Credit: David Alvarado

When asked about medical cannabis cards in a postlegalization state, cannabis-friendly doctor Rahul Khare said there are two different stories to be told: before the coronavirus pandemic and after.

Before the rapid spread of COVID-19 turned the world upside down, your decision to get a medical card likely depended on a) whether you could prove you had one or more of 50-plus qualifying conditions and b) whether you could afford a couple visits to the doctor and a $100 application fee. If you answered yes to both of these questions, you’re still just a couple of forms away from reduced prices, shorter lines, and a wider range of cannabis products. 

But now, getting a med card has become the most reliable way to legally buy weed in Chicago for the foreseeable future. When Governor J.B. Pritzker ordered that nonessential businesses cease operations starting March 21, medical cannabis made the cut as an essential good, and most if not all of the ten dispensaries that usually serve Chicago’s recreational cannabis consumers voluntarily stopped or limited selling to recreational customers.

At Innovative Wellness, a cannabis-focused clinic in Lincoln Park, Khare said he’s seen many patients who started out buying cannabis recreationally but now use it for medical purposes, whether they have a card or not. “All of a sudden, the people who are recreational [who were] getting cannabis without their cards, that were using it medically, are freaking out,” Khare said.

Now that recreational adult use of cannabis is legal in Illinois, he’s seen people emboldened to finally get their medical cards. “I hear that a lot. It’s like, ‘Oh, I know I’ve been using this medically but I just never wanted to get my card. But now that it’s legal, I feel it’s OK to,’” Khare said.

Since January, Khare’s practice has seen a 50–60 percent increase in patients seeking physician certification for medical cannabis cards. Cannabis users have plenty to gain by getting a med card, and saving money on taxes may be the most tangible benefit.

Abigail Watkins, marketing manager at Dispensary 33 in Andersonville, said there’s a 2.25 percent pharmaceutical tax built into the price of all cannabis products at any medical or recreational dispensary in Illinois. But based on factors like potency, type of product, and local excise taxes, recreational customers can end up paying an additional 20–40 percent of retail price. That’s the difference between a $60 eighth and an $80 eighth, Watkins said.

“If someone is a recreational customer and is coming in over and over again but would qualify for a medical card, we would always suggest that they get one,” Watkins said.

Some people might be surprised to find that they qualify for a medical card. Social media influencer Elise Swopes said when she applied for a medical card last year, she wasn’t sure what condition to list. 

“For me, I was like, I really want this card but I don’t want to have to pretend that I have something,” Swopes said. She arranged a video call with a therapist at Innovative Wellness to see if she might qualify for a medical card. After discussing a lifetime of experiences that contribute to her present-day anxiety, Swopes was prescribed cannabis to help with post-traumatic stress disorder.

Swopes didn’t think she had PTSD when she began the application process. Some other patients said the diagnosis is used as a catchall for mental health disorders like anxiety and depression, which are not on Illinois’s list of debilitating conditions for medical card eligibility. But Swopes used her new diagnosis as an opportunity to learn more about cannabis and mental health, continuing to see her therapist for several sessions after her first appointment.

Even after Illinois legalized recreational cannabis, Swopes said she felt like she still benefited from her medical card. As a medical patient, she was able to skip the line at MOCA, her dispensary of choice, and she established a rapport with budtenders there. She had access to a wider range of edibles, tinctures, and balms, although she said cannabis flower is pricey even for medical patients.

Nick Disabato, a web designer who got his medical card last year, said he also noticed that the flower selection at most dispensaries has been lacking since Illinois went recreational. 

“It’s the equivalent of you going to a liquor store and you’re looking at the craft beer selection, and literally all they have for you is Bud Light and Goose Island 312,” Disabato said. “I’m like, ‘OK, well I’ve done these, that’s cool. Got any stouts or Belgians?’”

For medical patients dissatisfied with what dispensaries have to offer, Illinois has another option for getting bud that’s open exclusively to them: home growing. Medical marijuana patients can grow up to five plants at home under Illinois law. Datrianna Meeks, a product designer who budtends part-time at MOCA and has a medical card herself, said this unique aspect of Illinois’s medical cannabis program allows patients to take control of their own medicine.

Meeks said having some agency in what she’s smoking was one thing that drew her to the legal weed market in the first place.

“I would rather take matters into my own hands and have more control and information about the products that I’m using, which you definitely don’t get when you’re buying off the street,” Meeks said.

With Chicago’s recreational dispensaries closed until at least April 7, buying off the street will be the only option for many cannabis users. Even that avenue is uncertain, as some dealers are raising their delivery minimums and others may just stay home.

But clinics like Innovative Wellness continue to consult with potential medical patients—they’re just doing it virtually. Last month, the Illinois Department of Public Health announced that all examinations for medical cannabis certification may be done via telemedicine, temporarily eliminating the need for an in-person appointment.

Someone who is able to book an online consultation with a physician could visit a medical cannabis dispensary just a few days later, Khare said. Since February 1, the online application has been streamlined so patients receive a printable, temporary medical card the morning after they apply.

Even though the process for getting a medical card is quicker than ever, Watkins said some of the customers she’s seen at Dispensary 33 can’t afford to pay the application fee and medical bills up front. Application fees range from $100 to $250 for most people, depending on how long the card lasts, with reduced fees as low as $50 for a year of coverage for veterans and people with disabilities.

“It is somewhat of a privilege to be able to have a medical card,” Watkins said. “And living with a chronic illness is a huge financial hardship for people already.”  v

Update: an earlier version of this article mistakenly indicated that Governor Pritzker’s order shut down recreational cannabis sales.