Georgia will be first US state where pharmacies sell medical cannabis

By Jen Christensen, CNN

(CNN) — For the past year and a half, medical cannabis company CEO Gary Long has spent a lot of his time reassuring Georgia’s small-town mayors about what will soon be coming to their local pharmacy: medical marijuana.

“They think that we’re going to be selling joints out of a pharmacy or something and that’s not right,” said Long, whose company, Botanical Sciences, is one of two licensed medical cannabis production companies in Georgia.

Contrary to what anxious local leaders may think, weed sodas won’t be sold alongside the Coke Zero at their local pharmacy. But by the end of the year, people who meet the extremely narrow criteria spelled out in Georgia’s conservative medical cannabis law, are expected to have the opportunity to buy low-dose THC products at their pharmacy — a first in the United States.

The Georgia Board of Pharmacy is currently processing applications from pharmacies around the state that want to sell low-dose THC products. Under Georgia law, the THC content can only be up to 5%. THC, or tetrahydrocannabinol, is the part of the cannabis plant that produces a “high” — one of the key reasons doctors may suggest patients use medical cannabis to help with pain, nausea, insomnia and other issues. Products can include THC oil, tinctures, topicals, capsules and lozenges.

National chains such as CVS and Walmart won’t be selling THC products in Georgia, but Long said 130 local pharmacies have already agreed to sell his product exclusively. The state has more than 400 independent pharmacies and many seem interested in getting the special THC sale license, according to the professional association representing those stores. That would put 90% Georgians within a 30-minute drive from a pharmacy that could sell it, Long said.

Other states, such as Connecticut, require a pharmacist to be on staff at the dispensaries, but pharmacies do not sell the products. There are at least three states other than Georgia that have a law on the books that would allow pharmacies to sell, but they have not implemented the law, according to Andrew Turnage, the executive director of the GA Access to Medical Cannabis Commission.

Making medical cannabis so accessible in such a traditionally conservative Deep South state like Georgia caught some by surprise. Last week, after Long’s company put out a news release about how products would soon be available at pharmacies, even late night television host Jimmy Kimmel did a skit about it.

“I’ve never seen anything like it,” Long said of the sudden attention. Before moving into the medicinal cannabis field, he was an executive in the more buttoned-up health care technology business.

“My 20-year-old kids were like ‘Dad, you just went viral,’ And I’m like, ‘Ok, cool,’ ” Long said.

Pharmacist Jonathan Marquess said patients have been asking for this kind of access for years.

“There are patients in my area that I talk to all the time who’ve been begging for this,” Marquess said.

The Georgia General Assembly approved the distribution of low-dose THC oil in 2019, but it has taken years for the state to create the regulatory infrastructure to sell it.

Creating regulations is a little tricky, experts say. While there has been a movement to change the designation, the US Drug Enforcement Administration still lists marijuana as a Schedule 1 substance, meaning that there is no current accepted medical use and a belief that it has a high potential for abuse. Since the federal government puts weed in the same category as heroin, LSD, and meth, technically, it’s illegal to sell any form of cannabis.

“It’s federally illegal for a pharmacist, I’m pretty certain, to dispense cannabis, but it’s also federally illegal to do anything with cannabis,” said Jay Wexler, a professor of law at Boston University School of Law, and the author of “Weed Rules,” a book focused on legalization. “In the cannabis space, many things are formally illegal, but the question becomes whether anybody can or is willing to do anything about it.”

The Justice Department is limited by a rider in appropriations that prohibits it from using any money to prosecute anyone who is acting consistently with state laws that allow the use of weed for medical purposes.

So within that legal gray area, Gov. Brian Kemp was able to sign off on Georgia Board of Pharmacy rules last month that cleared the way for pharmacies to apply to sell THC.

Many of Marquess’ patients in the meantime have secured a doctor’s permission to register and get a card from the state needed to buy THC oil products.

“I’ve had many, many of my patients show me their cards,” said Marquess, who is vice president of the Georgia Pharmacy Association’s Academy of Independent Pharmacy, and he owns a handful of independent pharmacies with his spouse who is also a pharmacist.

Marquess said the lack of access to low THC products has been dangerous for his patients.

“Unfortunately, right now many of them go out of state or to places that I wouldn’t necessarily send a patient to, to get the product now,” Marquess said.

Marquess said there’s a real advantage to getting THC from a pharmacist.

“They can provide some education, some resources, and even counsel to get on the right product,” Marquess said. Patients also often seen their pharmacists more often than they see their doctors.

Turnage, the executive director of the GA Access to Medical Cannabis Commission, said he has heard from a number of states that want to replicate Georgia’s program.

“States that have adult use of recreational cannabis are struggling to preserve their medical programs and those states are reaching out to learn about the dispensing pharmacies as a potential avenue to preserve patient access in their state so that their patient program doesn’t collapse under the weight of recreational use,” Turnage said.

In states where recreational use is allowed, low THC products sometimes become difficult to find, he said, since it’s the cannabis flower that becomes the most profitable product. For a lot of patients — particularly for children — smoking, vaping or even consuming THC as an edible like a gummy is not an option, or at least not ideal, he said.

Long said he hopes Georgia will consider expanding who is eligible to get access to THC. While access in Georgia is more equitable with pharmacy sales, the law is more restrictive than most of the 38 states allow medical use of cannabis products.

“The Georgia law itself still has a long way to go,” said Aaron Smith, the executive director of the National Cannabis Industry Association. Californians have been able to buy medical cannabis since 1996 and adults there got the right to use it recreationally in 2016.

“So it’s good to see Georgia come into line with the vast majority of states that already have medical use, but other states have done it in a way that I think is more effective at actually meeting the needs of patients,” Smith said.

In states such as Massachusetts, doctors can prescribe medical marijuana for any patient they think it will help. Georgia restricts access to 16 diseases, including Alzheimer’s, some stages of cancer, PTSD, sickle cell, and Crohn’s.

Turnage said that while the products and patients able to use them are limited, expanding where patients can buy the products will matter. He said when he has been to the grand openings of the dispensaries and sees so many patients lined up outside, often they will come hug him and say thank you for making access possible.

“I’ve been really grateful for the heat this summer, because I can tell them the moisture on my face is just from sweating, they don’t have to know it’s my tears,” Turnage said. “That makes the moment and all of the difficulties to get here worth it.”

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