When New York legalized medical marijuana in 2014, the opportunity to access medical cannabis was not created equal for all.
One major player in the marijuana industry, MedMen, recently opened its first Manhattan location on Fifth Avenue, a luxurious, boutique-style store that calls itself the “Apple of cannabis.” With a police officer, a drag queen and a grandma featured in its latest advertising campaign, MedMen wanted to create a “marijuana store where people shop,” according to Daniel Yi, a MedMen spokesman. “We think it should be completely free of stigma. Nobody should be buying marijuana in the shadows.”
But New York’s medical-marijuana law is one of the most restrictive in the nation. The New York State Department of Health tightly regulates the location of dispensaries, who can register as a patient and the price of the medical cannabis products.
Currently, only 10 companies in New York are licensed by the Health Department to manufacture, distribute and sell medical marijuana products in their stores. Each registered organization is permitted to have up to four dispensing facilities. As of now, there are 21 dispensaries across the state.
“We do want to open more stores but right now, we are restricted by what the state law allow us,” Mr. Yi, the MedMen spokesman, said. “Prices are also set by the Department of Health.”
In New York, there are two ways to become a medical marijuana patient: Someone with internet access can register online through NuggMD for a $150 fee, billed if approved, or can visit a registered physician, physician assistant or nurse practitioner.
None of that is easy for someone who can’t afford registering for a license, doesn’t have internet access or can’t afford a visit to a health care provider. In addition, medical marijuana is not covered by insurance anywhere, because, under federal law, marijuana is still considered an illegal substance. All those obstacles turn accessing medical marijuana into an economic issue affecting many potential patients, especially in lower-income communities.
Lorraine Rodriguez, a nurse practitioner, believes medical marijuana should be covered by insurance, and its price controlled.
“It’s medical. It’s not something luxurious,” Ms. Rodriguez said. “It’s just like any other medication: Its cost should be across the board. Everyone should get the same price.”
Because of the difficulty of getting or paying for medical marijuana, some patients are forced to seek treatment another way: the streets.
“It is expensive and a lot of the patients can try it, but they can’t continue paying for it,” Ms. Rodriguez said, “So you might as well just have to get the street marijuana.”
Street marijuana, often adulterated with other substances, may not have the appropriate strength or dosage to treat a patient’s condition.
Luis Miguel Rodríguez, 25, who was a licensed medical marijuana patient in Puerto Rico, moved to the Bronx three months ago from San Juan.
At 19 he learned he had epilepsy, and after he began using medical marijuana, he went from having two to three seizures a year to having none. But he said his financial situation does not allow him to be licensed in New York.
“To get this medication in New York, I’d have to pay for another license, go through all these legal processes like you’re a criminal, and you’re not even covered by insurance,” Mr. Rodríguez said. “It’s really expensive, even though it’s proven to help with so many health conditions.”
Mr. Rodríguez has two jobs and he’s currently looking for another part-time job. For him, medical marijuana in the state is not cost effective.
“Buying it on the street is cheaper,” he said. “In Puerto Rico, getting medical marijuana is as easy as getting a hamburger.”
Apart from the price, the location of medical marijuana dispensaries in New York City limits some potential clients, including those who lack transportation.
Jill Montag, a spokeswoman for the health department, said, “The idea isn’t for everyone in New York state to get medical marijuana. In general, this is for sick people, no matter what ethnicity or race or community they live in.”
According to the Department of Health, medical marijuana in New York might be available to someone with illnesses including cancer, H.I.V. or AIDS, Parkinson’s disease, multiple sclerosis, PTSD or chronic pain.
But Ms. Montag acknowledged that, “for medical marijuana, there is only some people who can get it in terms of socioeconomic status.”
Whether intended or not, New York’s medical marijuana program is setting itself up to turn into an economic disparity problem.
By MedMen’s standards, 21 medical marijuana dispensaries in the entire state of New York is “inadequate.”
“That’s way too little,” Mr. Yi said. “We need to have more stores in different neighborhoods so people can have access to it.”
The only woman-owned, family-run medical marijuana business in New York state, Etain Health Medical Marijuana Dispensary, opened its first store in Yonkers.
“We’ve been very conscious about prices and we’ve always offered a hardship discount for restricted income, Medicare, Medicaid, seniors and veterans,” said Hillary Peckham, Etain’s chief operating officer and co-founder. Etain’s patients typically spend between $150 and $400 a month, depending on volume.
One of its first partnerships in the community was with the Hebrew Home, a senior care center in the Bronx.
Ms. Peckham also thinks medical marijuana should be covered by insurance. She says there’s no way to compete with opioids, which often only have a $10 copay. Medical marijuana is regulated to a near-pharmaceutical standard, she said, yet it is not covered by insurance.
“There’s a disparity there, inherited,” Ms. Peckham said.
Getting medical marijuana “is truly an effort,” said Etain’s chief executive, Amy Peckham, who co-founded Etain with her daughters, Hillary and Keeley. “We’ve had communities that have provided the funding for patients, we have patients that have done crowdfunding, we have one patient whose employer became a 50 percent contributor,” she said.
Despite the obstacles, New York state went from having 1,301 medical marijuana patients in 2016 to more than 55,000 in 2018, according to Procon, a nonpartisan educational organization that provides research on controversial topics.
As the medical marijuana program in New York grows and product demand increases, it continues to face challenges to benefit a wider audience.
“Whether you are poor or rich, black or white, every American should have access to safe regulated marijuana as easily and transparently as possible,” Mr. Yi said. “People of all social strata and all demographics should get easy access to affordable marijuana products.”