I’d Rather Be an Outlaw: Kentucky’s Medical Marijuana Program and Me

I had an agenda when I first conceived of this article. It was going to be a “hit piece.” I was going to grouse about everything I would have done differently, using the advantages afforded to an armchair quarterback. But that all changed.

Please understand, I hate writing in first person. Formal essays should be written in the third person, objective perspective. More importantly, first-person writing feels so much more emotionally vulnerable, already a character trait, but not one I like to extend to my writing.

This essay is different. It is personal, and I feel extremely vulnerable.

The Executive Order That Changed Everything

In November 2022, Kentucky Governor Andy Beshear signed Executive Order 2022-798, which granted a sweeping pardon, effective January 1, 2023, for anyone arrested or convicted for possession of marijuana if the accused was diagnosed with one of several qualifying conditions.

The executive order incensed the Republican controlled legislature, which had repeatedly killed any previous medical marijuana bill in legislative committee. Senate President Robert Stivers stamped his feet and screamed about executive overreach, before realizing just how incredibly well the EO was greeted by Kentuckians across the political spectrum.

Finally, in March 2023, the light of self-preservation popped on, and the legislature did the right thing, passing Senate Bill 47. This legislation created the legal framework for the state’s medical marijuana program. The governor signed it into law the day it hit his desk.

Before my diagnosis, when the executive order was first issued, I discussed it with my doctor. He knew my medical history. More importantly, he knew I smoked cannabis. He told me to bring in a copy of the Executive Order; he would circle the qualifying condition that applied to me and sign his name beside it.

At the time, I did not follow through, electing to remain outside the law.

Encountering A Hitch In My Giddy-Yup

Several years ago, people in my life started telling me I had a hitch in my giddy-yup. I was dragging my left leg, and it was getting worse. I had noticed it previously and tried to ignore it, but the voices of my friends got louder. I finally listened, and in the summer of 2024 started asking my doctor, “WTF?”

After tests and more tests to confirm the first tests, I learned I had Multiple Sclerosis. It is “a chronic autoimmune disease of the central nervous system where the immune system attacks the protective myelin sheath covering nerve fibers in the brain and spinal cord.”

This “attack” comes in the form of lesions, which interrupt the electrical signal from your brain to your body, in my case predominantly my left leg.

I remain devastated by the diagnosis and am still processing it emotionally, physically, and strategically. Until this article, I had kept my diagnosis closely held, telling only a few close friends, family, and need-to-know co-workers. However, it has altered my perspective on the medical marijuana program in the Commonwealth of Kentucky.

My qualifying condition is clear. There is no grey area.

What I am left with on the medical front are questions. Did my decades-long dance with cannabis help keep the disease on the down low? With regard to MS, how exactly does cannabis help? What is muscle spasticity?  Are there specific cannabinoids that help this condition, certain symptoms more than others? Anyone with a strain recommendation?

The Medical Marijuana Program in Kentucky

From an advocacy perspective, I have a major bone to pick with the design and administration of the program. The state legislature in the Commonwealth of Kentucky is very conservative and pro-business.

The program breaks the state into 11 regions, with each region allotted four dispensary licenses. The two major population centers, Louisville and Lexington, get additional licenses for a total of 48 dispensaries. There is no provision for home grows.
Yes, Kentucky is not the size of the western states, but the limited number of dispensaries per region forces some patients to face a significant drive to access their medicine.

Of more significance is the economic impact this model has on the cost of medicine. Lawmakers claim they want to avoid what they considered “problems” encountered in the states where the number of dispensaries created overcrowding and oversaturation.

A more functional interpretation of their reasoning is that the legislature prioritized protecting the profit margins of the businesses awarded licenses over access to affordable medicine for patients. The licensing process itself required deep pockets, between application fees, legal fees, and the upfront capital required to show a valid business plan. Then, after the licenses were awarded, dispensaries had to wait and wait some more before they could stock their shelves.

The bill was signed into law in March 2023; the program was supposed to open to patients in January 2025. The first cannabis did not reach a dispensary until January 2026. The process tied up a lot of capital indefinitely, rendering the prospects for local independent operators a pipe dream.

Finally, as product has trickled onto the shelves and dispensaries slowly come online, pricing has not been patient-friendly. Yes, pricing may come down as growers scale up and more product slowly flows into stores, but limiting the number of dispensaries eliminates competition, creating a ripe environment for inflated prices.

Here is what’s confusing.

Kentucky’s conservative “pro-business” governance passed legislation that restricts access to being a market provider to those with large financial resources. Some license holders may be operating out of pocket for 2 years before product flows into their business. Is that “pro-business?” It seems like any model that eliminates free market competition and protects profits seems more “pro-monopoly” than “pro-business.”

Limiting opportunity is a stab in the back to every Kentuckian, not just patients. The model is symbolic of a bigger problem. Governments are supposed to function in the best interests of their citizens. Historically, the rich and powerful have their interests served first, but that’s a debate for another day.

Medical marijuana is a health issue. It is supposed to focus on the needs of patients, people, citizens, constituents. Nothing in Kentucky’s medical marijuana program seems patient-centric. Indeed, the entire program appears geared to ensure the profitability of businesses and tax revenue, and not towards providing patients with safe, affordable access to medicine.

How to Improve Kentucky’s Medical Marijuana Program

If Kentucky truly wants to prioritize the concerns of patients, the legislature should seriously consider these recommendations:
  1. License More Growers and Dispensaries: This should result in more access and lower prices for patients.
  2. Allow Home Grows: Kentucky has a rich history as an agricultural state, and many of its residents can claim an ancestor who “grew hemp.” More importantly, home grows will allow patients in isolated areas to supply their own medicine. Additionally, gardening is therapeutic and proven to improve physical and emotional health. Even growing plants indoors requires physical activity and interaction with the plants.
  3. Free the Flower: The section of the law “prohibited methods of consumption” targets “combustion of cannabis such as smoking.” I’m sorry. What? From 1916 until about 1996, tobacco was the leading cash crop in Kentucky. The University of Kentucky once had a “Tobacco Health” research center; don’t start acting like “smoking” is now a health issue.
Titration is the scientific word to describe how much of an agent needs to be added to another substance to get the desired reaction. Smoking cannabis…ahem, “combusting” cannabis flower is the most efficient way to administer and regulate the therapeutic compounds in medical marijuana. Edibles can be extremely inconsistent, hitting hard one time and barely registering the next. These provisions reek of a way to sell processed products and gear for ingesting concentrates (vaping). Smoking flower can be a meditative ritual. Don’t take that from people.
Imagine someone taking your bourbon and replacing it with Tennessee sipping whiskey, explaining that they both get you drunk. No, it’s not the same. Sometimes the journey is as important as the destination. Besides, rolling a joint is good therapy, and it keeps your fingers limber.

Final Notes from a Patient of Kentucky’s Medical Marijuana Program

I am grateful that Kentucky implemented a medical marijuana program. It was the right thing to do. As a decades-long advocate for cannabis legalization, I recognize what an important first step it is. That said, it is a severely flawed system that seemingly values profits over patients. Fix it.

When I first discussed medical marijuana and the governor’s decriminalization executive order with my doctor, my decision to remain an outlaw was based on not wanting to “game” the system. He would certify me with one of the more broadly defined conditions, like chronic pain and I had a get out of jail free card.

Now, I have been diagnosed with a qualifying condition that scares the crap out of me, and I carry a Team Kentucky Medical Marijuana card. I wish I were still an outlaw.

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