In 2013, the Maryland General Assembly passed Senate Bill 881 legalizing marijuana for medicinal use, and Maryland joined 22 other states across the country, scrambling to coordinate the myriad aspects of dispensing marijuana to eligible patients. It’s an enormous undertaking, like launching a giant startup. Nobody wants to get it wrong, but the logistics are complicated and the clock is ticking toward an expected date in mid to late 2016. Patients, doctors, growers, sellers, and bankers in Maryland are all waiting impatiently for answers to questions about how it’s going to affect them.
In December 2014, Hannah Byron was plucked from a plum job at Maryland Tourism, Film and the Arts (part of the state Department of Business and Economic Development) and tapped to be the first full-time director of the Maryland Medical Cannabis Commission. A long-time state government executive, her success at the Maryland and Baltimore Film Offices had been particularly impressive – VEEP and House of Cards among others, were filmed here under her watch – and she became known for a singular ability to get things done. Lauded as “an extraordinarily effective public official” by Dr. Paul W. Davies, chairman of the MMCC, she seems to be living up to that reputation. Draft regulations and implementation guidelines were published just last month, right on schedule for a 2016 operational rollout date. A recent article in the Washington Post gives details and current issues surrounding the regulations, which were promulgated on September 14.
Byron has taken on a unique position in the highly bureaucratic world of state government. Starting virtually from scratch, she is setting up a comprehensive regulatory system in a marketplace that is potentially worth millions, if not billions, of dollars. Early on, she sent a message about the seriousness of her mission by changing the commissions name from the Maryland Medical Marijuana Commission to the Maryland Medical Cannabis Commission, explaining that “cannabis is the scientific name of this plant, and indicates its evidence-based use as a medical treatment. Marijuana is a slang term, and it has pejorative connotations.”
Always at issue, in Maryland and every other state where cannabis has been legalized, is the fact that possession remains a federal offense. The tug of war between federal banking laws and state marijuana commerce activity is a frequent stumbling block. And yet, according to government sources, “Maryland is becoming the place that other states are looking to as a model for their own cannabis legislation.”
Hannah Byron, 58, grew up in Baltimore and went to high school at the former Hannah More Academy. She has two grown sons and lives in Baltimore County with her husband Kimball, a former US Air Force Lt. Col. and currently an American Airlines pilot. He is the son of Goodloe and Beverly Byron, who successively represented the sixth Congressional district in Maryland for decades. Recently, we met with Mrs. Byron in her office on Patterson Avenue to talk about how she gets things done.
This isn’t exactly a posh corner office.
Well I’ve got a desk now, and some chairs. No, it’s true, my last office was in the Inner Harbor with water views…
Why did you take this on?
That’s a good question! The truth is, it just kept popping up on my radar. One of the (16) Medical Cannabis Commissioners, Deborah Mirin, is a someone I’ve known for many years. She is the patient advocate on the commission, and a leukemia survivor herself. We had talked about medical cannabis on a personal level, and once Senate Bill 881 was passed and the commission formed, she would call and occasionally ask for my advice on dealing with state agencies. Early on, the commission found itself stalemated, and I spoke a lot with Dan Morhaim, a State Delegate, a physician, and longtime supporter of medical cannabis. Then, coincidentally, the acting executive director of the commission resigned, and a number of people contacted me about the job. I thought it was time for the public service chapter of my career. A chance to use my skill set for a cause I believe in.
What’s the best part of the job?
Well, it’s like climbing Mt. Everest. I’m happiest when I reach another milestone along the road to full implementation. Then I move on to the next peak! But the real reward is that I get a lot of calls from patients, grandparents, spouses – and I take those calls. Each story is different. I hear the pain these people are in, and it is a gift to know that I’m helping.
Well, it was a true startup. I just didn’t realize how much needed to be done in terms of getting all the processes in place. I came in with no office, no staff, no phone. Fortunately the Commission – all volunteers, by the way — has been enormously supportive, and I was able to have James Johnson, former CFO from the state Department of Health and Mental Hygiene on the team. Together, we have worked with the Commission to develop a budget, an IT system, procurements, and a new set of regulations. We’ve just passed that second set of regulations. It’s coming together.
What happens now?
The applications. We are working with RESI, the Regional Economic Studies Institute at Towson University – on scoring rubrics which will evaluate applications for growers, processors and dispensaries. Information about this is available on our website, [email protected], with a preliminary target date of of the end of September for the actual applications to be posted online. We’ve also developed contracts for compliance – hiring investigators and regulators to make sure everyone involved meets a high standard for compliance. There are RFPs (Request for Proposals) for investigative services, because everyone involved will have to have background checks. And we’re also developing registries for physicians, caregivers and patients.
How many staff members do you have?
Two. With a third coming on, and five others over the next few months. I have brought on consultants and contractual help.
Where do you look for guidance in creating a regulatory apparatus – other states?
In the beginning we were looking closely at other states where medical cannabis was being implemented, but we got to the point where it seemed more effective just to start with a blank slate – every state has such different legislation. We looked especially at what didn’t work elsewhere, and based on that, decided to focus on what worked best for Maryland. I will say that we’ve also sought out and received a lot of input from the public – more than most states — which I believe has helped to strengthen the result.
Why was it decided not to tax cannabis?
That was the Maryland State Assembly’s decision, with the consideration that cannabis was medicine for sick people. That may be something they look at in the future, but for now they are not taxing it.
Which area of new regulations has been the most problematic?
I don’t know that there’s been anything we haven’t been able to address. Edibles are not included in legislation, and that was a big decision. We chose not to move forward on edibles because they would require a whole other set of regulations. Tinctures will be available, if you want to put it in a drink or whatever, and the dried powder, which can be vaporized, will be allowed, as will ointments, oil, suppositories and patches. But we are not going to package it in brownie, candy or drink form. Also, Maryland cannabis regulation will allow for transport – if a patient is not close to a dispensary, it can be delivered to them.
Which of your constituents take the most time – doctors, patients, growers …?
Right now, potential licensees have a lot of questions. We’ve spent lots of time developing FAQs. It’s essential to be completely transparent. If someone has a question, like “what is the definition of premises? ”, we have to answer that in a way that is available to everyone. Different counties have had questions about zoning, for example. So, it’s not really one constituent that takes the time, it’s providing a lot of information in a way that any interested party can access.
Will doctors need special training to be able to prescribe for patients, given that medicinal marijuana has not been approved by the FDA?
There has actually been a lot of training in recent years, with conferences going on in America and around the world. Israel and Europe have been leading the way in this area. My hope is that as physicians become more familiar with medical cannabis, it’s usage will be taught routinely in medical and nursing schools. We are partnering with hospitals now, using the Grand Rounds, the weekly educational symposium open to any doctor or medical student, to present current research to physicians via the hospital system.
What percent of physicians have been trained?
I don’t have an exact number. A small group initially, but we are working very hard on that.
Who are the people doing the training?
There are people with experience in other states who are going to come to Maryland to set up these systems. As I said earlier, there is actually an incredible amount of research that has been done on the endocannabinoid system. The knowledge is out there. Growers and dispensers in Maryland will have to include in their applications how they will assure quality, how they will train their staff, how they will provide expertise on dosage, and demonstrate knowledge of all the ways that cannabis can be delivered.
Is the pot grown for medical use less likely to get you high?
Cannabis is a very complex plant, with at least 80 cannabiniods which have receptors in the human brain. THC is the most psychotropic part of the plant – the part that gets you high. But many of the other cannabinoids are little, if at all psychoactive — something that is not widely known. For any medical symptom for which cannabis can provide relief, there will be a different strain of cannabis appropriate for treatment. So, for example, if you are a two year old suffering from seizures, you are likely to be prescribed a strain without THC.
Will there be an age limit for medical marijuana?
No, but patients under 18 will required to have a caregiver.
What’s your feeling about legalizing marijuana for recreational use?
My charge is strictly medical.
How about the potential for criminal activity?
In terms of law enforcement there are very, very strict security components with tough penalties for violations. We will certainly work with the Maryland State Police. If our compliance officers find violations, we will immediately turn it over to the police, but our purview is not law enforcement.
You’ve said that dispensaries will look like “boring medical offices” …
I wanted to really make that point because I know people were watching TV and seeing Colorado bud bars, or bong lounges. We are providing cannabis for medical use — our dispensaries will be clinical in nature, and will look the part.
What do you want to tell Marylanders know about medical cannabis?
One thing, and it’s important. Ask your doctor about it. If you or a relative have a condition that you think may be helped by medical cannabis, ask. The more that patients request information, the more doctors will seek training and become confident with recommending it. Physicians are an absolutely integral part of this program.
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