing, and specialized product development. Curio already has two proprietary products, one focusing on sleep and the other on gastrointestinal issues. While each market is unique due to state-specific regulations, Curio will get insight into how its therapeutic products perform in an adult use market through its new dispensary franchise Far & Dotter, which will open its first two out-of-state franchises in Mississippi and New Jersey, the latter of which has a brand-new adult use industry.
“Some of the knowledge we learn in these markets will be transferrable, but some will not because regulations vary by state,” Bronfein says. “But anything that has to do with how you engage with people and what the customer experience feels like is most likely transferrable.”
Additionally, the franchise owners will receive support from the $30-million Curio Wellness Investment Fund, which provides women, minorities, and disabled veterans access to startup capital and operational infrastructure with a three-year path to 100-percent ownership.
The idea to franchise first came up in 2018, just a year into the state’s medical cannabis program, Bronfein says. Curio’s team got to know the pain points for local dispensary owners while selling their wholesale products to 91 of the 93 dispensaries in the state. “As an operator, we saw it’s not as simple to run a dispensary as thinking, ‘I could own and run a retail store,’” she says. “It not only requires a great retailer, but also requires you are highly compliant to a series of regulations that don’t make it easy to do business, plus you have to be a world-class marketer to make your location what a customer is going to choose,” Bronfein explains.
The Curio Wellness Investment Fund is Curio’s response to conversations in the industry around the need for more diverse ownership. Together, Bronfein and the Curio team hope the franchise model and access to capital will provide needed resources to others looking to succeed in medical cannabis.
“It is more important to us to promulgate a brand and customer experience in this industry than to outright own the dispensary and the license,” Bronfein says. “To turn what we’re doing into a toolkit à la a franchise, or business-in-a-box, allows prospective entrepreneurs to step up, follow a playbook, receive a brand and operating toolkit, and become that owner in the dispensary every day leading a team and engaging customers as the face of the brand in the community.”
The potential for growth in both medical and adult-use cannabis programs will have a huge economic impact on the state through tax revenue and job creation.
“Many people get focused on the idea of the opportunity being rooted in the license that one person wins and reaps wealth off of, and obviously that’s a piece of the puzzle, but there are so many jobs and opportunities created through these career paths that can’t be ignored,” Bronfein says. “The medical program has been a massive catalyst for job creation and career development, and adding another layer with adult use creates a really strong economic agent for everyone in Maryland.”
Laura Barrett-Nutting, a registered nurse for more than 25 years who formerly worked for Johns Hopkins Medicine implementing an integrated, electronic medical record-keeping system, is just one example of someone whose career path has pivoted thanks to the state’s medical cannabis program.
“I wasn’t a cannabis user or cannabis advocate at all prior to 2016,” explains Barrett-Nutting, known professionally as “Nurse Laura.” Today, she is president and founder of the National Clinical Directors Consortium, which brings together cannabis clinical directors across the nation, as well as a consultant providing cannabis education and services to individual patients, dispensaries, and health care providers.
She found her way into the space when a friend asked her to serve as the medical advisor to a grow facility he was opening in Howard County. After some time and a lot of research, Barrett-Nutting agreed. Before starting her own business, Barrett-Nutting had experience in all sides of the local cannabis market, from growing and processing to distribution and retail. When consolidation in the medical cannabis industry resulted in Barrett-Nutting leaving the business, she put her skills to use where she saw a need in the market.
Maryland requires every dispensary to have a registered clinical director—a position that can be filled by a nurse, pharmacist, or doctor—available to provide training and education for dispensary staff. Barrett-Nutting established the National Clinical Directors Consortium in 2021 as a resource for clinical directors in Maryland to create reliable standards for patient care, improve dispensary staff education, and continue to advocate to reduce the stigma of cannabis. The group quickly expanded to support practitioners in this role beyond the state.
She points to the leveling out of the medical cannabis market and a surplus of product in Maryland as a challenge as adult-use programs loom over the industry.
Because cannabis use is illegal at the federal level, every product sold in the state must also be grown and processed locally. “In the beginning, we had no plant—we had nothing to sell. It was very hard to get the industry off the ground,” Barrett-Nutting says. “Now we’re in the opposite boat. Now the growers have a surplus. There’s more flower than we have patients to sell it to.
“Prices are coming down a little, but not a lot, because the cost of growing and processing is still high,” she continues. “When we started, we had all these projections going up and up, and now it’s kind of leveling off. You’re not having as many patients sign up.”
As of mid-October, Maryland was just shy of 160,000 registered medical cannabis patients, according to data from the Maryland Medical Cannabis Commission (MMCC)—the state’s largest number to date. But as the market matures, it’s seeing a slower rate of growth over the last six months than the same period in prior years.
Launching an adult use program would reduce some barriers to cannabis use that currently exist with the medical program, including the red tape associated with registering as a patient and regulations preventing medical cannabis patients from buying or possessing a firearm.
However, Barrett-Nutting and some of her peers see challenges in the huge consumer education need that comes along with launching an adult use program.
“A concern is that any requirement for having some type of health care professional support at dispensaries might go away, and that patients, even people who are just shopping in adult use dispensaries, will accidentally get side effects from the things they purchase that are unintended,” she says.
If people aren’t properly educated about dosage, potential interactions with other drugs, and what to expect, she explains, they could get too high and have negative experiences.
In the fall, the MMCC conducted a patient survey to help prepare for public health measures in anticipation of adult use legalization. According to the MMCC, the survey is part of a broader research effort to inform future public health initiatives around cannabis use in the state. The survey assesses data on a variety of topics including product preferences and patterns of use, product efficacy and health outcomes, access and barriers to medical cannabis acquisition and consumption, and additional health and safety measures related to cannabis use and storage.
“The valuable information collected through the patient survey and these additional studies will be indispensable for planning future program and policy efforts to protect and safeguard consumers and the public,” said the MMCC chair Tiffany Randolph in a press release.
With good policies, there’s potential for thriving adult-use and medicinal cannabis programs to coexist, meeting the needs of different types of users.
Benefits to continuing as a medical patient in an adult use market include no or lower tax on the product to shorter lines. Additionally, Barrett-Nutting expects that medical dispensaries would offer a broader range of products.
“If they’re looking for some of the other more minor cannabinoids, the less intoxicating products, those will hopefully still be available in the medical market, whereas the adult use market will more likely have some of the fun and the higher-THC type of products,” she says, noting that the MMCC recently reduced the cost of the administrative fee and extended the card length for medical patients to further reduce barriers to entry. Plus, says Barrett-Nutting, medicinal users would have access to a health care professional for guidance. “For those reasons, it’ll make sense to stay a medical patient.”
