North Carolina should not mistake retail access for medical care.
North Carolina must not bypass establishing a medical cannabis program in favor of a retail cannabis sales only program. A comprehensive medical system is needed and intended to serve the unmet needs of sick North Carolinians including counsel and oversight from medical professionals.
Although the State’s panel “does not view a medical-only program as an effective interim step or compromise solution,” that view belies a misunderstanding of the role and importance of a medical system. It is there to provide the basis of care for patients, not as a stepping-stone to recreational legalization. Further, “availability of medical-consumer protections” as “an important component of a broader regulatory structure,” again overlooks the responsibility to provide care to patients, not simply access to products.
That distinction becomes even more important in the wake of federal rescheduling of cannabis to Schedule III. In states that fail to establish a medical cannabis program, patients will be left with no meaningful pathway to cannabis-based medications at all. They will not have a regulated therapeutic system nor a clinically supervised option for treatment, which is especially troubling for patients who may benefit from cannabinoid-based therapies as part of a legitimate medical plan.
Furthermore, due to the new rescheduling, medical cannabis companies will benefit from relaxed 280E tax requirements. Given this boon to medical companies, North Carolina would be in a position to use licensing fees to offset the costs of medical cannabis infrastructure. It was the medical program’s cost to the State which was cited as a key aspect of the committee’s recommendation to skip creating a medical program.
A commercial only cannabis model creates a public health risk. As demonstrated in other states, including Washington, Oregon, Colorado, and Massachusetts, marketing normalizes use, promotes overconsumption, and encourages the belief that more is better. That can increase cannabis use disorder, impaired driving, accidental ingestion, and emergency department visits, especially among non-therapeutic users. Cannabinoid medicine deserves the same seriousness we apply to every other field of medicine. Patients deserve care, not marketing. In a post-rescheduling environment, states that fail to build medical programs risk abandoning patients entirely, while amplifying the harms of nonmedical commercialization.
The only responsible way forward for North Carolina is to prioritize serious patient care, and build a real medical framework, not just a retail one. Patients deserve access to cannabinoids as medicine when appropriate, with clinician oversight and product standards. They should not be forced into a consumer marketplace when what they need is medical care.