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and social equity, consumer protection and product safety and penalties.

The report does not evaluate recreational or adult-use cannabis programs.

ASA found that the number of medical cannabis patients continues to expand across the country, now numbering more than 6 million. That represents an increase of close to 1 million patients from the 2021 State of the States report.

The authors say that two states have added legal medical cannabis access programs in 2022, bringing the total to 48 states plus the District of Columbia, Guam, the Commonwealth of the Northern Mariana Islands, the U.S. Virgin Islands and Puerto Rico.

Churgai notes that when the group started issuing the report, only 14 states had medical cannabis legislation.

The letter grades distributed to states in the report range from B, meaning a strong medical cannabis program, to F, for a fatally flawed or absent program. Churgai explains that an A represents the “ideal medical cannabis law” and no state received one.

“We know that we already know that some things do not exist in states, like coverage under health insurance for cannabis products,” Churgai says. “We base everything on a perfect program that we know cannot exist right now without federal oversight.”

Missouri got its lowest scores on affordability, though the report suggests lawmakers focus on policies that “protect medical cannabis patients in the state, like employment and parental right protections.”

ASA averaged the 56 state and territory grades to find that medical cannabis access in the United States only received 46.16 percent, or a “D+” on ASA’s grading scale. The authors said that the score marked a two-point improvement from

2021.

“We’ll take that,” Churgai says. “But one of the themes actually in this year’s report was our surprise that more states are not making improvements.”

More than anything, the ASA team emphasizes the growing challenges represented by the recreational market.

Missouri voters approved recreational marijuana last year, and sales began February 3.

“This is a huge trend that we’re seeing as more states are allowing adult use,” Churgai says. “Unfortunately, they’re giving a regulatory preference to it, so much so that they’re ignoring or pushing aside the patient medical program.”

The report says that as Missouri works on its recreational program, legislators need to ensure that “the adult use/recreational cannabis program and the medical cannabis program remain distinct, as each consumer base has separate needs that must be addressed.”

The executive director notes that 14 states were penalized on their report cards this year for giving regulatory preference to adult-use cannabis operations. Churgai adds that the ASA analysis also showed states lumping their medical and recreational cannabis programs together and not comprehending patient needs and protections.

“It’s not the regulators’ fault, or policymakers’ fault,” Churgai says. “I believe that they think that they’re still helping people. But they don’t understand the needs of patients and why patients actually still want a medical program, and they still need a medical program.”

Steph Sherer, president of Americans for Safe Access, adds that the consolidation of these cannabis programs is lead- ing to consolidation of product for costsaving purposes, as companies fire their chief medical officers and compete with the upstart cannabinoid market. Cannabinoids are cannabis-derived chemicals, like Delta-8 THC and cannabidiol, or CBD. Products containing these substances can be sold in grocery stores and gas stations and have no federal age requirement.

“I think that what we’re seeing is that without these companies being able to increase their available market size to a federal market, they’re really struggling to stay in business,” Sherer says. “They’re finding that they often have to serve the adult-use population in order to pay for the business altogether.”

This decision ultimately harms medical cannabis patients, as their needed medicine gets sold as a consumer product.

The ASA leaders offer policy ideas, including increasing insurance coverage of cannabis, expanding medical cannabis licensing, standardizing lab testing and reducing taxes along the supply chain.

“It’s really important to understand that we’re not just telling states what they’re doing wrong, or what they could be doing better,” Churgai says. “But we actually give them ways to improve the law for patients.”

“The big elephant in the room for these programs is that when we first created access programs to medical cannabis, they were meant to be a type of triage, to get patients off the battlefield of the war on drugs while we changed federal law,” Sherer says.

“And 25 years later, states have done a lot to navigate this very odd situation of regulating an illegal substance. It’s really time for the federal government to move forward with the comprehensive program for medical cannabis.”

The first medical cannabis laws in the United States were implemented 26 years ago.

Consumption and sales of medical cannabis are illegal under federal law. n

Damon Davis’ installation by CITYPARK recognizes a Black neighborhood destroyed in the name of “urban renewal”

Written by BENJAMIN SIMON

Damon Davis grew up five miles away, just over the bridge in East St. Louis. But he’d never heard about Mill Creek Valley.

Then, five years ago, Davis learned about the history of the demolished Black neighborhood for the first time.

“When I found out,” Davis said, “I wanted to make sure that no more Black kids would grow up without knowing about this thriving Black community that was in the center of St. Louis, downtown.”

Last Thursday morning, Davis shared this story with a crowd of people in the ULTRA Club at CITYPARK stadium at the ceremony for