The Weed Issue: Both Ohio and Kentucky are Making Strides on Cannabis Legalization

Both Ohio and Kentucky are in the process of expanding medical marijuana access.

click to enlarge Both Ohio and Kentucky are in the process of expanding medical marijuana access. - Photo: Jeff W., Unsplash
Photo: Jeff W., Unsplash
Both Ohio and Kentucky are in the process of expanding medical marijuana access.

This story is featured in CityBeat's April 19 print edition.

Ohio: A State of Flux

There’s a chance Ohio could become a safe haven for medical marijuana users and casual tokers in 2023. Legislation to expand the state’s medical program is making its way through the statehouse, even as a citizens’ push seeks to get recreational weed on the November ballot. 

In order to understand what’s now allowed, what could change through these efforts and what the future may look like for local cannabis users, take a deep breath and consider Ohio’s ever-evolving marijuana landscape.

Current weed laws in Ohio

Ohio decriminalized marijuana in small amounts in 1975, but that doesn’t mean it’s legal to use recreationally. If someone is caught in possession of less than 100 grams (about 3.5 ounces, which is known as a traditional “eighth”), they can be charged with a misdemeanor and fined $150. 

Possession of anything more than an eighth of weed is considered criminal and could result in a felony charge depending on the amount or other factors in the arrest.

Even with decades of decriminalization, Black people in Ohio are 3.4 times more likely to get arrested for marijuana possession than white people, according to the American Civil Liberties Union. 

In 2015, Ohioans voted against legalizing recreational marijuana, but voted in favor of medical marijuana sales the following year. It wasn’t until 2019 that patients could start buying medical marijuana from licensed dispensaries, of which there are currently 68 in the state.

Medical requirements to be prescribed marijuana

In order to legally buy and possess medical weed, Ohio residents must be diagnosed with one of the following conditions by a certified doctor:

  • Amyotrophic lateral sclerosis (ALS)
  • Alzheimer's disease
  • Cachexia, wasting syndrome
  • Cancer
  • Chronic pain (severe/intractable)
  • Crohn's disease
  • Chronic traumatic encephalopathy (CTE)
  • Epilepsy (seizures)
  • Fibromyalgia
  • Glaucoma
  • Hepatitis C
  • Huntington's disease
  • Inflammatory bowel disease (IBD)
  • Multiple sclerosis
  • Parkinson's disease
  • Post-traumatic stress disorder (PTSD)
  • Sickle cell anemia
  • Spasticity
  • Spinal cord injury
  • Terminal illness
  • Tourette syndrome
  • Traumatic brain injury (TBI)
  • Ulcerative colitis

In 2021, the State Medical Board of Ohio confirmed that arthritis, chronic migraines and complex regional pain syndrome are all considered either chronic or intractable pain conditions that would qualify for a prescription under the existing list. 

How do medical patients consume their cannabis?

While smoking marijuana is historically the most popular form of consumption, especially for recreational users, patients of the state’s medical program have more limited options for treating their condition.

The only approved forms of medical marijuana in Ohio are oils, tinctures, plant material, edibles, lotions, creams and patches. The law prohibits the use of medical marijuana by smoking via combustion (read: a joint) but does allow for vaping. The law also prohibits licensed retailers from selling any form of marijuana that is considered “attractive to children.” 

A patient can petition the state for permission to use a different method of consuming medical cannabis, but smoking is expressly forbidden.

And just because you qualify for medical weed doesn’t mean you can buy it on the street. Medical marijuana patients must purchase their cannabis from a state-approved distributor, and each patient can only possess up to a 90-day supply at once. Patients are not allowed to grow their own marijuana. 

How many Ohioans have been approved for medical marijuana?

As of Feb. 28, 2023, Ohio had 166,643 medical marijuana patients with both an active registration and an active recommendation, meaning they have the green light from both a doctor and the state to buy cannabis. Since the program kicked off in 2019, the state has seen 346,582 patients register, 21,028 of them with military veteran status.

The state does allow children to receive prescriptions for medical marijuana with the consent of a parent, but data on the number of children in Ohio’s program is not publicly available.

If a patient from another state that also has a medical marijuana program wants to buy cannabis legally in Ohio, the two states would first need to enter into a reciprocity agreement. In order for out-of-state patients to qualify for medical marijuana use, Ohio’s Board of Pharmacy must prove the other state’s medical marijuana program is “substantially comparable” to Ohio’s, and that the other state would recognize a patient registration card issued in Ohio. Ohio has yet to enter into any reciprocity agreements, although the Board of Pharmacy is required to “attempt in good faith” to do so. 

Senate Bill 9

In January, state senators Steve Huffman, R-Tipp City, and Kirk Schuring, R-Canton, introduced Senate Bill 9, which would allow doctors to recommend cannabis for any debilitating condition and would expand dispensaries and growers in the state.

The bill would shift regulation of the medical program away from the Board of Pharmacy to a commission within the Department of Commerce. The 13-person commission, appointed by the governor and legislative leaders, would include doctors, law enforcement and addiction specialists. SB9 would also loosen restrictions on out-of-state medical card holders and would allow dispensaries to advertise on social media and offer drive-thru service.

Ballot vote to legalize marijuana

While SB9 expands access to marijuana for some, advocates with the Coalition to Regulate Marijuana Like Alcohol want to put legal weed on the ballot for all.

The coalition’s proposal would, as its name suggests, regulate marijuana much like alcohol. Ohioans age 21 and older would be able to buy and possess 2.5 ounces of cannabis and 15 grams of concentrates. They could also grow their own marijuana — up to six plants individually or no more than 12 in a household with multiple adults.

After efforts to get near-total legalization on the ballot fell through in 2022, state lawmakers agreed to reintroduce the coalition’s initiative in January 2023. Ohio Secretary of State Frank LaRose submitted the proposed statute to lawmakers on Jan. 3. They have until May 3 to approve it, which they likely won’t — and if they don’t, the question will go before voters.

Polling from 2022 suggests Ohioans might be in favor.

Emerson College conducted a poll of 410 likely voters in February 2022, asking, "Do you think marijuana should be legal for recreational purposes in Ohio?" Results showed 50.4% of respondents in favor of legalizing recreational weed, 39.7% opposed and 10.0% undecided.

Kentucky: Grass for the Bluegrass State

After a long and unconventional path, Kentucky is set to establish a medical marijuana program, although it’s likely to be one of the most restrictive in the country and it won’t begin until 2025.  

After several years of failed attempts to pass similar legislation, a bipartisan medical marijuana bill cleared the Commonwealth’s Republican-controlled General Assembly on March 30, the final day of the 2023 session, and was signed by Gov. Andy Beshear the next day. 

The program will be operated by the state’s Cabinet for Health and Family Services and offers eligibility to patients with one of at least six conditions, including cancer, chronic pain, multiple sclerosis, chronic nausea and post-traumatic stress disorder. Under the bill, patients will not be allowed to smoke marijuana but will be able to vape and ingest it.

The bill is separate from Gov. Beshear’s November executive order, which automatically pardons Kentuckians with 21 medical conditions who obtain up to eight ounces of marijuana out of state and bring it back to the Commonwealth — provided they have documentation of their medical condition and keep a receipt for the marijuana.

That executive order went into effect on Jan. 1 — and will likely be all that medical marijuana users have to lean on until the state program is established in two years. Even so, some critics have challenged the governor’s action as flawed and convoluted. Beshear himself called the order “imperfect.”

In short, there’s a lot to unpack.

Beshear’s Executive Order

When Gov. Beshear’s executive order took effect on January 1, 2023, it theoretically opened the door for people with among 21 qualifying medical conditions — or their caregivers — to possess and use small amounts of marijuana in Kentucky. The order doesn’t allow dispensaries in the state, but instead says that qualifying people who bring back and use legally obtained marijuana would automatically receive a pardon if needed. The caveats are that the patient or caregiver can possess no more than 8 ounces, they must keep their receipts and they must have documentation from a licensed healthcare professional of the qualifying medical condition. The governor’s office also said it provided “palm cards” to state law enforcement agencies to advise them on the rules of the order.

Because most states with medical marijuana require out-of-state users to be cardholders from a reciprocal program, Kentuckians currently have the best chance of obtaining legal marijuana from the two bordering states with recreational dispensaries: Illinois and Missouri.

The qualifying medical conditions under the executive order are cancer, ALS/Lou Gehrig’s disease, epilepsy, intractable seizures, Parkinson’s disease, Crohn’s disease, multiple sclerosis, sickle cell anemia, severe and chronic pain, post-traumatic stress disorder, cachexia/wasting syndrome, neuropathies, severe arthritis, hepatitis C, fibromyalgia, intractable pain, Huntington’s disease, HIV or AIDS, glaucoma and terminal illness.

When I co-reported a story last December about the executive order for CityBeat’s sister paper in Louisville, LEO Weekly, advocates and supporters were cautiously optimistic that the governor’s action would be an incremental improvement, but several sources pointed out confusing and problematic aspects. 

For instance, two members of the General Assembly who have each consistently sponsored marijuana-related legislation — one Republican, one Democrat — both expressed qualms with Beshear’s action.  

State Rep. Nima Kulkarni, a Louisville Democrat who supports decriminalization of marijuana, called the executive order a “modest step forward” but said she has concerns about how the pardons would work and how compliance with the order would be enforced.

“On a practical level, how is somebody supposed to navigate this?” she told LEO.

State Rep. Jason Nemes — a Republican who has been a longtime advocate for medical marijuana in the General Assembly — told LEO, “The governor knows it’s not legal, but he’s doing it anyway for politics.” In that same conversation late last year, Nemes told LEO that despite his feelings about the executive order, he was open to working with Beshear leading up to the 2023 General Assembly because passing a medical marijuana bill was “all hands on deck.” 

In March, on the day that the medical marijuana bill was signed into law, Beshear and Nemes were at the press conference together, all smiles and compliments.

The General Assembly’s Bill

Prior to the medical marijuana bill passing in March, Kentucky’s previous two legislative sessions saw a similar bill make it through the statehouse, only to be stalled and never voted on in the Senate.

In those previous sessions, both bills were sponsored by Nemes, who has spent years trying to persuade his fellow Republicans that Kentuckians suffering from serious medical conditions need medical marijuana access.

In the 2023 session, Nemes didn’t file a bill in the House, saying it needed to clear the Senate first. 

That tactic proved successful. The legislation that passed, Senate Bill 47, allows “registered qualified patients” and designated caregivers to purchase up to what the Cabinet for Health and Family Services determines is an “uninterrupted” 30-day supply during a “given” 25-day period. A “visiting qualified patient” can purchase up to a 10-day supply during a “given” 8-day period. 

Even qualified patients, though, may not smoke marijuana in public; they could be charged with a crime and lose their cardholding status. A board created by the cabinet will also be able to recommend other conditions to be included in eligibility.

Right before he signed the bill into law, Beshear reflected on the day he announced the executive order and how it fits into his ultimate goal.

“That day and the many days that followed, I talked about that executive order being imperfect, and that we needed legislative action, and last night the General Assembly delivered,” Beshear said at the press conference.

Nemes also spoke during the press conference, offering his perspective on what the medical program will mean for Kentucky. 

“There are thousands and thousands of Kentuckians who just want to be — and feel — better. This will help them with that,” Nemes said, with Beshear standing by his side.

He continued: “This is such a good bill because there are tens of thousands of Kentuckians who will never know our names, who will never walk these halls, but will be helped. So, I’m happy to have played a small part in that.”

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