After a long day of work, a minor headache has you down. Nothing serious, just some sinus pressure. You hit the grocery store, grab an over-the-counter pain reliever (and some donuts) and head for the exits.
But what if the headache had been more severe? That might have called for stronger medicine, maybe even something prescribed specifically for headaches by a doctor.
The above scenario is a good template for thinking about the differences here in Arizona between the recently passed Prop. 207 that allows recreational purchase of marijuana (the equivalent to over-the-counter pain meds) and its slightly older cousin, the AMMP, or Arizona Medical Marijuana Program (which requires a doctor's recommendation).
On a basic level, the laws are very similar to each other and contain parallel language.
That’s by design according to Will Humble, current executive director for the Arizona Public Health Association and the director of Arizona’s Department of Health Services during the passage and implementation of the medical marijuana program.
“Oh they block copy/pasted a lot of it,” he said. “In state government, plagiarism can be a virtue.”
How Medical Marijuana came to Arizona
When voters passed Prop. 203 in 2010, they approved Arizona’s Medical Marijuana Program, making the state the 15th in the U.S. at the time to pass a medical program.
Over the years, the state's program has been extremely successful according to Dustin Klein, former owner of Sun Valley Certification Clinic, one of the largest medical marijuana certification clinics in the state.
“I think we’re the third most successful medical program in the country,” he said. “We did $800 million in gross revenue last year. That wasn’t recreational, that was just medical. That’s unbelievable.”
An industry lobbying firm, Arizona Dispensaries Association, estimated that medical marijuana sales brought in $46 million in state and local tax revenue in 2018.
Per the AMMP, those tax dollars are used by local governments to fix roads, support education and preserve public safety
Humble said that he and his department were charged by voters to lay out rules for a system that was to be as user-friendly as possible. In order to do that, they scoured existing laws from other states for best practices.
"We copied a lot of our inventory control and security, etc. from Colorado. We borrowed some other stuff from New Jersey," he said. "Wherever we could find something that looked like it was good public policy, we used it."
What resulted was a set of rules and guidelines for medical patients to navigate to obtain licensing, education and, ultimately, marijuana under the purview of the state of Arizona.
According to Humble, the program's rules were laid out to be as medical (and as far from recreational) as possible.
Because of that, and even in the face of state-wide legalization, there remain some regulatory and purchasing guidelines that are different for medical patients than for recreational clientele.
Medical Marijuana Guidelines
First, and most obvious, is that medical patients require a license or “green card.” The cards aren't green, but look similar to an Arizona-issued drivers' license or ID. If you are just looking to purchase recreationally, you won't need one of these cards.
In order to obtain a green card, however, a prospective patient must be at least 18 years old (or, if younger, have a parent or guardian registered as a caregiver); possess an Arizona Drivers License or Identification Card; and have one of a number of qualifying conditions listed here.
By contrast, recreational customers just need to be 21 years old and present a state-issued ID at the point of purchase.
Next, medical patients must visit with a doctor who prescribes, or in this case, certifies, patients for use of medical marijuana. According to Klein, whose clinics have certified over 100,000 patients since 2013, a visit to one of these doctors can range in price from $75 to $125.
Then, once a patient has been certified by a doctor, either the doctor or patient submits the required paperwork to the Arizona Department of Health Services, along with a $150 payment to obtain a state-issued green card that is good for two years.
"In general, you're looking at about $275 to be covered for two years in Arizona," Klein said. "And you gotta repeat the process every two years, all the paying the state, seeing the doctor, completing the documentation."
With so many hoops to jump through, both Humble and Klein pointed to three basic reasons why a green card makes sense for patients who have a qualifying condition.
First, Klein said that while it may seem like a steep initial investment for a green card, it more than pays for itself financially. And quickly.
"We like to jokingly say, but it's totally true, at $150 bucks a year for your card, if you literally smoke one bowl a day, you're financially incentivized to get that card," he said.
That's partially due to medical patients being exempt from paying the state's 16% excise tax and 5.6% sales tax that recreational customers are subject to on all marijuana transactions.
Klein also noted that medical patients are not subject to the same procurement limits and dosage restrictions as recreational customers.
By state law, a person purchasing marijuana recreationally can only purchase up to 1 oz. of marijuana, with up to 5 grams of that total allowed to be marijuana concentrates (products like hash oil), every two weeks. For medical patients, the limit is 2.5 oz. with no limit on concentrates.
Klein says with a card it can be anywhere from about 25-75% cheaper than a similar recreational purchase.
Additionally, the potency of available edible products is limited to 10 mg of THC per serving and no more than 100 mg of THC per package for recreational customers. Medical patients can purchase products of up to 1,000 mg THC.
But aside from the value and access to more potent products, Humble said that perhaps the most important perk of carrying a green card are the workplace protections from losing a job, for example.
"If you're a patient you've got more protection than you would have as a non-patient," Humble said.