A recent expansion of treatable conditions in Louisiana's fledgling medical marijuana program could grow the industry by millions of dollars and move the state's once-narrow program closer to a full-blown medical marijuana industry seen in other states.
But those close to the industry also worry that some of the rules on the program will place bottlenecks on production, and wonder whether the state's two growers -- only one of which is close to getting product on the shelves -- will be able to meet the heightened demand.
The strain of demand depends in part on how quickly and how many doctors get on board, given that the state limits them to 100 patients each for a nonsmokable product that is expected to be available later this year. There also is a limit of 10 medical marijuana pharmacies spread regionally through the state.
Legislation signed by Gov. John Bel Edwards expanded the program by adding intractable pain and several other conditions to an original list of 10 diseases that qualify for medical marijuana.
"It's a massive, massive increase," said Brian Rudin, a Colorado-based dispensary owner and co-owner of the Lafayette region's planned marijuana pharmacy. "It's the difference between a handful of (patients) and potentially a massive amount of people that suffer from chronic pain that would see relief with cannabis."
"It is the golden standard for therapeutic marijuana programs," Kevin Caldwell, head of CommonSense NOLA, said of intractable pain being added.
The dozens of people who staked out risky positions as the state's exclusive growers and pharmacies dispensing the drug did so expecting to weather losses in the first few years. Once they got in on the ground floor, many expected the state to eventually widen the program and turn it into a viable industry.
The expansions passed into law this year mean that wish could be fulfilled much earlier than those people hoped.
A study from Colorado consulting firm Marijuana Policy Group in 2016 estimated several hundred thousand people suffer from chronic pain in Louisiana, and between 27,000 and 37,300 would use medical marijuana if allowed.
Under the previous iteration of the marijuana program, estimates of how many patients would use the drug ranged from less than 2,000 patients to north of 20,000.
The market size for chronic pain alone in Louisiana is $102 million, according to the Marijuana Policy Group's median estimate.
Adam Orens, who authored that study, said the numbers represent the potential if the medical community is fully on board with recommending the drug -- an open question in a conservative state that has thus far only seen a handful of doctors sign up to do so.
"The medical community really holds the key to this," Orens said. "If they see the benefits of this as a treatment, and they recommend it, then you potentially could see this type of activity in the market."
A bill by state Rep. Ted James added intractable pain, glaucoma, severe muscle spasms, PTSD and Parkinson's disease to the list of conditions eligible for medical marijuana. Another bill by state Rep. Vincent Pierre extends the sunset on the program to 2025, and a bill by state Rep. Rodney Lyons makes certain people with autism spectrum disorder are eligible for medical marijuana. All three bills have been signed by the governor.
The original list of eligible treatments was limited to cancer, HIV, AIDS, cachexia or wasting syndrome, seizure disorders, epilepsy, spasticity, Crohn's disease, muscular dystrophy or multiple sclerosis.
Because of the treatment expansion and sunset being extended, GB Sciences, the company partnered with the LSU AgCenter to grow the plant, said it will set out on phase two of its growing operation more quickly.
John Davis, president of GB Sciences Louisiana, acknowledges the firm's phase one plans, currently underway, were not designed to meet the demand from the expanded disease states, including intractable pain.
But he insists the firm still will be able to meet demand when it gets off the ground, possibly in October, because demand is expected to be slow on the uptake.
"We've got capacity," Davis said, "but clearly we were not building to cover the new conditions."
"We're not going to see 100 percent market penetration in month one because there are a lot of people still learning about this."
To help with the learning curve, Davis said GB Sciences recently hired the Curry Rockefeller Group, a New York-based firm that provides medical education, to provide information to doctors in Louisiana about the medical marijuana program.
Southern University, the only other state-sanctioned grower, just approved a partnership with a Lafayette-based company in recent weeks after the firm's owners spent weeks battling in court with each other over company ownership and university contract negotiations before saying the issues were resolved.
Southern did not make any officials available for an interview for this story, and said in an emailed statement that "the bill will not affect the university's plan for the market." Advanced Biomedics, the company partnered with Southern, is "prepared to increase production based on the market's demand."
Asked by how much the company will increase production and how it will meet the increased demand, Southern spokeswoman Lakeeshia Giddens Lusk said the school "doesn't have enough information to answer these questions at this time." She added the school's timetable, which calls for having the product available early next year, is still in place. The firm plans to build a facility on a 176-acre plot of land at 15453 Old Scenic Highway 964 in Zachary over the coming months.
'PEOPLE WANT THIS'
The state Board of Medical Examiners' rules place a 100-patient cap on each doctor for recommending medical marijuana. Advocates and industry leaders already were worried that would hamstring the program before legislation added intractable pain and expanded the program.
Dr. Chad Domangue, a neurologist and pain specialist based in Covington and Hammond, said in the past two weeks alone he already has heard from 100 patients who want recommendations for the drug to treat chronic pain.
"The state is only allowing you to write 100 patients. I see more than 100 patients in a week," he said. "People want this. People want a healthier option to deal with their issues."
Domangue, who calls himself an "organic pain doctor" and who is also working on a natural alternative to benzodiazepines like Xanax and Valium, plans to move away from prescribing opioids for pain use entirely once medical marijuana is a viable option. Advocates say the addition of medical marijuana as a pain treatment option could help stem Louisiana's opioid epidemic.
Dr. Victor Chou, of Baton Rouge, founded the Medical Marijuana Clinic of Louisiana earlier this year and began consulting with patients. He wondered whether there would be enough interest for a standalone medical marijuana practice.
That question has been put to rest, Chou said, as a surprising number of patients have called asking for consultations. Now that pain is added, Chou said it will roughly quadruple the market.
"I've had 300 people contact me" about medical marijuana, he said. "Easily 75 percent of those have contacted me for chronic pain."