Illinois’ medical marijuana program is just getting started. The first stores opened last fall and some 6,000 people are now approved to buy cannabis through the pilot program. That number is much smaller than what many advocates say is needed to create a viable business. There are a number of factors behind the slower-than-expected rollout of a pilot program scheduled to expire in January 2018.
Sylvia, a resident of Champaign, has lived with Multiple Sclerosis for 25 years. We’ve agreed not to use her last name to protect her privacy. She uses a wheelchair much of the time, and says her illness meant retiring from her career as an attorney. Sylvia now lives in a supportive living facility.
Since February, she’s been treating her symptoms with medical marijuana.
“I just feel much more alert now, like I know what I’m doing, and I’m actually standing better,” Sylvia said. “My hands aren’t shaking anymore.”
Before her doctor recommended her for cannabis, Sylvia says she was prescribed a slew of drugs, including five different medications just to deal with muscle spasticity, leaving her literally, as she put it, ‘in a fog.’
“I’m realizing now that getting off all those prescription meds, I think my brain function and my ability to reason and judgment is not as impaired as I thought it was from the MS,” she said. “I think it was the dozen prescription medicines they had me on.”
Now, Sylvia takes one medication - ingesting marijuana through a vaporizer pen, and using a tincture, or a liquid extract of the drug.
Several early estimates predicted there would be at least 30,000 people like Sylvia buying medical marijuana by now in Illinois. By the end of April, it was just a fraction of that number.
There are several reasons for that.
In order to be treated with medical cannabis in Illinois, a patient not only has to have one of the 39 qualifying conditions approved by the state, like MS, but also needs to find a doctor willing to recommend them for the treatment.
Many patients say they can’t find a doctor to do that. Sylvia’s recommendation came through her physician at Christie Clinic, but she said he was a bit hesitant first, unsure of company policy.
Caprice Sweatt is CEO of Medical Cannabis Outreach, in the Peoria area. It’s a group that connects potential patients across the state with a physician – as well as other services, including fingerprinting as part of a criminal background check.
She says most physician support for the drug in Central Illinois is from those in private practice, and with patients they’ve been seeing for some time.
Sweatt says that’s not good enough.
“If they’re only writing them for their normal, everyday patients that have seen them for years, it won’t touch the volume that we have over there - the people we need,” she said. Because there are many. Actually, hundreds approaching thousands, most likely, of people that need – and have reached out to us that we might be able to get them a physician.”
It’s important to note that doctors don’t prescribe marijuana. They recommend a patient for the program. That allows a patient to apply for a card that lets them use the drug through Illinois’ Department of Public Health. Sweatt calls the process ‘very non-committal’ for doctors.
Regardless, she sees little support around the region, to the point where her business is planning to bring in more help for patients. Her group already held a mobile clinic in Canton in May.
“Probably, the first of July, we’ll be offering a mobile clinic to Champaign-Urbana," she said. "Because if the big groups aren’t going to do it, we’ll bring the doctors in.”
Sweatt contends doctors at Urbana’s Carle Hospital and its clinics aren’t recommending cannabis, but in a statement, system chief medical officer Matthew Gibb says his physicians have no organizational policy, and those decisions lie solely between a physician and patient.
A Christie Clinic spokesperson says their doctors are allowed to, when determined appropriate. Presence Covenant Medical Center hasn’t responded to a request seeking comment.
Getting the doctor recommendation is only the first step, though.
And Sweatt says there’s another factor that’s hampering the pilot program - it’s taking far too long for patients to be approved - 45 to 60 days - with a backlog of about 2,000 medical cannabis cards yet to be approved.
The director of Illinois’ medical marijuana pilot program, Joseph Wright, contends that process takes about a month. But he will admit some physicians are reluctant to recommend the drug, something he’s seen in other states.
“Some doctors don’t necessarily disagree with the idea of medical cannabis in principle, but may just want to see more scientific evidence,” Wright said. “And that’s something that is difficult to allay that concern, because it’s just hard to do medical studies on cannabis.”
While Sweatt and others say the program needs more patients to be successful, Wright has a different measuring stick – he says the program’s safety, including criminal protections - not the number of patients - should be seen as a barometer for its success.
As for any legislation that might extend it beyond 2018, Wright, a Governor Bruce Rauner appointee, says that’s not up to him.
“There was an amendatory veto that would have added some time onto the program,” he said. “The governor has indicated that he’s willing to work with the legislature in the past on this issue. I don’t see this as being a closed door.”
With just over 6,000 patients now approved in Illinois, Caprice Sweatt says she’s hoping to see upwards of 10,000 by the end of this year as incentive for legislators to extend that deadline. To do that, she says the state needs to expand the list of qualifying conditions.
A few weeks ago, the Medical Cannabis Advisory Board recommended 10 new conditions, including Post-Traumatic Stress Disorder and chronic pain.
It was the third time the board made the recommendations. Illinois' Director of Public Health, Nirav Shah, has twice ruled against adding to the list of 39 qualifying conditions.
Caprice Sweatt says there have been efforts to work around the governor in order to approve more conditions. She also cites a recent poll of Illinois voters, released in March by the Paul Simon Public Policy Institute at Southern Illinois University.
“I know that there are lobbyists and legislators that are working diligently to do what they can to make this program survive,” she said. “Eighty Two-percent of Illinoisans want the medical cannabis program. They like it - 82 percent! If someone had that in an election, that’s a landslide.”
Illinois’ law has been called one of the most restrictive in the country. The National Council on State Legislatures says Illinois’ program includes more oversight and rules than those in states like Colorado.
Jeremy Unruh thinks that’s a good thing. He's General Counsel and Chief Compliance Officer with PharmaCann, which runs cannabis dispensaries and cultivation sites in Illinois and New York state.
He admits the pilot program isn’t perfect, but prefers a tightly controlled setting that might be flexible later rather than the opposite.
In this Oct. 20, 2015 photo, products for use with marijuana are available inside of Salveo Health and Wellness, a licensed medical cannabis dispensary, in Canton, Ill
“In Denver, Colorado, they’re placing a cap on the number of dispensaries that are out there,” Unruh said. “That’s a very loose regulatory framework that’s now sort of being clamped down on. But I think we’re learning that this is a process – not only are these start-up businesses, but they’re start-up companies in a brand new regulatory environment that’s literally being started from scratch.”
There’s also the challenge of cannabis still being classified as a Schedule One drug by the Drug Enforcement Administration, making it harder for federal research, and requiring patients like Sylvia to pay for the product with cash, and out of their own pocket.
As for the future of medical cannabis in Illinois, Sylvia says it’s ‘beyond irritating’ that the Rauner administration won’t consider more treatable conditions for what she calls ‘purely political’ reasons.
Her condition has improved as she’s taken part in a University of Illinois program for MS patients. And she says if the medical marijuana pilot program does go dark in 2018 – she’s planning to move out of state.
“I’ve been working with an Illinois student with walking – and she says the improvement in my walking has just been amazing,” Sylvia said. “If I can do that with cannabis – and Illinois is going to quit - there’s no reason to stay here.”