By Jack Porcari

It was 2:50 p.m. on September 2nd, and medical marijuana patient Alicia P. noticed something different about her trip to the dispensary; her medicine was no longer on the shelf. She has found particular relief from Curaleaf’s cannabis flower products. A recovering addict with over six years of sobriety, the patient said that it helped cut her Suboxone dose in half.

“I was seeing studies about the entourage effect … it was all seeming to go in the right direction and then this happened,” Alicia said. Verilife, a local Amherst dispensary, offered ground flower for a little over a month before it was recalled. This difference in product availability can mean a great deal for some patients.

“Flower is by far the most accessible dosage form, both in terms of patient familiarity and, most importantly, in terms of cost,” said Stacia Woodcock, Pharm D, Dispensary Manager for Curaleaf’s Forest Hills Dispensary. Due to the fact that it requires minimal processing to adhere to regulations, ground flower will cost the patient less than other cannabis products that are expensive to produce. Vape cartridges, which are the closest comparable product to vaped flower, can cost up to twice as much as flower on a dollar per milligram basis.

Woodcock also noted that cannabis flower is essential in giving patients a versatile treatment option, allowing for homemade oral, topical, and sublingual medications. “When flower is not available through a legal, regulated market, it drives patients toward illicit sources, which creates great risk, especially in terms of potential contamination with mold or fungus, which could be life-threatening to immunocompromised patients,” Woodcock said. Now more than ever, the Department of Health should be ensuring that all New Yorkers have access to high quality, affordable cannabis.

Medical cannabis flower was recalled from the 18 stores carrying Curaleaf products in early September, leaving the shelves vacant for weeks. The DOH cited the measurable size of the cannabis nuggets as their reasoning behind the administrative hold.

After further investigation, it appears that this may not be the only reason why the DOH decided to pull a medicinal product from the shelf with such an ambiguous explanation.

Dispensaries were ordered to “immediately stop offering these products to patients until further notice,” according to a leaked document sent to all NYS registered organizations. Patients and doctors were not aware that this administrative hold was imminent and were unable to plan accordingly. This decision to recall medicine and change the guidelines for the program was made promptly without the input of the community through a public hearing.

Original communication (recall) from the Department of Health

We spoke with an inside source (who wished to remain anonymous) from one of the dispensaries that stocked Curaleaf’s flower.

“We believe another registered organization filed a complaint to the DOH that Curaleaf didn’t have their flower ground down to an acceptable size. This year seems to have jaded a lot of people and it just seems like it brought out the worst in everybody when it shouldn’t have. When higher-ups start these pissing matches, I don’t think they realize the impact that it has… In New York City there have been a couple of dispensaries that they’re actually so down and out that they’re only open Thursday through Saturday.”

This massive product recall shows that even in the midst of a pandemic, competing companies in the cannabis industry are willing to resort to blowing each other into their regulators.

These decisions, both by the Department of Health and the alleged registered organization that filed the complaint, echo the realities of the cutthroat business tactics in this industry. Over 15,000 wholesale units of flower were recalled by the Department of Health, according to Timothy Mitchell, a patient advocate. With a price tag of roughly $1.1 million, the ripples of this regulatory charade are felt by patients and workers alike. While some registered organizations feel the need to fight for a larger share of a market, patients and those working within the cannabis industry are wondering how such a useful product was able to disappear over a technicality. In the legislation, there is no section expressly stating the guidelines for the size of medical cannabis. In fact, 10 NYCRR § 1004.11 only mentions ground cannabis once: It is displayed on a list of approved forms of medical marijuana products. With this level of inconsistency and transparency, many patients like Alicia feel that the program doesn’t work with them in mind.

Guidance on metered ground plant preparations from the Department of Health

Recently, the eight weeks ban on ground flower was lifted. “The Department has lifted the quarantine and approved Curaleaf to continue product manufacturing and sales,” a spokesman from the Department of Health said. Despite this, there are still many barriers to achieving access to affordable flower across the state. “Testing turnaround time under the best-case scenario can be three to four weeks. We are pretty sure that the Wadsworth Center is doing 100% of the testing,” said Timothy Mitchell, an advocate who is very familiar with the medical industry. Now with a backlog of thousands of units and only a single testing location, it could take a long time before all New Yorkers can see their medicine back on the shelf.

What this series of events shows us is that New York’s medical program can do much better for the patients it serves. Instead of trying to cut others out of the market and monopolize, dispensaries ought to work together, innovate, and create the most positive patient experience. Our medical industry doesn’t have the foundation to handle the intense corporate wars that other industries currently endure.

If we ever expect to legalize and open up the adult-use sector, registered organizations need to focus more on the impact their decisions have on the community. The program needs a more robust set of regulations that focuses on the actual application of the plant with the advice of patients, consumers, and industry professionals. “Patients can expect the same quality flower which will now be ground according to the Department of Health’s new guidelines. Our patient community has been incredibly patient with us and, to show our appreciation, Curaleaf’s ground flower will be sold at a lower price point once it returns to the market,” said Patrik Jonsson, Regional President, Northeast for Curaleaf. The ground flower is slowly being re-released in small batches at Curaleaf’s dispensing locations in the Hudson Valley, Plattsburgh, and Queens this week. From here, patients need to ask more questions and demand more of a program that truly has the potential to be successful.