A bud of marijuana goes into packaging at Green Releaf Dispensary

Marijuana is sent to Green Releaf Dispensary in one-pound bags from various local cultivators. Missouri medical marijuana patients are permitted to purchase 4 ounces per month.

In November 2018, Missouri voters approved a measure to legalize medical marijuana. Now, Missouri is one of 36 states and four U.S. territories where medical marijuana is legal. To answer some common questions, Vox spoke with experts about the medical marijuana industry to find out how it all works.

Who is eligible to receive medical marijuana?

Adults with Missouri residency and a licensed doctor certification can buy medical marijuana. “If you’re 18 years old, you can apply to get [a patient card],” says Lyndall Fraker, Missouri’s medical marijuana director. Fraker says that once you have a certification from a physician, you can fill out an application online to be issued a card.

Patients must have one of the many qualifying medical conditions that are listed in the state constitution. “The state of Missouri has made it pretty broad so that almost any condition can qualify,” says Dr. Anand Dugar, founder and owner of Green Health Docs, a clinic that helps patients get medical marijuana cards. “You just need to have an existing condition. Most patients we see are suffering from chronic pain of some kind, or they might be suffering from mental health conditions like anxiety, depression or PTSD.”

Where is it sold?

There are three ways to legally obtain medical marijuana. Patients can buy products from dispensaries, cultivate at home — this requires additional licensing and fees — or have a caregiver grow for them. Fraker says there have been 192 dispensary licenses issued, and 71 are in operation as of April 2.

A Green Releaf employee packages 3.5 grams of Bubba Fett marijuana into a bag

Achilles Kenney fills a bag with 3.5 grams of Bubba Fet marijuana at Green Releaf Dispensary. "We have to be extremely precise with the measurements," Kenney says. "Consistency matters."

What types of products can the dispensaries sell?

Dispensaries are allowed to sell medical marijuana, which contains over .003% THC. “Any products in Missouri are okay — edibles, flower, bud, products that can be smoked or vaped,” Fraker says. “They can also sell other items. They could sell CBD products. They could also sell convenience items. They could sell candy bars and snacks.”

Dispensaries are a place where patients can learn about different strains, products and the benefits associated with each. “We definitely have been seeing patients coming in back-to-back because they’re receiving the care they are looking for,” says Achilles Kenny, inventory manager for Green Releaf Dispensaries.

What is the difference between CBD and medical marijuana?

The two biggest differences between CBD and medical marijuana are chemical structure and psychoactive components. CBD contains less than .003% THC and can be derived from either hemp or the marijuana plant. “CBD won’t get you high, but it can make you feel a little relaxed,” Dugar says. “It can make your body feel less pain.”

Is medical marijuana safe?

The industry is strictly regulated and monitored. From seed to sale, the Department of Health and Senior Services tracks the plants. “The first thing the constitution said is we would have to have a track and trace system,” Fraker says. “When that plant is planted in the ground at the cultivation facilities, there’s actually a batch number assigned, and that batch number follows that plant all the way through the process to the very end into the patient’s home.”

Although some people are still skeptical, Kenny attests to the strong monitoring and regulations that have created a safe industry. “Now everything’s lab-tested and stays tracked,” Kenny says. “You can definitely know what you’re getting, know what it is, where it came from and what’s inside of it.”

How does the medical marijuana industry affect the state economy?

The first dispensary sale took place on Oct. 16, 2020, and as of April 2, the state has seen over $27 million in cumulative sales. From the cumulative sales, an additional 4% sales tax goes to the Veterans Health Care fund. Nationally, the tax revenue from cannabis sales surpassed $3 billion in 2020 alone.

“It’s providing jobs — there have probably been increases almost daily, probably 2,500 jobs added around the state in this industry,” Fraker says.

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