‘State’s Medical Cannabis Programs: In The Rearview Mirror’ by Kirsten Velasco

Editor’s note: This article was written by Kirsten Velasco and originally published at VapeNProp.com. It is republished here with permission.

Cannabis advocates fuel their work with vivid memories and current damage of the diabolical drug war. Expanding access legislatively progresses at a snail’s pace. Each state’s transition from prohibition to safe access began by registering patients to allow the consumption of cannabis. These programs vary widely from state to state, but all legal access stands on the shoulders of patients, their loved ones, and advocates.

When adult-use programs open, what happens to the medical cannabis programs? What happens to the patients and their medical supply needs? State medical programs are focused on serving the desperately ill. Recreational programs are focused on revenue. Hence, the flatlining of registrants over the last 5-10 years throughout the US.

Illinoisans pay the highest in the country for cannabis. Through their “Compassionate Care Act” patients pay only 1-3% tax and can grow up to five plants. However, it required patients (over age 18) and their caregivers to prove, through fingerprinting, that they did not have a drug-related criminal conviction. Patients regularly waited 3 or more months between application submission and license receipt. Now, fingerprinting has stopped, chronic pain was added to the list of qualifying conditions, the standard fee is reduced by half, and the processing is automated. Improvements have been made but the onerous application process and adult-use availability is suppressing participation. Last year, the number of participants increased by 4-6K per month, but the number of active licenses have remained at around 137K. As many licenses are expiring as being issued, and only half of those licensed make a purchase each month.

Typically, the incentive for participating in a medical program is that products are taxed at a much lower rate than “rec,”a.k.a. “adult-use.” However, some patients avoid medical programs for several reasons. 1) legacy market is the least expensive, 2) they don’t want the state to hold their private health info, 3) inconvenient purchase process and location, 4) inconsistent inventory 5) false belief they will lose their 2nd amendment rights, 6) employment termination.

Illinois opened adult-use in January 2020. Their 12.8M residents have only 55 dispensaries that fully honor the benefits of having the medical cannabis card. Many adult-use dispensaries offer a 15% discount to medical license holders. As of December 2025, there are over 263 adult-use dispensaries, patients take advantage of convenient locations, large inventory, and more discreet (unmonitored) purchases.

Conversely, Florida, without adult-use and a population of 22M, has 930,000 qualified patients and approximately 737 licensed dispensaries. The market is projected to exceed $2.5 billion in sales in 2025. Registered patients pay $75 annually for their license. Even with red tape and expense, the patient count is 4% of the total population.

The opportunities:

Expanding program participation through education and simplified access provides anonymous data to analyze trends in health and Rx use while helping our population relieve pain, sleep better, diminish Rx use, and treat complex conditions.

Women and seniors are the two most rapidly growing demographics of cannabis consumers. 60% of purchases are made by men; therefore, most marketing is catered to them. The growth in sales to women and seniors is getting attention. The wellness economy has increased five times as fast as economic growth. Education focused on wellness strategies facilitates transition from non-consumers into dedicated, brand-loyal consumers. A whole country that witnesses the improvements in its senior population are sure to consider cannabis as not just “joy juice,” but also an essential supplement to their own healthcare strategies.

States are raking in millions in tax revenue from adult-use and the fees charged for medical programs. They would honor the people who suffered while coaxing their legislators by leaning into the “cannabis-as-wellness” opportunity. The fiscal and healthcare benefits are immeasurable.

This article was originally published by Kirsten Velasco at VapeNProp.com and is republished here with permission. All rights remain with the original author.

Kirsten has appeared on The Cole Memo Podcast in the past. You can watch her latest appearance by clicking here or by viewing below video.

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#250 – Illinois Is Still Arresting People for Weed, Even After “Legalization” – The Cole Memo

Cole is joined by recurring guest Phil to break down Part 1 of ColeMemo.com’s overview of Illinois’ 2025 annual cannabis report, a required compilation of updates from state agencies covering licensing, enforcement, public health, and revenue. They discuss IDFPR reporting that 93 dispensaries received operational licenses, the agency’s description of Metrc entering its post-launch phase, and a discrepancy in reported craft grow license counts across state reports and press releases. Most of the conversation focuses on the Illinois State Police section, including Chicago’s arrest heat map, the first year-over-year increase in Cannabis Control Act arrests since legalization, and how hemp and THCA products have complicated prosecutions. Cole and Phil also discuss ISP’s push for phlebotomy training to speed up DUI cannabis blood draws, K9 policy changes, gaps in expungement tracking, and what the data suggests about cannabis-related criminal enforcement continuing in Illinois despite legalization. Watch video version and read full show notes here: https://thecolememo.com/2026/01/13/e250/

The Cole Memo