Medical cannabis industry struggles to expand access in Georgia

60-year-old Sylvia Hayes from Stone Mountain, Ga., lives with severe chronic pain resulting from several car accidents. She says medical cannabis is the only way she experiences relief.

That's why Hayes was one of the first patients lined up at the door of Trulieve, a Marietta dispensary of low-THC oil, when it opened this year. 

THC, or Delta-9-tetrahydrocannabinol, is the chemical component of marijuana that produces psychoactive effects. Street marijuana has a percentage of THC usually between 15% and 25%.

However, a low-THC oil card allows patients to legally purchase products with a THC content of 5% or less if they have a qualifying medical condition. The card is valid for two years and certifies that the owner is able to possess up to 20 ounces of low-THC oil.

Before the dispensary opened, Hayes had already researched the steps to register with the Department of Public Health (DPH). She knew in order to be eligible for a medical cannabis card, Georgia patients must have one of the listed qualifying conditions, including epilepsy, multiple sclerosis, and PTSD. The process requires an appointment with a certified physician to verify the condition, and then the patient picks up the medical card from their local health department.

But Hayes said this process was more difficult than she anticipated.

“None of my doctors knew anything about it or knew what to do,” Hayes said. “Only this doctor can do it, only that doctor can do it, and you’re not a patient of that doctor.”

Georgia’s laws are more restrictive than most of the other 37 states that allow the medical use of cannabis products, and it took lawmakers eight years to legalize medical cannabis. Sales of low-THC oil products weren't approved until 2021, and the first licensed sales began in April.

Because of how new the low-THC oil industry is in the state and the lack of FDA approval, many doctors are hesitant to prescribe it to patients. To complicate the matter further, not all Georgia doctors are able to certify patients.

According to Dr. Trista Marshall, a specialized physician in physical medicine and rehabilitation, physicians have to first go through a certification process themselves.

“A physician needs to complete the application process to become approved by the state, so a person can't just assume that their physician is [certified], they would need to specifically ask them,” Marshall said.

The Georgia Department of Public Health doesn’t currently know how many doctors are certified, and will not disclose their locations. This lack of transparency and confusion has caused patients like Hayes to be frustrated with the process.

“Nobody is educating people,” Hayes said.

Cost can be another barrier to access. According to Trulieve, consultation appointments with outside physicians usually range from $100 to $200. A low-THC oil card itself comes with a $25 fee, and the products can be between $40 to $120.

None of this, including the prescribed product, is covered by insurance.

Another obstacle to access is combating stigma, according to former NFL and University of Georgia cornerback Champ Bailey, who is Trulieve’s chief diversity officer and has become a spokesperson and advocate for education surrounding medical cannabis.

“I grew up in South Georgia, so I grew up thinking marijuana was a gateway drug and marijuana is going to lead to this and lead to that,” Bailey said.

As an athlete, Bailey witnessed those around him resort to other alternatives like opioids to cope from pain resulting from intense physical training and injuries. He says cannabis is a much safer solution compared to opioids, which are highly addictive.

Many people are scared to pursue low-THC oil as an outlet for relief from their chronic conditions because they are unclear on Georgia regulatory laws — laws that operate in a gray area.

In legal terms, Georgia is not a “medical marijuana state.” Current laws simply present a pathway for patients to lawfully possess up to 20 ounces of low-THC oil if they’re registered with the Georgia Department of Public Health. But if a person is not on the registry, possession of over an ounce of marijuana is a felony punishable by over $1,000 in fines and a minimum of one year and maximum of 10 years imprisonment in Georgia. 

In Atlanta in 2017, ordinance 17-O-1152 eliminated jail time as a valid penalty for possession of an ounce or less of marijuana under the city code.  

Currently, about 40 people are serving prison sentences in Georgia on marijuana-related convictions. 

That leaves dispensaries like Trulieve focusing on education and community outreach.

“Every day, we’re constantly telling people that it's available, it's legal,” Bailey said. “That's really what it's all about. It's going to take time, but Georgia is ready for it.”

According to Georgia DPH, only 14,000 low-THC oil cards have been issued in the state so far. DPH previously reported that there were 50,000 card holders in the state, but this number was retracted in a message to Atlanta TV station WXIA after having been discovered to be inaccurate.

Because the number of patients initially registering for the cards was lower than predicted, the number of licenses allowed in the state could be affected.

Bailey is excited about the new partnership with pharmacies, which will allow 90% of Georgians to be within a 30-minute drive of access to medical cannabis products.

“That way, people in very rural counties around the state will have access and they don't have to travel to Macon or Columbus,” Bailey said.

Larger chains like CVS and Walmart will not offer the products. The Georgia Board of Pharmacy is currently accepting applications from independent pharmacies across the state.