It’s 2017, and medical cannabis patients are still struggling. But you might not always get that impression from reading this region’s newspaper of record, the Boston Globe. Take, for example, the recent article by Dan Adams, “State warns Leafly on ads for pot-delivery services,” in which a theme emerges that gray market providers are endangering patient safety.

In this now-infamous Globe atrocity, a spokesperson from the Mass Department of Public Health, a dispensary lobbyist, and even patient advocates team up to disparage non-DPH sanctioned caregiver delivery services, as well as the website Leafly for allowing them to advertise on its site. The Globe piece parrots the propaganda line that Leafly and such cannabis providers are inherently unsafe. Unchallenged by the Globe, the DPH statement is laughable but ran as gospel: “Leafly’s decision to again accept these ads appears to be in direct conflict with the principle of safe patient access and the law.”

From another perspective, of course, it is actually the DPH that compromised the current situation. Regulations that limit the caregiver services available to patients are not within the spirit of the medicinal law, and so our enduring lack of dispensaries has endangered patients for years. In my mind and in the opinion of innumerable other advocates, sending patients to drive long stretches for medicine doesn’t make sense or sound safe when delivery is readily available.

Meanwhile, another group of medical cannabis advocates seems to disagree—and has echoed some of the rhetoric we have heard from the Globe and other reefer-mad outlets. Nichole Snow, executive director of the Massachusetts Patient Advocacy Alliance, went so far as to blame Leafly and discount the legitimacy of gray market dealers. “I don’t know what Leafly is thinking,” Snow told the Globe. “They may see it as a calculated business risk, but they’re putting our patients at risk. I thought we were beyond this.”

A representative for the MPAA later noted that Snow’s statements to the Globe were “taken out of context.” (Snow declined an opportunity to comment for this article.) But it’s worth noting that the MPAA, whose spokespeople have regularly been quoted in my column and are well known for representing the interests of patients, are critical at all of those working behind the backs of bureaucracy. Nevermind that caregivers on Leafly require a valid medical marijuana card, while many boast of how they independently test their products at reputable area laboratories.

My point isn’t to spite the MPAA, which has historically been primarily concerned with patient safety. Nor do I simply wish to air all of the Commonwealth pot community’s dirty laundry in public. But as marijuana becomes more mainstream, people who are newly interested in the movement influencing legislation should know that there are different schools of thought, even among those of us who agree, at the macro level, that pot is positive. And they should also note where advocates (and media outlets, for that matter) get their money from, with medical dispensaries as just one example, and consider whether that sways behavior. Because in the same way that different strains may look the same to civilians but in reality have wildly different effects, right now in Mass, activists like me believe that patients who need services beyond the existing dispensary system should be supported in their use of gray market caregivers as well as matchmakers like Leafly, while others would rather work within inadequate DPH designations.

PATIENT PERSPECTIVE

Grant Ellis offers a perspective that was missing from the aforementioned Globe article, as well as most coverage of cannabis around here. A patient who uses caregiver delivery services, Ellis, 27, is a Belmont resident and one-time graduate student at Boston College who was studying for a Phd until he fell seriously ill in 2014. Ellis has a disability that affects the optic nerve in his right eye, and says, “Cannabis has been a lifesaver in regard to my disability, and in its absence I would no doubt be on far more intense narcotics.”

It’s a familiar story. Ellis says that in the absence of dynamic portals like Leafly, many patients like him could be put at greater risk. He needs specific strains for certain ailments, and Ellis cites the “community monitoring,” menus, and reviews as benefits to such delivery sites. Ellis also uses such sites to screen his potential caregivers; he’s bound to his home and doesn’t want to let just anybody in the door. Now that he has a routine in place, with all the backlash aimed at black market sellers, Ellis fears that his current caregiver could get busted. It’s happened before, leaving him without access to quality meds for two weeks. Ellis’ previous caregiver, Ray Crowell of Boston’s Best Buds, is currently facing distribution charges in Quincy District Court. Crowell was charged in March after a Boston Globe story, with an assist from Snow, characterized the cannabis sold in the gray market as “subpar,” and spoke of “tense encounters with gun-toting drivers.”

“Yes, I’m frustrated by that coverage,” says Crowell, who mostly blames the DPH for cannabis hardships.

Jessica Edwards and Dan Skelton of Canna Better Consulting express similar sentiments. They provide education and information to an elderly Cape Cod population seeking access to medical cannabis. The first question they get from inexperienced patients is typically related to the procurement of affordable quality meds. Canna Better doesn’t sell or offer cannabis directly, but rather informs patients of options. For most people on the Cape, a locale with no dispensary to date, the potential of a six-hour round-trip car ride to the nearest dispensary in Quincy during tourist season is out of the question. A nonstarter.

All of which leaves patients to either grow it for themselves, or more often than not, to find a caregiver delivery service online. Edwards also stresses the importance of Leafly, and of patients being able to screen providers. Of the dozens of patients who Canna Better has advised and use gray market services, none have reported complaints. To the contrary, Edwards says that many even rave about their medicine.

A review of Leafly-like sites for this article show that many licensed dispensaries in Mass have poor reviews compared with delivery services that prohibitionists are attempting to shutter and that authorities continue playing whack-a-mole with. As if they can fight the market. Or have the right to limit access.

Yet the Globe, as well as advocates with the MPAA, “questioned [the] legality” of such caregivers—as if legality is relevant to somebody who needs a medicine that’s not available at a dispensary. Or who is stuck out on Cape Cod on Memorial Day weekend without the cannabis they need.

PERSONAL ADVOCACY

I am not a bystander to this ordeal. In 2013, after campaigning hard for the winning medical marijuana initiative, marijuana advocates, including myself, began to have misgivings about the proposed DPH regulations that would essentially outlaw feasible caregiver services to patients, all while helping medical marijuana dispensaries corner the market. Along with the since-dearly departed Michael Malta, also known the King of Pot (KOP), I decided to make it an issue—with him bringing the love and entertainment, and me playing the straight man role, serious and about the politics, a topic KOP sort of despised.

“Why can’t we just grow the plant and allow businesses to supply those who want it?” he would ask.

By the time we got to protesting, though, KOP was fired up. “It’s all for the suits,” he charged. Addressing state officials and fellow advocates alike, he added, “I want to know what are you going to do for the patients.”

Going back even further, there were already rifts within the Mass cannabis activist world. In 2011, those drafting what would become the following year’s medical marijuana ballot initiative disappointed many, myself included, with language that stopped short of providing the access and home grow protections that some had hoped for. Despite such hangups, Malta and I—along with countless other people, friends as well as strangers in the struggle—campaigned hard for the winning 2012 initiative.

But in 2013, when the DPH showed its intent to roll back regulations and endanger patients, we returned to protest. Only this time MPAA reps chose not to attend, citing concerns with making patients look bad in the press. The insulting snub hurt the standing of those advocates who stayed at home among Mass cannabis activists, but by late 2014, when we went back to protest the DPH again, MPAA members, including Nichole Snow, came along. It appeared that the org was choosing patients over politics, and people, myself included, were excited to see the MPAA present a bill, which gained a dozen legislative sponsors in the process, with a goal to repeal bad DPH regs that limited caregiver services. The bill died in the legislature, but the fight was hopeful.

‘DYING AND BEGGING’

Some in the Mass marijuana community point the finger at MPAA over the lack of concern for underserved populations. “If they listened, even if what they heard was criticism, they could use that as an opportunity to improve,” reasoned one local medical advocate on Facebook. At the least, myself and others have been asking questions, like if an organization that represents patients should be actively soliciting donations from dispensaries and if that creates conflicts of interest. In the case of Snow, she was back in headlines last week. This time applauding a delivery operation, though one that’s operated by a licensed medical dispensary. “A delivery service is what patients have been dying and begging for,” she told Globe reporter Dan Adams.

Look, Snow is furious with me for addressing this. Understandably. But this isn’t about me. Or her. Or even MPAA. It’s about representing all the patients in Mass, those with cards as well as those without them. Those shopping in dispensaries, as well as those who are growing at home, and especially those who need delivery access. No ifs, ands, or buts.

If your leaders aren’t willing to hear that criticism, it’s going to cause some problems. Don’t say I didn’t tell you so.