The law creating Maryland’s present medical marijuana program was enacted in 2014 after a research-based law enacted in 2013 proved difficult to implement. The law itself is brief and concise. It gives broad authority and discretion to a regulatory agency called the Natalie M. LaPrade Maryland Medical Cannabis Commission (MMCC) to adopt and enforce regulations.

Regulation of intrastate industry

Maryland’s medical cannabis law creates three types of licensed operators to perform industry functions. Applications to become a licensed grower, processor, and/or dispensary came due in October 2015.

Growers– The law establishes a maximum limit of 15 on the number of grower licenses that can be awarded.  After June 1, 2018, MMCC can increase the number of grower licenses if necessary to meet demand.

Processors– Neither the law nor MMCC regulations specify a maximum number of processor licenses. In August 2016, MMCC awarded pre-approval for processor licenses to 15 companies.

Dispensaries- MMCC regulations specify a maximum of licenses per each state senatorial district (Maryland has 47 senatorial districts). The two per district is in addition to any grower-dispensary facilities that may be in the district. MMCC has not yet awarded dispensary license pre-approvals or indicated how many it will award initially.

Independent Testing Laboratories- Labs perform the necessary function of performing chemical analysis testing on cannabis buds and derived medicine products to ensure safety and accuracy of labeling. Labs are required to register with MMCC and thereby submit to regulation and inspection, but they don’t compete for a limited number licenses as is the case with growers, processors, and dispensaries.

Secure Transportation Company- Registered labs and licensed growers, processors, and dispensaries can use their own agents to transport items or they can contract the services of a secure transportation company. MMCC regs 10.62.18 define a secure transportation company as “business that is licensed, whose employees are bonded, and that provides highly secure vehicles for the transportation of valuables, and can assure that medical cannabis is secured at all times during transport.”

Physician Certification Rules

Rules for certifying physicians are in 10.62.03 of MMCC regulations. A physician must first register with MMCC to become a certifying physician. Physicians are not required to take special training or Continuing Medical Education courses before gaining the ability certify patients.

Qualifying conditions

MMCC regulations are construed to reflect a trust in doctor’s discretion rather than an obsession with hard and fast rules that define permissible medical conditions.

The lowest common denominator rule is 10.62.03-.01(C): “A physician may be registered as a certifying physician to treat a patient who has a condition that is:

  1. Severe;
  2. For which other medical treatments have been ineffective; and
  3. If the symptoms reasonably can be expected to be relieved by the medical use of cannabis.”

A separate rule indicates more specific conditions for which certification is acceptable, 10.62.03-01(B): “The Commission encourages physicians to apply to register as a certifying physician to treat patients who:

1. Have a chronic or debilitating disease or medical condition that results in the patient being admitted into hospice or receiving palliative care.

2. Have a chronic or debilitating disease or medical condition or are receiving treatment for a chronic or debilitating disease or medical condition that causes:

  • Cachexia
  • Anorexia
  • Wasting syndrome
  • Severe or chronic pain
  • Severe nausea
  • Seizures
  • Severe or persistent muscle spasms

3. Have the the following diseases and conditions:

  • Glaucoma
  • Post traumatic stress disorder (PTSD)