Oops! We Seem to Have Forgotten to Protect Patients in Washington

Enough on the Labs, Already! My Closing Words on a Filthy Issue.
May 16, 2017
Active Store Count & Average per-Store Cannabis Sales
July 20, 2017
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Oops! We Seem to Have Forgotten to Protect Patients in Washington

The closet numerologist and gregarious creature hidden deep within compels me to wish you a happy 7/17/17!

In one of the many numerical quirks of the Universe, if one takes 7-17-17 and decomposes it, the result is three lucky 7s and two decimal-centric 10s. If one then adds the three 7s, to get 21 and then the two 10s to get 20 and then takes the audacious and admittedly somewhat frivolous step of multiplying those two interim results — guess what one gets as the core numerical foundation driving this particular date in history?

420 that’s what one gets.

This is proof, by the way, (or QED as academics are prone to say) that the Ultimate Answer To Life, the Universe, and Everything (42) is NOT a necessary interim result in efforts to arithmetically uncover a path to 420.

One hypothesis that I’m entertaining as a result of this observation is that it is ALWAYS 420, and that it is simply human inability to factor and calculate quickly enough to transform each numerical representation of time into the 420 it represents …. And, even if one gets there quickly, the moment in time for which one’s calculations have completed would have passed. Yet another place where Philosophy meets Science.

On to the primary topic of the day.

7/17/17 also represents the 16th day (2^4) following the 1-year birthday of Washington State’s newer, better regulated medical Cannabis market. Back when our Legislators were dreaming up the cruel vagaries of the Patient Protection Act and our regulators were drafting the constraints necessary to balance the implementation of those dreams with an obsessive fear about evoking further wrath from the Feds, I wonder if they thought ahead to how implementation of their dreams and rules would look from the perspective of the PATIENTS that were now to be subject to the resulting market?

This article will, with as few editorial asides as I can limit myself to, focus on the facts that have been spit out by our PPMC Market (PPMC = Patient-Protecting Medical Cannabis). A blog inspired by and structured to reflect the 5 W’s of critical thought.

WHO (the Patients)?

Back when the LCB and Legislature were presumably putting some thought into how Cannabis would be regulated in the State, BOTEC informed them that there were about 750,000 – 800,000 adult users of Cannabis in Washington and that about 1/3 of those could reasonably be considered to be Patients.

After one year (361 days, actually), 23,327 Washingtonians have registered as Protected Patients. 21,465 of those are adults (18+ years), 1,738 are Designated Providers (presumably adults, as well), and 124 are children (< 18 years). This represents 1 in 240 adult Washingtonians and one in 14,537 minor Washingtonians having taken the step to be registered in the DOH-designed database/registry/system. Is that a good number for a year of implementation? Given that it represents about 1 fifth of the per-capita sign-up rates for Patients in Colorado and Oregon, I’d say it suggests an unexpectedly low adoption of the official self-incriminating process by Washington’s Patients (and by the parents of Washington’s younger Patients). Put another way … DOH and the LCB are supposed to be protecting the 250,000+ Patients in this State that incorporate Medical Cannabis into their medication and /or supplement regimes. Fewer than 10% of those have signed up after a year. During the most recent 12-month period for which there are data (2016), Washington’s Legal/Regulatory/Enforcement machine was able to identify and, more specifically arrest, an estimated 24,858 Washingtonians for DUI. They have arrested more people for something they are trying to eliminate than they have been able to attract to something they are in the process of enabling. On this measure, the embrace of the DOH-inspired Patient Registry is not apparently attractive to the Patients it is supposed to protect.

WHAT (Sales to Patients)?

In the 11 months ending May, 2017, Washington saw $744 million in total Retail Cannabis sales. During that same period, $7,656,969 of sales were considered exempt from sales tax, due to being sales TO A REGISTERED PATIENT made BY AN ACTIVE MEDICALLY-ENDORSED STORE.

These $7.6 million represent just under 1% (0.99%) of total retail sales for the first 11 months of the regulated medical market. Recent months have shown patient sales to be levelling off at about 1.6% of total monthly sales.

For the first 11 months of the PPMC, 100 times more sales were made to non-Patients than were made to Patients (as Patients). Given that Patients will, on average, be consuming about 2-3 times what the “average” re-creator will consume, this suggests a VERY low propensity for the 23,327 Patients to purchase Cannabis at regulated stores AS PATIENTS.

Put another way, these Patients can be expected to have spent, on average, about $360 each AS PATIENTS on Cannabis products purchased inside the system of regulated access points during the first 12 months of the market.

A buck a day. For a Patient. Sounds a touch light to me. Note that, while Skagit County tops the “percapita sales to Patients” list at $6.09 during the first 11 months of the market, a full 1/3 of Washington’s counties have sold not even even 25 CENTS per person to Patients, as Patients, during that time. Eight of Washington’s Counties have not seen a single penny sold to a Patient as a Patient. Now THAT’s protection, for ya!

Remember that anything that a Patient buys that contains Cannabis is considered medicine for purposes of sales taxation (Patients are still heartlessly required to pay the 37% excise tax on their purchases).

There is another class of Cannabis – designed by those implementing the Patient Protection Act to protect Patients. That is DOH-certified, stamped-by-Guvn’r Jay MEDICAL-GRADE-CERTIFIED-CANNABIS.

In a nutshell, these products have undergone additional testing for things (pesticides and heavy metals) that can hurt Patients. Molds and funguses and ratshit can also hurt Patients, but those things are (or at least were) already being tested for in non-Medically-certified products available at retail.

There are very real practical and economic dis-incentives built into the existing system that tend to bias growers away from taking the RISK of attempting to produce and sell certified-medical-grade product.

As of June, only 22 producers, Statewide, have produced and sold products certified as Medically-Compliant. Kudos to them all for assuming more than a little bit of risk in attempting to service Patient needs under this awkwardly regulated system..

The top four deserve a shout-out as they represent over 50% of the medical product produced: These four are: Optimum Extracts, Evergreen Nirvana, Green Volcano Hemp Products, and Ninja Gardens. I’ll post a list of all producers/processors that Patients might want to try, once I’ve collated the various related metrics on them.

22 Producers are producing certified medicine. The other 1000+ are not. I wonder if punitive mind-numbingly harmful regulations might not be playing a role?

WHERE (access points, Co-ops and back alleyways)?

Regulated access points are now the only place (aside from Cooperative Gardens) where Patients (and other Washingtonian adults) can legally purchase products containing Cannabis*.

*(Note that some CHABAs -Cannabis Health and Beauty Aids are available in better non-Cannabis stores today through the efforts of the wonderful Ah Warner and others). If you ever have problems with dermatological fungi, you might want to consider looking into her CANNABIS BASICS Sole’s Desire product — it has replaced lotramin ultraextrastrong in my cabinet).

As of July 5 (just before the 3rd birthday of the start of retail sales in the recreational market), the LCB lists 494 licensed Retail Access Points on their “Applicant” database. That’s a few fewer than the 800-1,200 Green Cross Dispensaries that were serving Patients in the days when regulations ignored them and laws viewed them as criminals (albeit with an affirmative defense).

But it’s still more than the number of liquor stores the State used to oversee (334), so it should be enough (they say) to handle Patient needs. Oh, yes, I almost forgot, that the UW study on the size of the medical market that used an idiotic methodology predicts that there are ZERO medical Patients in the State, so 494 is lots thank-you-very-much.

Enough of the bullshit mis-representation of numbers on their websites.

Of these 494 licensed stores, only 383 had any sales at all in the month of June.
According to the Dept of Health (different set of books), there are 472 stores in the state that are “Medically Endorsed”. That means they applied with the Bureau of Licensing Services for a Medical Endorsement (around the time the SSB-5052 222 medical stores were being activated). All that involved was a 1 page form and (I believe) a $10.00 fee.

Of these 472 stores, the DOH has only 191 listed as currently being “ACTIVE” (e.g., able to serve patients as patients … which requires at least one Certified Medical Consultant to be on staff and a number of administrative/technical hoops to have been jumped through.

Bottom line, there are only 191 access points, Statewide, that can POTENTIALLY serve patients as patients (and another 192 -or-so open stores that are not medically “active”.

At least there are 191 access points, Statewide that the DOH thinks can serve Patients as Patients.

That’s a good thing. However, only 162 of these (about 40%) have sold any product whatsoever to a Patient as a Patient and are currently (as of June 28th) considered to be an Active Certified Medical Access Point for patients. The DOH has a list of these up on it’s website. It’s got a few errors in it, but it’s a pretty good resource.

One ancillary point. There have been 1,061 applications received by the DOH for Medical Cannabis Consultant Certificates. That currently translates into 745 certified consultants in the State, 556 of whom are actively working in an Active Certified Medical Access Point (for an average of about 3.5 per certified store). This also means there are 189 certified medical cannabis consultants out there that, while they MAY be working at a retail access point, are not currently able to consult with Patients as Patients. I hope retailers give consultants a pay bump vs. their non-certified counterparts.

I would like to reiterate that after one year of Regulated medical Cannabis ….. and after 3 years of State-legal Cannabis sales in Washington, there are only 162 stores in the State that appear to be able to currently serve Medical Cannabis Patients as Patients. Fewer than ½ of the number of Liquor Stores that he LCB used to control in their monopoly days.

It is also only around 1/10th of the number of brick & mortar pharmacies that currently supply FDA-approved medicines to Patients in this State (Patients that, by the way, are also served by over 800 “mail-order” pharmacies that do business in the mail-order traffic of prescription drugs to Washingtonians).

One might almost get the impression that some within the ranks of our Legislature and the regulatory departments within the DOH and/or LCB do not believe that the plant they are regulating on behalf of Washington’s now-protected Patients is, actually, medicinal.

One other (State-legal) way in which Registered Patients can obtain Cannabis is through membership in Cooperative Garden. I’ll cover those later, and one of the local papers recently did a good job covering their rollout in a local publication (the Stranger?) … however, I know that through May 15, only 60 applications had been received, Statewide and that over ½ of those had been rejected.

At the time, around 15 applications were still in process but none had yet (I believe) been approved. The fact that the LCB just did some emergency rule stuff to allow sales of seeds and plants to Co-ops leads me to believe they are about to “license” a Coop, if they have not already.

(Author’s update …. as of 7/17/17 at 8:19am, there have now been 78 Coop Applications, of which 48 have been denied/withdrawn/cancelled/otherwise pissed-on and 30 are in process (11 of which have been sent to final approval)

Once they’ve licensed 7 Co-ops, that will be one for every 1 million Washingtonians. Too bad they can only each serve the needs of 4 Patients. I have a public records request in on this, but I am wondering how many Coop Garden applications were torpedoed by the new restriction that they cannot be located within 1000 feet of a Retail Cannabis store (no shit!).

As of May, the following Counties have not seen a single dollar of Cannabis sold to a Medical Cannabis Patient as a Patient: COLUMBIA, FRANKLIN, GARFIELD, LEWIS, LINCOLN, PEND OREILLE, SAN JUAN, WAHKIAKUM.

The more I look at the data, the more I am convinced that a large proportion of Washington’s Patients have either quit medicating or have found non-regulated sources for their meds.

WHEN (1 year in)?

It’s one-year into Washington’s apparently-aborted attempt at creating a regulated market for medical Cannabis Patients.

One year in, and the State-regulated medical Cannabis market almost does not exist.

For residents in about 13 of our Counties, it almost DOES NOT exist at all. Certainly not as much as does drunk driving.

Beyond that, I don’t have much to say about the timing of this.

Except that, given that it is 7/17/17 as I write this, it is really 420.
Nothing wrong with that.

WHY (has this happened)?

The Democrats will, no doubt, blame the Republicans and the Russians.

The Republicans will, no doubt, blame the Democrats and the North Koreans.

The Russians will, no doubt, continue to profit and the North Koreans will improve their missiles and terminal targeting abilities.

WHY has the medical market in Washington largely failed to materialize after one year of diligent Patient Protection?

I submit to you that this rollout is failing because it was intended to from day one.

I would love to hear your comments on the facts and opinions I’ve expressed above. I will try to be responsive to those comments.

For the Patients and legacy Practitioners and for the subset of wholesalers and retailers that appear to be putting Patient needs above convenience and short-term profit HANG IN THERE. I plan to publish a series of Patient Protection Announcement to help mitigate the mess of SSB-5052 and it’s implementation. I will make an effort to call out good businesses (and, perhaps, rat bastard ones, as well) in these posts.

I’ll let you know which stores seem to give a shit about your medical needs (Dockside immediately comes to mind … but the good guys and gals are scattered around the State and I prefer to let the data do the describing). Given what I’ve seen thusfar, I expect I’ll make fewer friends than detractors when I name these names.

I’ll let you know the producers and processors that also seem to care about you and about Cannabis as a medicine. This is also not about making friends. Hopefully, it will help consumers make better choices.

I’ll also try to help you know … when there are a number of stores clustered in an area …. which ones might be better for you to shop at (and, in some cases, ones which you may prefer to NOT shop at).

I was accused recently on Facebook of being a gadfly (relating to my “outing” of labs whose data suggested that they might be hurting consumers through their practices). As such, I’ll try not to be too persistent and/or nagging in my criticism of the rollout of State-regulated Medical Cannabis in Washington.

I’ll try to be constructive and positive …. Like a butterfly settling on the horn of a unicorn watching the rainbows waft by.

I plan to ask both the WSLCB and the DOH what Legislative recommendations they are working on for the next session in order to address the shortcomings of the Patient Protection Act that have been made painfully clear in the first year of it’s implementation. I would encourage you to do the same.

If you have any specific suggestions of legislative and/or regulatory language that should be introduced next year to improve medical access in Washington, please share via a comment on this post (or PM, if you are so inclined). I have recently joined a very effective lobbying organization. I’ll promise to do my best to make your voices heard in that context.

Hempfest is just over a month away … and 4:20 pm on 7/17/17 is less than 135 minutes away at this moment.
.
Time to go to press with this.

I appreciate your patience with me and my delay in getting this summary together.

13 Comments

  1. Sam Smith says:

    CO and OR had patient registries.. We know their numbers. WA patients avoided this to remain anonymous. Seems that annonimity has now become a basis forcspeculation as to the number in existence. That number is crucial to make your point. High numbers= good. Low numbers = bad. I suspect you will gravitate to high numbers.

    • Jim MacRae says:

      Suspect away, Sam. What you say regarding “their” registries is true. All WE had here in Washington was a highly-functioning medical system that served 100s of thousands of Patients without any requirement for a centralized registry.

      The number of Patients in OUR registry has little to do with the number that were in existence in the State at the time … it has EVERYTHING to do with the number of those people (and others who where not previously Patients) willing to put their name in the Registry given the risks of and very limited advantages of being in that registry.

      One of the things that I did NOT emphasize when I mentioned that Oregon has, percapita, about 5x the number of Patients in their Registry than does Washington: OREGON’S REGISTRY IS DYING AND PATIENTS ARE NOT RE-UPPING THEIR REGISTRATIONS WHEN THEIR ANNIVERSARIES COME UP. There is now virtually no (or very little) advantage to being on the Registry in Oregon now that their other laws are in-place and somewhat sensible. Bottom line, had I done the comparison when their registry was at it’s peak levels of adoption, the 5x multiplier would have been even greater (don’t have the data readily at hand, so I’m not going to bother to look it up right now).

      Also, I’m quite happy to speculate, but I very much prefer to estimate. When I’m speculating, I’ll generally let folks know that I am. If you catch me doing so without acknowledging the fact that “it’s my opinion” or such, please call me out on that. I would value that service.

  2. Joshua Rutherford(currently holding ranks with the 502 community despite the bs) says:

    Great article, thanks for clearly laying out the numerical facts. One point that I’d like to make is that, in my opinion, Legislators took action on medical marijuana as a result of failing or fear of failing 502 businesss resulting in failure to collect that tax.

    I watched as the 502 community rallied hard against the medical community painting them as criminals and misfits. I point my finger at the 502’ers that pushed this. You know who you are and you are most likely reading this.

    Shame shame shame.

    I wonder if those same 502 business owners are receiving the rewards of their hard fought political war. Or if Indeed it was all a waste their profits are still weak, and the patients are getting even weaker.

    • Jim MacRae says:

      Thank-you, Joshua. There is truth in what you suggest, I believe.

      I also appreciate that you did not paint the overly-broad brush stroke of “all 502’ers”.
      There are good ones and bad ones, no doubt.

      One interesting tidbit that will be part of a new post in a day or two is that the RATE of Retail licensees getting DOH “Certifications” to be able to serve Patients as Patients is, surprisingly, higher in the I-502 licensees than in that group of High-Priority Priority 1 examplars of medical wonderfulness that were able to leverage the grossly inadequate (and inappropriate) definitions that the LCB put into effect through Rule in order to fake out that they were “Medical” and worthy of bumping true Medical Practitioners out of the way

      Note to all currently-licensed Retailers that became licensed under SSB-5052 and the LCBs shit rules surrounding prioritization. I currently know each and every one of you that, as of June 28, were not currently “Certified Active” by the DOH. Within a week, all of Washington will know who you are. I think you are owed that SINCE YOU BUMPED A MEDICAL PRACTITIONER OUT OF THE WAY IN YOUR RUSH TO PROFIT.

  3. Michelle says:

    I am interested in the sales data of medically endorsed stores throughout the state. When will your next article address this?

    • Jim MacRae says:

      Michelle – I will touch on that issue, but the main way in which I plan to use the info is as a single component in a large segmentation exercise I’m in the middle of to subset Access points into different types. This is intended to be a follow-on to some earlier work that I did regarding “Fair Trade” retailers.

      My intent will be to identify groups of stores that have characteristics that some consumers, Patients, Farms, Regulators, and other (competing) stores might find useful.

      You will likely find this stuff initially in a Patient Service Announcement wherein I give specific suggestions regarding stores that seem (irrespective of the marketing hype they employ) to be the type of store I might like to go into where I a Registered Medical Patient in the State of Washington (or even a “recreational” consumer).

  4. Joshua Rutherford(currently holding ranks with the 502 community despite the bs) says:

    In terms of moving forward… what can be done? I know most folks are afraid of the registry.

    And the risks involved from a 502 business perspective could be mitigated with reducing the burden on the farmers(the lowest paid). Maybe they could create incentives for farms to grow a higher quality medical product?

    Trying to bring up solutions instead of only bitches.

    • Jim MacRae says:

      Thank-you for the constructive direction you are taking, Joshua.

      I have lots of ideas on how to fix the issues I’m seeing with medical (from the registry, production AND access-point perspective).

      For now, I’ll leave the question open for others to add to the list you’ve started.

      Fixing this virtually non-functional medical system will be MY personal priority with the LCB, DOH and my Legislators through the next Session (and no … I do not mean our next Attorney General).

  5. Kirk Ludden says:

    Sad but very true:

    When Legislators don’t have compassion, we get the ironically named Cannabis Patient Protection Act, when myself and over 200,000 are now #PatientsNowPotOutlaws. The plus is that there is no longer a criminal influence on the cannabis market in this state, therefore no longer a “black market” but an “underground” or “free” market.

    It was never about the patients, it was Profits Over Patients. With an unscientific standard for measuring impairment, it is surprising the almost 25,000 DUIDs aren’t higher.

    • Kirk Ludden says:

      Also, for public knowledge. E2SSB 5052, CPPA is technically an illegal law. Not only does it violate our state constitution, federal law, and US Amendments 4, 5, and 6–The House DEMOCRATS violated the process by bypassing the House Finance Committee public hearing on the ILLEGAL “Voluntary” Database/Registry $2-3 million fiscal note. Not to mention the Governor Outslee signed and you legal law.

      This year High School Capitol Campus continued the #ProfitsOverPatients removing the only compassion is 5052 by taking away the priority licensing, and requiring patients who wish to grow their medicine to sign up in the database.

      This goes totally against I-692’s intent of providing humanitary compassion, and not making patients criminals. Legislators at HSCC Olympia also violate the intent of I-502, which was to stop making adult use of cannabis a crime, and direct does funds to law enforcement for property and violent crimes. Legislators continue to make cannabis use crimes, in 2015 they made cannabis use in a park a felony. How is that not making cannabis use by adults a crime?

      We have a state where the governor, legislature, and the attorney general are violating state and federal law, and not doing the job of representing the will of the people of Washington state.

      • Jim MacRae says:

        I’ll let that stand, as is, Kirk (I don’t completely disagree with you and I do tend to go along with the notion that the rollout of medical in the State has been a failure in many many ways … some hurting the old-time Providers and many hurting the Patients).

        However, I’d not read too much into Federal illegality of the laws they put into place for a product that is, after all, Federally illegal (or so I hear).

    • Jim MacRae says:

      I hear you, Kirk. I don’t know how many of the 25k DUIs were Cannabinoid-related. I do know that in the prior year there were fewer than 400 Cannabinoid-related DUIs in the State. I expect the number will be higher now.

      My “best guess” (which, in this case, comes fairly close to me pulling the number out of my ass) is that about 7-10 % of the 25,000 were Cannabinoid-related.

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