While state officials clamor over adult-use cannabis sales that brought in $300 million in revenue over the first year, the number of medical cannabis patients has consistently dropped. The state’s health department at first predicted the patient count would rebound after an initial post-legalization drop, but now it expects numbers to level off.
For years before the Cannabis Regulation Act, having a medical cannabis card meant the advantage of being able to buy weed for a medical condition without the fear of being hassled by the cops. After sales expanded beyond medical, the additional advantages of avoiding taxes along with being allowed higher potency products sweetened the deal.
Leading up to full legalization, skeptics expressed concern that a profit-driven and high-THC market focus would leave medical cannabis patients in the dust with rising prices, limited choices for products and other complications.
But now, data indicates that patients, whose numbers have been dropping by the thousands each month since last April when adult-use sales officially began, would rather pay upwards of 20% in taxes than jump through the hoops of renewing their cards.
Dr. Dominick Zurlo, the head of the state’s Medical Cannabis Program, told SFR in October 2022 patient numbers had started decreasing because a large number of patients had not renewed their medical cards in anticipation of the new law. He expected those numbers to rise again. Instead, the opposite has occurred, says Department of Health spokesman David Morgan.
“We expect for now the number of patients enrolled in the program to continue to decrease, but the pace in recent decreases has slowed significantly,” Morgan wrote in an emailed statement to SFR. “We anticipate patient numbers will stabilize.”
Patient numbers peaked in May 2022 with more than 135,000 enrolled patients; every month since then, that number fell by between 1,000 and 3,000 to a low of 100,000 last month, which amounts to nearly a 26% overall decrease.
For comparison, the number of medical cannabis patients in Arizona dropped by about 14% during its first year of recreational-use sales and a further decrease of about 40% between April 2022 and April 2023. Colorado actually saw a slight increase in patients during its first year of full legalization, but about a 13% decrease in the past 12 months.
Those who have made a career of vouching for patients have also felt the impact of the decline. Ashley Carro, a nurse practitioner who has been helping patients get their cards for about five years at her practice New Age Medical Santa Fe, first started seeing fewer patients when the Department of Health relaxed its card renewal rules in light of COVID-19 and the restrictions that came with it. Carro says adult-use came shortly after public health orders started to ease, and the flow of patients never ramped back up, so she began looking for ways to pivot her practice.
“I worked for the last three years to get my psychiatry practice up and running because of the cannabis decline,” she says.
Before the pandemic, Carro says, she was seeing about 20 to 30 patients for card renewals every week, but those numbers have dwindled to 10 renewals a month. She speculates that patients are opting to pay more at the pot store register out of convenience.
“I guess they’d rather pay the taxes,” she says. “I mean, I only charge $40 to $50 for a renewal, so it’s really not that much money if you look at it in the long term, for three years.”
But the three-year lifespan of a medical card will switch to two years in June. During this year’s legislative session, lawmakers tweaked the cannabis statute to require card renewals every two years, but they dropped the requirement that patients have to show proof of annual check-ups.
Morgan says the change was designed to make everything easier.
“It’s less paperwork for both patients and medical providers, but more importantly, it reduces the out-of-pocket expenses many patients currently pay during their enrollment,” he wrote in his email to SFR.
Along with downward patient numbers, the Medical Cannabis Program has seen less money from the state. Lawmakers cut the program’s budget by about $3 million last year and kept it flat this year.
Morgan insists the budget and patient numbers are unrelated.
“Funding for the Medical Cannabis Program is not tied to the number of patients enrolled in the program,” he wrote.
The state allows patients with one of 30 conditions to qualify for a medical cannabis card. The department added anxiety disorder to the list in December and this month included insomnia as the latest qualifying condition.