How Missouri Medical Marijuana Backers Learned from Illinois' Mistakes 

In Missouri, a Program That Benefits from Illinois' Mistakes

Missouri is late to the party when it comes to medical cannabis. But for once, this could pay off, says Dan Viets, the director of the Missouri chapter of the National Organization for the Reform of Marijuana Laws. The plan approved by Missouri voters last November was based on the hard-won lessons learned by activists and state officials in the 32 other states that came first.

The Missouri program allows registered caregivers to grow up to six plants. It imposes a four percent tax on marijuana sales. Instead of slowly phasing in dispensaries and eligible medical conditions, as Illinois did, the Show Me State will make it possible for nearly 200 dispensaries and dozens of production and grow centers to open as early as next year. And because the constitutional amendment permitting medical marijuana includes such widespread conditions as sleep disorders and chronic pain, Missouri's market could easily ramp up to 200,000 patients over the first several years, according to Viets, who played a key role in getting Amendment 2 on last November's ballot.

One of the states whose mistakes Amendment 2 backers learned the most from is Missouri's neighbor to the east. Illinois relied on its legislature to set up its medical cannabis system, which Viets says was problematic, because legislatures are naturally cautious. Says Viets, "They'll compromise the hell out of anything if it's in the least controversial."

The Illinois General Assembly passed the Compassionate Use of Medical Cannabis Pilot Program Act in 2013, and it took effect the following January 1. The law rolled out slowly. While Illinois' list of approved medical uses covered 39 conditions and illnesses, it omitted a few big ones, such as post-traumatic stress disorder, sleep disorders and chronic pain.

What's more, the patient application process was widely criticized as cumbersome and expensive. Patient applicants had to be fingerprinted for background checks at their local police stations, and had to get a physician with a "legitimate" doctor-patient relationship to sign their patient cards. Few physicians proved willing.

As a result, by 2016, only 4,000 Illinois residents had patient cards. That was less than one-fifth the number the Illinois cannabis industry said was needed to make businesses sustainable.

On top of those problems, Illinois lawmakers made it hard for entrepreneurs to obtain dispensary licenses. After showing the state they had $400,000 in liquid assets, dispensary applicants had to pay out $60,000 in fees just to apply, with no guarantee they'd be awarded a permit.

Illinois' medical cannabis program continues to underperform today. The state has twice as many residents as Missouri, yet has certified only a little more than 73,000 qualifying patients — about one-third the patient total some industry sources expect in Missouri by 2022.

Bowing to public demand, the Illinois General Assembly in August 2018 expanded medical cannabis use by allowing it to be used as a replacement for opioid painkillers. The legislation also eased the application process: applicants will no longer have to be fingerprinted or undergo criminal background checks. Some industry analysts estimate the expansion could bring in up to 365,000 new patients into Illinois' medical program, generating at least $425 million in new revenue for the state.

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